Pasternak L Reuven, Johns Amballur
Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Pavilion 01-1-22, Baltimore, MD 21224, USA.
Best Pract Res Clin Obstet Gynaecol. 2005 Aug;19(5):663-79. doi: 10.1016/j.bpobgyn.2005.06.003. Epub 2005 Jul 11.
Assessment of patients undergoing elective surgical procedures on an outpatient basis carries risks that range from mortality through non-lethal injuries to costs incurred for inappropriate testing. Ambulatory surgery accounts for over 60% of elective surgical procedures for most areas of the USA, Canada and Australia and a growing proportion of procedures in Europe and Asia. However, data to determine the true risk of these procedures are difficult to find due to standardized criteria for risk assessment and management. Nonetheless, this type of medical procedure, with appropriate preparation, is regarded as safe and standard. Assessment of patients undergoing these procedures must take into consideration the nature of the medical and surgical conditions. Diagnostic testing is only performed if the results might change the management of the patient. At present, the American Society of Anesthesiology (ASA) classification system and the ASA guidelines for pre-anesthesia evaluation serve as the most current examples of risk assessments and algorithms that can be used for appropriate management of patients undergoing elective surgical procedures.
对接受门诊择期外科手术的患者进行评估存在多种风险，范围从死亡到非致命伤害，再到因不适当检查产生的费用。在美国、加拿大和澳大利亚的大部分地区，门诊手术占择期外科手术的60%以上，在欧洲和亚洲，这一比例也在不断上升。然而，由于风险评估和管理的标准不统一，很难找到确定这些手术真正风险的数据。尽管如此，经过适当准备，这类医疗程序被认为是安全且规范的。对接受这些手术的患者进行评估时，必须考虑内科和外科疾病的性质。只有当诊断检查结果可能改变患者的治疗方案时，才会进行该项检查。目前，美国麻醉医师协会（ASA）分类系统和ASA麻醉前评估指南是可用于对接受择期外科手术患者进行适当管理的风险评估和算法的最新范例。
