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老年外科问题(作者译)

[Problems of surgery in old age (author's transl)].

作者信息

Becker T

出版信息

Z Alternsforsch. 1978;33(1):61-4.

PMID:706439
Abstract

Objects of surgery of the higher age are accident injuries, malignant tumors, thoracial and gastrointestinal emergency conditions as well as disorders of the central and peripheral circulation of blood. The aim of surgery of the old age is the complete recovery of the old men and the integration in his familiar surroundings. In many cases this aim can be realized only to a certain degree on account of the polymorbidity of the higher age. For men older than 50 years the risk of operation is continuously increasing. In the 10th decennium the value of postoperative letality is reaching almost 30%. The reason is not in first line the basic disease or the accident, but the complication for intervention is in most cases an absolute one, because cases of emergency are predominant. The consequence of surgery with high risk is the prophylaxis, that means: all pathologic, already in younger years existing states, which are generally treated by operation, ought to be operated early, in order to prevent complicationsin the higher age. In tumor surgery, which is characterized by a high delay rate, looking for tracks of cancer and early diagnosis are the ways to diminish the burden of the older men.

摘要

高龄患者的手术对象包括意外伤害、恶性肿瘤、胸腹部急症以及中枢和外周血液循环障碍。老年手术的目的是使老年人完全康复并融入其熟悉的环境。由于高龄患者存在多种疾病,在许多情况下,这一目标只能在一定程度上实现。对于50岁以上的男性,手术风险持续增加。在60 - 69岁年龄段,术后死亡率几乎达到30%。首要原因并非基础疾病或意外事故,而是在大多数情况下,干预引发的并发症是绝对的,因为急症病例占主导。高风险手术的结果是预防,也就是说:所有在年轻时就存在的、通常通过手术治疗的病理状态,都应尽早手术,以防止在高龄时出现并发症。在以高延误率为特征的肿瘤手术中,寻找癌症踪迹和早期诊断是减轻老年患者负担的方法。

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