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衰弱和肌肉减少症对老年结直肠癌手术患者术后麻醉恢复及并发症影响的调查

An Investigation into the Effects of Frailty and Sarcopenia on Postoperative Anesthesia Recovery and Complications Among Geriatric Patients Undergoing Colorectal Malignancy Surgery.

作者信息

Özdemir Rüştü, Yaman Ferda

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir 26040, Turkey.

出版信息

Medicina (Kaunas). 2025 May 23;61(6):969. doi: 10.3390/medicina61060969.

Abstract

In this study, we aimed to assess preoperative frailty among hospitalized patients over 60 undergoing colorectal cancer surgery. We investigated the impacts of frailty and sarcopenia on postoperative recovery, complications, and discharge time, while also identifying a cost-effective, bedside-accessible USG parameter for diagnosing sarcopenia among patients assessed using the "Sonographic Thigh Adjustment Ratio" method. In this prospective study, we investigated the impacts of frailty and sarcopenia on the postoperative outcomes of 42 geriatric patients (with American Society of Anesthesiologists (ASA) scores of I-III) undergoing colorectal cancer surgery under general anesthesia. Frailty was assessed using the FRAIL scale, and sarcopenia was evaluated using the STAR (sonographic thigh adjustment ratio). Ultrasonographic measurements of rectus femoris and vastus intermedius muscle thicknesses were taken, and thigh lengths (TLs) were recorded. Ratios, including rectus femoris thickness/TL (RFT/TL), vastus intermedius thickness/TL (VIT/TL), and total muscle thickness/TL (TMT/TL), were calculated. Postoperative anesthesia recovery was monitored using the Modified Aldrete Score, indicating the time until discharge from the recovery unit. Complications were classified using the Clavien-Dindo system, and hospital discharge times were noted. We observed significant differences between frailty status and ASA scores, as well as between age and frailty status. Muscle thickness significantly differed between the frail and pre-frail patients. Among the sarcopenic patients, age differences were significant. In men, VIT/TL was significantly correlated with sarcopenia diagnosis, whereas, in women, RFT/TL, VIT/TL, and TMT/TL were all correlated with sarcopenia. Based on our results, we conclude that VIT/TL measurement can serve as a predictive marker for preoperative sarcopenia, optimizing patient health before surgery.

摘要

在本研究中,我们旨在评估60岁以上接受结直肠癌手术的住院患者术前的衰弱情况。我们调查了衰弱和肌肉减少症对术后恢复、并发症及出院时间的影响,同时还确定了一种经济高效、床边可用的超声参数,用于在使用“超声大腿调整比率”方法评估的患者中诊断肌肉减少症。在这项前瞻性研究中,我们调查了衰弱和肌肉减少症对42例老年患者(美国麻醉医师协会(ASA)评分为I - III级)在全身麻醉下接受结直肠癌手术术后结局的影响。使用FRAIL量表评估衰弱情况,使用STAR(超声大腿调整比率)评估肌肉减少症。对股直肌和股中间肌的肌肉厚度进行超声测量,并记录大腿长度(TL)。计算包括股直肌厚度/TL(RFT/TL)、股中间肌厚度/TL(VIT/TL)和总肌肉厚度/TL(TMT/TL)在内的比率。使用改良Aldrete评分监测术后麻醉恢复情况,该评分指示从恢复室出院的时间。使用Clavien - Dindo系统对并发症进行分类,并记录住院出院时间。我们观察到衰弱状态与ASA评分之间以及年龄与衰弱状态之间存在显著差异。衰弱患者和衰弱前期患者之间的肌肉厚度存在显著差异。在肌肉减少症患者中,年龄差异显著。在男性中,VIT/TL与肌肉减少症诊断显著相关,而在女性中,RFT/TL、VIT/TL和TMT/TL均与肌肉减少症相关。基于我们的结果,我们得出结论,VIT/TL测量可作为术前肌肉减少症的预测指标,在手术前优化患者健康状况。

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