Böckler D, Schumacher H, Allenberg J-R
Abteilung für Gefässchirurgie, Vaskuläre und Endovaskuläre Chirurgie, Ruprecht-Karls-Universität Heidelberg.
Chirurg. 2005 Feb;76(2):113-25. doi: 10.1007/s00104-004-0982-x.
The prevalence of vascular disease among the elderly population is high (approximately 20%). The morbidity and mortality of many vascular operations show no differences between the fit elderly and younger patients. A major problem is that the elderly are often not diagnosed and treated early enough to prevent emergency operations, which carry a much higher mortality. Many new surgical techniques, especially endovascular interventions, have made vascular surgery less invasive. These advances have increased the potential of life saving and prolonging vascular surgery that can be offered to all patients regardless of age. Risk-benefit analysis, especially in elderly patients, is a cornerstone of proper patient selection. The main goal of vascular surgery in the elderly is preservation of quality of life and independence. Surgery of a ruptured aneurysm is a life saving exception. Indications for treatment in the elderly remains an individual decision making process. Advanced age should not be considered as a limitation or contraindication for carotid, aneurysm and bypass surgery. Age is not a disease, it is just a chapter of life.
老年人群中血管疾病的患病率很高(约20%)。许多血管手术的发病率和死亡率在健康的老年人和年轻患者之间并无差异。一个主要问题是,老年人往往没有得到足够早的诊断和治疗,从而无法避免急诊手术,而急诊手术的死亡率要高得多。许多新的外科技术,尤其是血管内介入治疗,已使血管手术的侵入性降低。这些进展增加了为所有患者(无论年龄大小)提供挽救生命和延长生命的血管手术的可能性。风险效益分析,尤其是在老年患者中,是正确选择患者的基石。老年血管手术的主要目标是维持生活质量和独立性。破裂动脉瘤的手术属于挽救生命的特殊情况。老年患者的治疗指征仍然是一个个体化的决策过程。高龄不应被视为颈动脉、动脉瘤和搭桥手术的限制或禁忌证。年龄不是一种疾病,它只是人生的一个阶段。