老年胃肠肿瘤患者围手术期衰弱管理方案的构建  

Construction of perioperative frailty management program for elderly patients with gastrointestinal tumors

作　　者：闫亚铃 乐美妮 姚桃琴 王雪莲 姜建玲[3] 辛艺 YAN Ya-ling;LE Mei-ni;YAO Tao-qin;WANG Xue-lian;JIANG Jian-ling;XIN Yi(Wuxi School of Medicine,Jiangnan University,Wuxi 214122,China;Dept.of Surgery and Anesthesia,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200050,China;Dept.of General Surgery,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200050,China)

机构地区：[1]江南大学无锡医学院,江苏无锡214122 [2]上海交通大学医学院附属同仁医院麻醉手术科,上海200050 [3]上海交通大学医学院附属同仁医院普外科,上海200050

出　　处：《护理学报》2025年第2期74-78,共5页Journal of Nursing(China)

基　　金：上海市长宁区医疗卫生科研专项课题(CNKW2020Y16)。

摘　　要：目的构建老年胃肠肿瘤患者围手术期衰弱管理方案,为改善老年胃肠肿瘤患者围手术期衰弱状态提供依据。方法运用循证方法系统检索文献,提取及汇总最佳证据形成老年胃肠肿瘤患者围手术期衰弱管理方案初稿。运用德尔菲法对17位专家进行2轮函询。结果2轮专家函询问卷的回收率均为100%,专家权威程度均为0.805;2轮肯德尔和谐系数分别为0.221、0.279(P<0.001)。最终形成包括围手术期衰弱评估、术前预康复、术中护理、术后管理、出院管理5项一级指标、12项二级指标、35项三级指标的管理方案。结论老年胃肠肿瘤患者围手术期衰弱管理方案涵盖围术期管理的全过程,具有较好的科学性、针对性和实用性,可进一步开展临床验证研究。Objective To construct a perioperative frailty management program for elderly patients with gastrointestinal tumors,and to provide reference for improving the perioperative frailty of patients.Methods Evidence-based methods were used to systematically retrieve the literature,extract and summarize the best evidence to form the first draft of a perioperative frailty management plan for elderly patients with gastrointestinal tumors.Two rounds of consultation were conducted in 17 experts with Delphi method.Results The effective recovery rate of the 2 rounds of expert correspondence was 100%,and the degree of expert authority 0.805;the Kendall’s harmony coefficients of the 2 rounds of consultation were 0.221 and 0.279,respectively(P<0.001).The final management program consisted of 5 first-level indicators including perioperative assessment,preoperative prehabilitation,intraoperative care,postoperative management and discharge management,12 secondary–level indicators and 35 third-level indicators.Conclusion The perioperative frailty management program for elderly patients with gastrointestinal tumors covers the whole process of perioperative management.It is scientific,targeted and practical.Further clinical studies could be conducted for its validation.

关 键 词：衰弱 老年患者 胃肠肿瘤 围手术期 循证护理 

分 类 号：R473.6[医药卫生—护理学]