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术前评估

2017-11-14 3页 doc 14KB 41阅读

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术前评估术前评估 麻醉管理 术前评估 要点: 1对接受麻醉治疗的患者进行术前和操作前医学的评估, 其最终目标是降低 手术的死亡率,提高质量,减少围术期治疗的开支,让患者尽快恢复功能。 2(术前和操作前评估的基础在于有资料能证明患者身体状况和优化围术期管理是术后 死亡率的显著预示指标。 3.术前和操作前评估给患者提空了获得更高生活质量的机会,因此不仅改善了短期预 后,也改善了远期预后。 4.影响围术期评估的急性病史有三个方面,分别是对运动的耐受,现有的疾病史和初 诊医生最近依次访视患者的情况. 5.影响围术期评估的慢性...
术前评估
术前评估 麻醉管理 术前评估 要点: 1对接受麻醉治疗的患者进行术前和操作前医学的评估, 其最终目标是降低 手术的死亡率,提高质量,减少围术期治疗的开支,让患者尽快恢复功能。 2(术前和操作前评估的基础在于有资料能患者身体状况和优化围术期管理是术后 死亡率的显著预示指标。 3.术前和操作前评估给患者提空了获得更高生活质量的机会,因此不仅改善了短期预 后,也改善了远期预后。 4.影响围术期评估的急性病史有三个方面,分别是对运动的耐受,现有的疾病史和初 诊医生最近依次访视患者的情况. 5.影响围术期评估的慢性病史有三个方面,用药史及使用原因,过敏史;社会史,包 括吸毒,嗜酒,吸烟及戒烟史;家族史和既往史。 6.体格检查的三个方面:气道,心血管和肺功能评估。 7.通常,无明确指征的常规实验室检查不能带来太多的好处,但如检查结果能促进患 者治疗改善或避免潜在的问题则应该保留。 8.手术操作程度也影响常规检查的需求;低风险操作不需要或仅需少量的诊断性检查。 Preoperative Evaluation KEY POINTS 1. The ultimate goals of preoperative and procedure medical assessment of patients who are receiving anesthesia care are to reduce the morbidity of surgery,to increase the care,and to return the patient to desirable functioning as quickly as possible. 2. The basis for preoperative and preprocedure evaluation are data demonstrating that patient conditions and perioperative optimization of care are significant predictors of postoperative morbidity. 3. P reoperative and preprocedure evaluation offer an opportunity to motivate a patirnt to achieve a higher quality of life and thereby improve longterm as well as immediate outcome. 4. The three areas of acute history that impact perioperative evaluation are exercise tolerance,history of present illness,and when the patient last visited with her/his primary care physician. 5. The three aspects of chronic history that impact perioperative evaluation are medications and reasons for their use,and allergies;social history,including drug,alcohol,and tobacco use and cessation;and family history and history of prior illness. 6. The three aspects of the physical examination are airway,cardiovascular and pulmonary evaluation. 7. In general,not much benefit appears to arise from unindicated routine laboratory testing,and testing should be reserved for those for whom the results may lead to improved care or avoidance of a potential problem. 8. The extent of a surgical procedure Influences the need for routine testing;low-risk procedures require no or minimal diagnostic testing.
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