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1、老年髋部骨折围手术期 相关问题Pre-operativeTreatmentstrategySurgicalfixationoffracturedhipsremainsthestandardofcarePre-operativeEvaluationCompletehistory,physicalexamination,laboratoryexaminationsAssessmentofthesurgicalrisksSystemdeficitsidentified,andcorrectedTheAmericanAssociationofAnaesthetistsgradingASAPhysic
2、alStatus(PS)ClassificationSystem*:ASAPSCategoryPreoperativeHealthStatusComments,Examples*ASAPSclassificationsfromtheAmericanSocietyofAnesthesiologistsASAPS1NormalhealthypatientNoorganic,physiologic,orpsychiatricdisturbance;excludestheveryyoungandveryold;healthywithgoodexercisetoleranceASAPS2Patient
3、swithmildsystemicdiseaseNofunctionallimitations;hasawell-controlleddiseaseofonebodysystem;controlledhypertensionordiabeteswithoutsystemiceffects,cigarettesmokingwithoutchronicobstructivepulmonarydisease(COPD);mildobesity,pregnancyASAPS3PatientswithseveresystemicdiseaseSomefunctionallimitation;hasac
4、ontrolleddiseaseofmorethanonebodysystemoronemajorsystem;noimmediatedangerofdeath;controlledcongestiveheartfailure(CHF),stableangina,oldheartattack,poorlycontrolledhypertension,morbidobesity,chronicrenalfailure;bronchospasticdiseasewithintermittentsymptomsASAPS4Patientswithseveresystemicdiseasethati
5、saconstantthreattolifeHasatleastoneseverediseasethatispoorlycontrolledoratendstage;possibleriskofdeath;unstableangina,symptomaticCOPD,symptomaticCHF,hepatorenalfailureASAPS5MoribundpatientswhoarenotexpectedtosurvivewithouttheoperationNotexpectedtosurvive>24hourswithoutsurgery;imminentriskofdeath;mu
6、ltiorganfailure,sepsissyndromewithhemodynamicinstability,hypothermia,poorlycontrolledcoagulopathyASAPS6Adeclaredbrain-deadpatientwhoorgansarebeingremovedfordonorpurposesPre-operativePain：acetaminophenApproximately40%ofpatientsmoderaterenaldysfunction(eGFR<60ml/min/1.73m2)Opioids：withcautionNSAIDS:r
7、elativelycontrindicatedPre-operativePreoperativetractionAbandonedPre-operativePreoperativeDVTprophylaxisPressuregradientstockings;LMWH:12hpriortosurgery;AspirinwithheldPre-operativeHemoglobin(Hb)Pre-operati
