老年创伤患者的围手术期管理
Perioperative Management of the Geriatric Trauma Patient.
作者信息
Muldowney Maeve, Aichholz Pudkrong, Cox Melina, Bentov Itay
机构信息
Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Center for Research in Education and Simulation Technologies, University of Washington, Seattle, WA, USA.
出版信息
Curr Anesthesiol Rep. 2025;15. doi: 10.1007/s40140-024-00673-6. Epub 2025 Jan 11.
PURPOSE OF REVIEW
An increasing number of trauma patients are elderly. These patients present unique challenges due to their distinct physiological changes and injury patterns. This article aims to summarize recent literature on perioperative management of geriatric trauma patients for anesthesia providers.
RECENT FINDINGS
Ageing is a multisystem process which may impair the ability of the older person to physiologically respond to trauma. The addition of frailty may further increase their vulnerability to complications.With regards to operative planning, regional anesthesia has not been shown to reduce the risk of delirium compared to general anesthesia. This has been mostly shown with regards to hip fractures, an injury with a high incidence amongst the elderly. There was no reduction in mortality with accelerated hip fracture repair within 6 h of presentation.
SUMMARY
Geriatric patients sustain different injuries and mount more limited physiological responses to trauma than their younger counterparts. Pre-existing frailty amongst the elderly may also contribute to complications in the perioperative period.
综述目的
创伤患者中老年患者的数量日益增加。由于这些患者独特的生理变化和损伤模式，他们面临着独特的挑战。本文旨在为麻醉医生总结近期关于老年创伤患者围手术期管理的文献。
最新发现
衰老是一个多系统过程，可能会削弱老年人对创伤进行生理反应的能力。虚弱的增加可能会进一步增加他们发生并发症的易感性。关于手术规划，与全身麻醉相比，区域麻醉并未显示出能降低谵妄风险。这在很大程度上是针对髋部骨折而言的，髋部骨折在老年人中发病率很高。伤后6小时内加速髋部骨折修复并未降低死亡率。
总结
老年患者遭受的损伤与年轻患者不同，对创伤的生理反应也更有限。老年人中预先存在的虚弱也可能导致围手术期并发症。
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