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老年患者颅脑手术后的加速康复:综述

Enhanced Recovery after Cranial Surgery in Elderly: A Review.

机构信息

Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.

Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.

出版信息

World Neurosurg. 2024 May;185:e1013-e1018. doi: 10.1016/j.wneu.2024.03.012. Epub 2024 Mar 11.

Abstract

BACKGROUND

Enhanced recovery after surgery (ERAS) is a multidisciplinary approach aimed at reducing the length of hospital stay, improving patient outcomes, and reducing the overall cost of care. Although ERAS protocols have been widely adopted in various surgical fields, their application in cranial surgery remains relatively limited.

METHODS

Considering that the aging of the population presents significant challenges to healthcare systems, and there is currently no ERAS protocol available for geriatric patients over the age of 65 requiring cranial surgery, this article proposes a new ERAS protocol for this population by analyzing successful ERAS protocols and optimal perioperative care for geriatric patients described in the literature.

RESULTS

Our aim is to develop a feasible, safe, and effective protocol for geriatric patients undergoing elective craniotomy, which includes preoperative, intraoperative, and postoperative assessments and management, as well as outcome measures.

CONCLUSIONS

This multidisciplinary and evidence-based ERAS protocol has the potential to reduce perioperative morbidity, improve functional recovery, and enhance postoperative outcomes after cranial surgery in elderly. Further research will be necessary to establish strict guidelines.

摘要

背景

术后加速康复(ERAS)是一种多学科方法,旨在缩短住院时间、改善患者预后并降低整体医疗成本。尽管 ERAS 方案已在各种外科领域广泛采用,但在颅外科中应用相对有限。

方法

考虑到人口老龄化给医疗系统带来了重大挑战,且目前尚无针对 65 岁以上需要颅外科手术的老年患者的 ERAS 方案,本文通过分析成功的 ERAS 方案和文献中描述的老年患者最佳围手术期护理,为这一人群提出了一种新的 ERAS 方案。

结果

我们的目标是为择期行颅外科手术的老年患者制定一种可行、安全且有效的方案,包括术前、术中及术后评估和管理,以及结局指标。

结论

这种多学科、基于证据的 ERAS 方案有可能降低颅外科手术后围手术期发病率,改善功能恢复,并提高老年患者的术后结局。需要进一步的研究来制定严格的指南。

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