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[老年骨科膝关节或髋关节置换术患者的围手术期管理]

[Perioperative management of ortho-geriatric knee or hip arthroplasty patients].

作者信息

Trabold Benedikt, Maderbacher Günther

机构信息

Institut für Anästhesie, Asklepios Fachkrankenhaus Bad Abbach, Bad Abbach, Deutschland.

Orthopädische Klinik für die Universität Regensburg, Asklepios Klinik Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland.

出版信息

Orthopade. 2022 Feb;51(2):91-97. doi: 10.1007/s00132-021-04207-4. Epub 2022 Jan 10.

DOI:10.1007/s00132-021-04207-4
PMID:35006285
Abstract

Due to the changing age structure of the Western population, an increase in geriatric patients in endoprosthetic care of hip and knee joints is to be expected in the future. The age-related frailty and the existing comorbidities pose great challenges for the entire treatment team. In the preoperative phase, geriatric patients should be identified as such and adjustable risk factors should be addressed prior to surgery. The primary goals of treatment are to minimize trauma from anesthesia and endoprosthetic surgery to ensure immediate postoperative mobilization of patients. At the same time, any perioperative complications, especially intensive care treatments, should be prevented. This is achieved excellently with algorithms that are well known from fast-track surgery.

摘要

由于西方人口年龄结构的变化,预计未来髋关节和膝关节假体护理中老年患者的数量将会增加。与年龄相关的身体虚弱和现有的合并症给整个治疗团队带来了巨大挑战。在术前阶段,应识别出老年患者,并在手术前解决可调整的风险因素。治疗的主要目标是将麻醉和假体手术造成的创伤降至最低,以确保患者术后能立即活动。同时,应预防任何围手术期并发症,尤其是重症监护治疗。这可以通过快速康复外科中熟知的算法出色地实现。

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[Day-case outpatient endoprosthetics-"Ultra-Fast-Track"].日间门诊内置假体——“超快速通道”

本文引用的文献

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[Fast track in hip and knee arthroplasty].[髋关节和膝关节置换术的快速康复]
Orthopade. 2021 Apr;50(4):333-343. doi: 10.1007/s00132-021-04071-2. Epub 2021 Feb 26.
2
Periprosthetic proximal femoral fractures in cemented and uncemented stems according to Vancouver classification: observation of a new fracture pattern.根据温哥华分类,骨水泥型和非骨水泥型股骨柄假体周围股骨近端骨折:一种新骨折模式的观察。
J Orthop Surg Res. 2020 Mar 10;15(1):100. doi: 10.1186/s13018-020-01619-4.
3
Dislocation following total hip arthroplasty using dual mobility acetabular components: a systematic review.
Orthopade. 2022 May;51(5):380-384. doi: 10.1007/s00132-022-04242-9. Epub 2022 Apr 12.
使用双动髋臼组件的全髋关节置换术后脱位:一项系统评价
Bone Joint J. 2017 Jan;99-B(ASuppl1):18-24. doi: 10.1302/0301-620X.99B1.BJJ-2016-0398.R1.
4
Peri-operative care of the elderly 2014: Association of Anaesthetists of Great Britain and Ireland.2014 年老年患者围手术期护理:英国和爱尔兰麻醉师协会
Anaesthesia. 2014 Jan;69 Suppl 1:81-98. doi: 10.1111/anae.12524.