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1、老年髋部骨折围手术期 相关问题Pre-operativeTreatmentstrategySurgicalfixationoffracturedhipsremainsthestandardofcarePre-operativeEvaluationCompletehistory,physicalexamination,laboratoryexaminationsAssessmentofthesurgicalrisksSystemdeficitsidentified,andcorrectedTheAmericanAssociatio
2、nofAnaesthetistsgradingASAPhysicalStatus(PS)ClassificationSystem*:ASAPSCategoryPreoperativeHealthStatusComments,Examples*ASAPSclassificationsfromtheAmericanSocietyofAnesthesiologistsASAPS1NormalhealthypatientNoorganic,physiologic,orpsychiatricdisturbance;excludesthev
3、eryyoungandveryold;healthywithgoodexercisetoleranceASAPS2PatientswithmildsystemicdiseaseNofunctionallimitations;hasawell-controlleddiseaseofonebodysystem;controlledhypertensionordiabeteswithoutsystemiceffects,cigarettesmokingwithoutchronicobstructivepulmonarydisease(
4、COPD);mildobesity,pregnancyASAPS3PatientswithseveresystemicdiseaseSomefunctionallimitation;hasacontrolleddiseaseofmorethanonebodysystemoronemajorsystem;noimmediatedangerofdeath;controlledcongestiveheartfailure(CHF),stableangina,oldheartattack,poorlycontrolledhyperten
5、sion,morbidobesity,chronicrenalfailure;bronchospasticdiseasewithintermittentsymptomsASAPS4PatientswithseveresystemicdiseasethatisaconstantthreattolifeHasatleastoneseverediseasethatispoorlycontrolledoratendstage;possibleriskofdeath;unstableangina,symptomaticCOPD,sympt
6、omaticCHF,hepatorenalfailureASAPS5MoribundpatientswhoarenotexpectedtosurvivewithouttheoperationNotexpectedtosurvive>24hourswithoutsurgery;imminentriskofdeath;multiorganfailure,sepsissyndromewithhemodynamicinstability,hypothermia,poorlycontrolledcoagulopathyASAPS6Adec
7、laredbrain-deadpatientwhoorgansarebeingremovedfordonorpurposesPre-operativePain：acetaminophenApproximately40%ofpatientsmoderaterenaldysfunction(eGFR<60ml/min/1.73m2)Opioids：withcautionNSAIDS:relativelycontrindicatedPre-operativePreoperativetractionAbandonedPre-operat
8、ivePreoperativeDVTprophylaxisPressuregradientstockings;LMWH:12hpriortosurgery;AspirinwithheldPre-operativeHemoglobin(Hb)Pre-operati
