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[老年外科手术干预中的危险因素、术前延迟与死亡率]

[Risk factors, preoperative delay and mortality in surgical gerontologic interventions].

作者信息

Steinau G, Haese C, Schumpelick V

机构信息

Chirurgische Klinik, Rheinisch-Westfälische Technische Hochschule Aachen.

出版信息

Langenbecks Arch Chir. 1996;381(4):228-31. doi: 10.1007/BF00571691.

Abstract

A total of 1026 patients over 65 years of age underwent abdominal surgery during the period from 22 September 1987 to 12 February 1992 at the Surgical Department of Aachen Technical University. The data of these patients were analysed with respect to pre-operative risk factors, pre-operative rest period, their history and mortality. The following most important pre-operative risk factors were considered: cardiovascular diseases (45.9%), hypertension (28.7%), pulmonary diseases (19.4%) and diabetes mellitus (16.6%). Patients without pre-operative risk factors showed the lowest mortality rates if the pre-operative rest period was 1-2 days only, whereas patients with four or more risk factors showed the lowest mortality rates if the period of rest was 10-14 days. Mortality after emergency intervention (16.54%) was about three times as high as after elective surgery (5.54%). The anamnesis was 2-10 months for 30% of the patients whereas 8.2% of the patients reported a history of complaints of less than 24 h.

摘要

1987年9月22日至1992年2月12日期间,亚琛工业大学外科共有1026名65岁以上的患者接受了腹部手术。对这些患者的数据进行了分析,涉及术前危险因素、术前休息时间、病史和死亡率。考虑了以下最重要的术前危险因素:心血管疾病(45.9%)、高血压(28.7%)、肺部疾病(19.4%)和糖尿病(16.6%)。无术前危险因素的患者,若术前休息时间仅为1 - 2天,则死亡率最低;而有四个或更多危险因素的患者,若休息时间为10 - 14天,则死亡率最低。急诊手术后的死亡率(16.54%)约为择期手术后死亡率(5.54%)的三倍。30%的患者病史为2 - 10个月,而8.2%的患者报告有不到24小时的主诉病史。

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