老年脓毒症患者围术期管理专家共识(2021年)  

Expert Consensus on Perioperative Management of Elderly Septic Patients(2021)

作　　者：于吉人[1] 王锷[2] 王迪芬 仓静 冯艺[5] 张西京 杨毅[7] 杨云梅[8] 吴水晶[9] 汪炜健[10] 杜斌 尚游[12] 林茹[13] 程宝莉[9] 谢郭豪[9] 方向明[9] YU Jiren;WANG E;WANG Difen;CANG Jing;FENG Yi;ZHANG Xijing;YANG Yi;YANG Yunmei;WU Shuijing;WANG Weijian;DU Bin;SHANG You;LIN Ru;CHENG Baoli;XIE Guohao;FANG Xiangming(Department of Gastrointestinal Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Anesthesiology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Critical Care Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,China;Department of Critical Care Medicine,Xijing Hospital,Air Force Medical University,Xi'an 710032,China;Department of Critical Care Medicine,Zhongda Hospital Southeast University,Nanjing 210009,China;Department of Geriatrics,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Anesthesiology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Medical Intensive Care Unit,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Intensive Care Unit,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Extracorporeal Circulation and Extracorporeal Life Support,the Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310051,China)

机构地区：[1]浙江大学医学院附属第一医院胃肠外科,杭州310003 [2]中南大学湘雅医院麻醉科,长沙410008 [3]贵州医科大学附属医院重症医学科,贵阳550004 [4]复旦大学附属中山医院麻醉科,上海200032 [5]北京大学人民医院麻醉科,北京100044 [6]空军军医大学西京医院重症医学科,西安710032 [7]东南大学附属中大医院重症医学科,南京210009 [8]浙江大学医学院附属第一医院老年医学科,杭州310003 [9]浙江大学医学院附属第一医院麻醉科,杭州310003 [10]温州医学院附属第一医院麻醉科,温州325000 [11]中国医学科学院北京协和医学院北京协和医院内科ICU,北京100730 [12]华中科技大学同济医学院附属协和医院重症医学科,武汉430022 [13]浙江大学医学院附属儿童医院体外循环-体外生命支持科,杭州310051

出　　处：《协和医学杂志》2021年第4期481-489,共9页Medical Journal of Peking Union Medical College Hospital

基　　金：国家重点研发计划(2018YFC2001904)。

摘　　要：随着人口老龄化加剧,老年患者手术量呈指数上升。一些危险因素如共病、用药前状态、营养不良、虚弱和免疫系统功能受损等与老年患者脓毒症的高易感性相关,这些因素不仅增加了脓毒症的发生风险,还可导致更严重的感染,并可能与更高的死亡率相关。与非老年患者相比,老年脓毒症患者的预后更差,但其治疗并无显著差异。此外,老年脓毒症幸存者的生活质量也较差。因此,为优化老年脓毒症患者围术期管理,相关学科临床专家就该问题进行讨论并制订了此共识。As the increasing of the aging population,the number of elderly surgical patients has in⁃creased exponentially.In elderly patients,a number of risk factors,such as comorbidities,premedication sta⁃tus,malnutrition,weakness,and impaired function of the immune system(or immune senescence),which are associated with a higher susceptibility to sepsis.These factors not only increase the risk of sepsis,but also lead to more severe manifestations of infection and may be associated with higher mortality.Elderly patients with sepsis had a poor prognosis compared to non⁃elderly patients,but there was no significant difference in the treatment.In addition,the survivors of elderly septic patients also had poorer quality of life.Therefore,in or⁃der to optimize the perioperative management of elderly patients,clinical experts from relevant disciplines dis⁃cussed this issue and formulated this consensus.

关 键 词：脓毒症 老年患者 围术期管理 专家共识 

分 类 号：R631[医药卫生—外科学] R782.053[医药卫生—临床医学]