老年患者围手术期衰弱管理的最佳证据总结  

Summary of the best evidence for perioperative frailty management in elderly patients

作　　者：钟欣怡 刘畅 路星星 廖佳丽 王倩[1] 王雨晴 胡晶晶 徐丽芬 熊丹莉[2] ZHONG Xinyi;LIU Chang;LU Xingxing;LIAO Jiali;WANG Qian;WANG Yuqing;HU Jingjing;XU Lifen;XIONG Danli(Urology Surgery,Wuhan Union Hospital,Wuhan 430030,Hubei,China;Gastrointestinal Surgery,Wuhan Union Hospital,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,湖北武汉430030 [2]华中科技大学同济医学院附属协和医院胃肠外科,湖北武汉430030

出　　处：《护士进修杂志》2025年第8期869-874,886,共7页Journal of Nurses Training

基　　金：华中科技大学同济医学院附属协和医院院内药剂护基金(编号:F016.01003.22003.183)。

摘　　要：目的 检索、整理和评价老年患者围手术期衰弱管理的最佳证据。方法 基于PIPOST模型构建循证问题,根据“6s”金字塔证据模型由高到低检索Up To Date、JBI循证卫生保健数据库、Cochrane Library、中国知网、中国生物医学文献数据库、万方、维普等数据库中关于老年患者围手术期衰弱管理的相关文献,并由2名研究人员独立对文献进行质量评价、证据提取及汇总。检索时限从建库至2023年11月7日。结果 共纳入15篇文献,包括指南6篇、专家共识4篇、专家意见1篇、系统评价3篇及证据总结1篇,最终汇总出筛查与评估、运动干预、营养干预、认知衰弱与心理管理、多重用药管理、麻醉管理、出院指导、其他8个方面共30条最佳证据。结论 临床医疗团队应高度重视老年患者围手术期的衰弱管理,审慎考量现有证据的实践性和实用性,制定个性化衰弱管理方案,以预防或尽可能逆转衰弱进程。Objective To search,sort out,and critically evaluate the best evidence of perioperative frailty management in elderly patients.Methods Evidence-based questions were constructed based on PIPOST model,and relevant literatures on perioperative frailies management in elderly patients were retrieved from top to bottom according to the"6s"pyramid evidence model in Up To Date,JBI,Cochrane Library,CNKI,SinoMed,Wanfang,and VIP.Two researchers independently evaluated the quality of the literature,extracted and summarized the evidence.The search period was from the establishment of the database to November 7,2023.Results A total of 15 literatures were included,including 6 guidelines,4 expert consensus articles,1 expert opinion article,3 systematic reviews,and 1 evidence summary article.A total of 30 best evidences were finally summarized in 8 aspects,including screening and evaluation,exercise intervention,nutrition intervention,cognitive frailty,and psychological management,multi-drug management,anesthesia management and discharge guidance.Conclusion The clinical medical teams should attach great importance to perioperative frailty management of elderly patients,carefully consider the practicability and practicality of existing evidence,and develop personalized frailty management programs to prevent or reverse the frailty process as far as possible.

关 键 词：老年 衰弱 围手术期 管理 证据总结 

分 类 号：R473.6[医药卫生—护理学]