切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 236 -240. doi: 10.3877/cma.j.issn.1674-0793.2022.03.017

综述

衰弱患者围手术期麻醉管理的研究进展
刘炽艺1, 李斌飞2,(), 古晨2   
  1. 1. 524023 湛江,广东医科大学
    2. 528404 广东省中山市人民医院麻醉科
  • 收稿日期:2022-04-28 出版日期:2022-06-01
  • 通信作者: 李斌飞
  • 基金资助:
    中山市社会公益与基础研究项目(2020SYF01)

Progress of perioperative anesthesia management in patients with frailty

Chiyi Liu1, Binfei Li2,(), Chen Gu2   

  1. 1. Guangdong Medical University, Zhanjiang 524023, China
    2. Department of Anesthesiology, Zhongshan City People’ s Hospital, Zhongshan 528404, China
  • Received:2022-04-28 Published:2022-06-01
  • Corresponding author: Binfei Li
引用本文:

刘炽艺, 李斌飞, 古晨. 衰弱患者围手术期麻醉管理的研究进展[J]. 中华普通外科学文献(电子版), 2022, 16(03): 236-240.

Chiyi Liu, Binfei Li, Chen Gu. Progress of perioperative anesthesia management in patients with frailty[J]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(03): 236-240.

随着衰弱患者数量增加和麻醉技术、外科水平提高,进行手术麻醉的衰弱患者数量逐年递增,围手术期麻醉管理已成为当今麻醉学研究的重点。本文综合叙述衰弱患者围手术期麻醉管理的研究进展,包括相关危险因素、术前评估及麻醉方法和药物的选择,供临床参考。

With the increasing number of frail patients and the improvement of anesthesia technology and surgical level, the number of frail patients undergoing operation and anesthesia is increasing year by year. Perioperative anesthesia management of frail patients has become the focus of anesthesiology research. In this paper, the research progress of perioperative anesthesia management in patients with frailty, including the related risk factors, preoperative evaluation and selection of anesthesia methods and drugs, is reviewed for clinical reference.

