Cantlay K L, Baker S, Parry A, Danjoux G
Department of Anaesthesia, James Cook University Hospital, Marton Road, Middlesbrough, Cleveland, TS5 3BW, UK.
Anaesthesia. 2006 Mar;61(3):234-9. doi: 10.1111/j.1365-2044.2005.04514.x.
Summary Patients undergoing major vascular surgery are at high risk of peri-operative morbidity and mortality owing to a combination of advanced age, significant co-morbidity and the nature of the surgery. A consultant-led pre-operative assessment clinic provides an opportunity to stratify these patients on the basis of risk in advance of surgery, to make timely multidisciplinary referrals where appropriate, and to prescribe medical therapies according to the current best evidence. This results in fewer last-minute cancellations for medical reasons and increased patient satisfaction, and may improve patient outcome. Such a clinic also provides an educational arena for nursing and trainee medical staff, and importantly allows those patients in whom the risks are felt to outweigh the potential benefits of surgery to be managed in a more fully informed manner.
摘要 由于高龄、严重合并症以及手术性质等多种因素，接受大血管手术的患者围手术期发病和死亡风险很高。由顾问主导的术前评估门诊提供了一个机会，可在手术前根据风险对这些患者进行分层，在适当情况下及时进行多学科会诊，并根据当前最佳证据开具药物治疗方案。这会减少因医疗原因导致的最后一刻取消手术的情况，并提高患者满意度，还可能改善患者预后。这样的门诊也为护理人员和实习医务人员提供了一个教育平台，重要的是，能让那些被认为手术风险大于潜在益处的患者得到更充分的知情管理。
