Lyssy K J, Escalante A
University of Texas Health Science Center at San Antonio, USA.
Postgrad Med. 1996 Feb;99(2):191-4, 199-201, 205-6.
The presence of rheumatoid arthritis can impose increased risks on patients undergoing surgical procedures. Affected patients often have peripheral joint inflammation, temporomandibular joint disease, laryngeal involvement, or cervical spine disease. Preoperative evaluation should also include assessment of cardiovascular disease, pulmonary disorders, and Sjögren's syndrome. Perioperative control of infection and prophylactic use of antibiotics are particularly important. To avoid wound-healing problems, preoperative discontinuation of therapy with aspirin, nonsteroidal anti-inflammatory drugs, and some slow-acting antirheumatic agents may be necessary. Effective management requires a team approach involving the primary care physician, the surgeon, other subspecialists, and allied healthcare personnel. To prevent unnecessary delays once the patient is hospitalized, preoperative assessment should be done primarily on an outpatient basis.
类风湿性关节炎的存在会给接受外科手术的患者带来更高的风险。受影响的患者通常会出现外周关节炎症、颞下颌关节疾病、喉部受累或颈椎疾病。术前评估还应包括对心血管疾病、肺部疾病和干燥综合征的评估。围手术期的感染控制和抗生素的预防性使用尤为重要。为避免伤口愈合问题，术前可能需要停用阿司匹林、非甾体抗炎药和一些慢作用抗风湿药。有效的管理需要团队协作，涉及初级保健医生、外科医生、其他专科医生和相关医护人员。为防止患者住院后出现不必要的延误，术前评估应主要在门诊进行。
