重视老年外科病人衰弱评估  

Emphasizing the importance of frailty assessment in elderly surgical patients

作　　者：周文涛 楼文晖 ZHOU Wen-tao;LOU Wen-hui(Department of General Surgery,Shanghai Geriatric Medical Center,Shanghai 201104,China;Department of Pancreatic Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市老年医学中心普外科,上海201104 [2]复旦大学附属中山医院胰腺外科,上海200032

出　　处：《中国实用外科杂志》2025年第2期160-164,共5页Chinese Journal of Practical Surgery

基　　金：上海市卫生健康委员会项目(No.202340104,20224Y0307)。

摘　　要：老龄化加剧使衰弱成为影响老年外科病人预后的关键因素,衰弱可显著增加术后并发症、死亡及非正常离院等不良结局的发生风险。因此,在围手术期中识别和评估衰弱状态尤为重要。当前常用的衰弱评估工具包括Fried衰弱表型、衰弱指数、临床衰弱量表和老年综合评估等,但因评估复杂、缺乏统一标准,临床实施率较低。通过老年筛查工具-8初筛并结合老年综合评估的“两步筛查”策略,可实现对高风险病人的高效、全面评估,从而推动精准干预。人工智能和分子生物学的发展为衰弱评估的自动化和个性化提供了有利条件,未来有望促进衰弱评估的标准化应用,进一步优化老年外科病人管理流程,改善术后生活质量。The acceleration of aging has made frailty a key factor influencing the prognosis of elderly surgical patients.The frailty significantly increaes the risk of postoperative complications,mortality,and adverse discharge outcomes.Therefore,identifying and assessing frailty during the perioperative period is crucial.Commonly used frailty assessment tools include the fried frailty phenotype,frailty index,clinical frailty scale,and comprehensive geriatric assessment.However,due to the complexity of these assessments and the lack of standardized criteria,their clinical application rate remains low.A "two-step screening" strategy using the geriatric screening tool-8 followed by the Comprehensive Geriatric Assessment enables efficient and thorough evaluation of high-risk patients,facilitating precisely targeted interventions.Advances in artificial intelligence and molecular biology provide new opportunities for automating and personalizing frailty assessment,which could promote standardized application of frailty evaluation,further optimize the management of elderly surgical patients,and improve postoperative quality of life.

关 键 词：老年外科病人 衰弱评估 围手术期管理 预后 

分 类 号：R6[医药卫生—外科学]