[1]
He B, Ma Y, Wang C, et al. Prevalence and risk factors for frailty among community-dwelling older people in China: A systematic review and Meta-analysis[J]. J Nutr Health Aging, 2019, 23(5): 442-450.
[2]
Silbert BS, Scott DA. Informed consent in patients with frailty syndrome[J]. Anesth Analg, 2020, 130(6): 1474-1481.
[3]
Simcox T, Antoku D, Jain N, et al. Frailty syndrome and the use of frailty indices as a preoperative risk stratification tool in spine surgery: A review[J]. Asian Spine J, 2019, 13(5): 861-873.
[4]
Keller DS, Reif de Paula T, Kiran RP, et al. Evaluating the association of the new National Surgical Quality Improvement Program modified 5-factor frailty index with outcomes in elective colorectal surgery[J]. Colorectal Dis, 2020, 22(10): 1396-1405.
[5]
Hoogendijk EO, Rijnhart J, Kowal P, et al. Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: results from the WHO Study on global AGEing and adult health (SAGE)[J]. Maturitas, 2018, 115: 56-63.
[6]
田鹏, 孙春丽, 彭朝明, 等. 老年病科住院患者衰弱发病情况及危险因素分析[J]. 国际老年医学杂志, 2021, 42(5): 268-271.
[7]
王坤. 石家庄某社区老年衰弱现况及影响因素分析[D]. 唐山: 华北理工大学, 2017.
[8]
Avgerinou C, Bhanu C, Walters K, et al. Supporting nutrition in frail older people: A qualitative study exploring views of primary care and community health professionals[J]. Br J Gen Pract, 2020, 70(691): e138-e145.
[9]
Brigola AG, Ottaviani AC, Carvalho D, et al. Association between cognitive impairment and criteria for frailty syndrome among older adults[J]. Arq Neuropsiquiatr, 2020, 78(1): 2-8.
[10]
Ikwuobe J, Bellary S, Griffiths HR. Innovative biomarkers for predicting type 2 diabetes mellitus: relevance to dietary management of frailty in older adults[J]. Biogerontology, 2016, 17(3): 511-527.
[11]
周巧学, 周建荣, 库敏, 等. 社区高龄老年人衰弱状况及影响因素的研究[J]. 护理学杂志, 2019, 34(21): 68-72.
[12]
Paul JA, Whittington RA, Baldwin MR. Critical illness and the frailty syndrome: mechanisms and potential therapeutic targets[J]. Anesth Analg, 2020, 130(6): 1545-1555.
[13]
Susano MJ, Grasfield RH, Friese M, et al. Brief preoperative screening for frailty and cognitive impairment predicts delirium after spine surgery[J]. Anesthesiology, 2020, 133(6): 1184-1191.
[14]
Kaplan SJ, Pham TN, Arbabi S, et al. Association of radiologic indicators of frailty with 1-year mortality in older trauma patients: opportunistic screening for sarcopenia and osteopenia[J]. JAMA Surg, 2017, 152(2): e164604.
[15]
Lee C, Park IJ, Kim KW, et al. Influence of postoperative changes in sarcopenia on long-term survival in non-metastatic colorectal cancer patients[J]. Cancers (Basel), 2021, 13(10): 2410.
[16]
Mirón Mombiela R, Facal de Castro F, Moreno P, et al. Ultrasonic echo intensity as a new noninvasive in vivo biomarker of frailty[J]. J Am Geriatr Soc, 2017, 65(12): 2685-2690.
[17]
张晓玲, 罗衡桂, 陈伟, 等. 加速康复外科管理模式在老年结直肠癌围手术期应用效果[J]. 中国普通外科杂志, 2022, 31(1): 132-138.
[18]
Nygren J, Thorell A, Ljungqvist O. Preoperative oral carbohydrate therapy[J]. Curr Opin Anaesthesiol, 2015, 28(3): 364-369.
[19]
孙燕婷, 吴畏, 薛荣亮, 等. 不同麻醉策略对衰弱老年胃癌患者麻醉效果的影响[J]. 山西医药杂志, 2021, 50(21): 2989-2992.
[20]
Memtsoudis SG, Poeran J, Zubizarreta N, et al. Do hospitals performing frequent neuraxial anesthesia for hip and knee replacements have better outcomes?[J]. Anesthesiology, 2018, 129(3): 428-439.
[21]
中华医学会麻醉学分会老年人麻醉学组. 中国老年患者围术期麻醉管理指导意见[J]. 国际麻醉学与复苏杂志, 2014, 35(10): 870-881, 901.
[22]
Stephensen BD, Reid F, Shaikh S, et al. C-reactive protein trajectory to predict colorectal anastomotic leak: PREDICT Study[J]. Br J Surg, 2020, 107(13): 1832-1837.
[23]
Punjasawadwong Y, Chau-In W, Laopaiboon M, et al. Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non-neurosurgical procedures in adults[J]. Cochrane Database Syst Rev, 2018, 5(5): CD011283.
[24]
Punjasawadwong Y, Phongchiewboon A, Bunchungmongkol N. Bispectral index for improving anaesthetic delivery and postoperative recovery[J]. Cochrane Database Syst Rev, 2014, 1(6): CD003843.
[25]
Won YJ, Lim BG, Kim YS, et al. Usefulness of surgical pleth index-guided analgesia during general anesthesia: A systematic review and Meta-analysis of randomized controlled trials[J]. J Int Med Res, 2018, 46(11): 4386-4398.
[26]
张祖进, 李辉, 张红远. 全身麻醉监测技术应用与发展现状[J]. 医疗卫生装备, 2017, 38(8): 122-126.
[27]
Chan S, Wong E, Ward SE, et al. The predictive value of the clinical frailty scale on discharge destination and complications in older hip fracture patients[J]. J Orthop Trauma, 2019, 33(10): 497-502.
[28]
Wade KF, Marshall A, Vanhoutte B, et al. Does pain predict frailty in older men and women? Findings from the English Longitudinal Study of Ageing (ELSA)[J]. J Gerontol A Biol Sci Med Sci, 2017, 72(3): 403-409.
[29]
Pirrera B, Alagna V, Lucchi A, et al. Transversus abdominis plane (TAP) block versus thoracic epidural analgesia (TEA) in laparoscopic colon surgery in the ERAS program[J]. Surg Endosc, 2018, 32(1): 376-382.
[30]
陈健聪, 赖佳明, 王炯亮, 等. 帕瑞昔布超前镇痛在肝射频消融中的应用:倾向匹配分析[J/CD]. 中华普通外科学文献(电子版), 2021, 15(6): 442-446.
[31]
刘硕, 王秋梅, 刘晓红. 老年手术患者衰弱的评估及管理进展[J]. 中国临床保健杂志, 2018, 21(6): 838-841.
[1] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 809-815.
[2] 马艳波, 华扬, 刘桂梅, 孟秀峰, 崔立平. 中青年人颈动脉粥样硬化病变的相关危险因素分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 822-826.
[3] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[4] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[5] 吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[6] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[7] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[8] 陆猛桂, 黄斌, 李秋林, 何媛梅. 蜂蛰伤患者发生多器官功能障碍综合征的危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1010-1015.
[9] 王军, 刘鲲鹏, 姚兰, 张华, 魏越, 索利斌, 陈骏, 苗成利, 罗成华. 腹膜后肿瘤切除术中大量输血患者的麻醉管理特点与分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 844-849.
[10] 李达, 张大涯, 陈润祥, 张晓冬, 黄士美, 陈晨, 曾凡, 陈世锔, 白飞虎. 海南省东方市幽门螺杆菌感染现状的调查与相关危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 858-864.
[11] 索利斌, 刘鲲鹏, 姚兰, 张华, 魏越, 王军, 陈骏, 苗成利, 罗成华. 原发性腹膜后副神经节瘤切除术麻醉管理的特点和分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 771-776.
[12] 李琪, 黄钟莹, 袁平, 关振鹏. 基于某三级医院的ICU多重耐药菌医院感染影响因素的分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 777-782.
[13] 孟科, 李燕, 闫婧爽, 闫斌. 胶囊内镜胃通过时间的影响因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 671-675.
[14] 杨艳丽, 陈昱, 赵若辰, 杜伟, 马海娟, 许珂, 张莉芸. 系统性红斑狼疮合并血流感染的危险因素及细菌学分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 694-699.
[15] 孙培培, 张二明, 时延伟, 赵春燕, 宋萍萍, 张硕, 张克, 周玉娇, 赵璨, 闫维, 吴蓉菊, 宋丽萍, 郭伟安, 马石头, 安欣华, 包曹歆, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病患病情况及相关危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 711-719.
阅读次数
全文


摘要