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老年人手术的风景:挑战和机遇
1Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Epilepsia open
|May 19, 2025
概括
手术对于老年人 (≥50岁) 是一个可行的选择,为年轻患者提供可比的发作自由率. 虽然存在风险,但年龄本身不应该阻止考虑这种有效的治疗方法.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 老年病的医生 老年病的医生
背景情况:
- 的患病率随着年龄的增长而增加,导致耐药性病例的增加.
- 手术在老年人中未得到充分利用,尽管有有效性的证据.
- 对风险和结果的担忧在历史上在这个人口群体中仅限于外科手术的考虑.
研究的目的:
- 评估老年人 (≥50岁) 手术的安全性和疗效.
- 为了比较老年和年轻成人手术患者之间的发作结果和并发症率.
- 探索并发症和虚弱对老年人手术结果的影响.
主要方法:
- 对50岁及以上成年人手术结果的证据的审查.
- 对抗发作自由率,并发症概况和手术后生活质量的比较.
- 分析影响手术结果的因素,包括并发症,脆弱性和手术技术 (例如,LITT,神经调节).
主要成果:
- 手术可以在老年人中实现无发作,结果与年轻人相似甚至更好.
- 老年人具有更高的伴随性疾病负担,可能会影响发作自由和增加非家庭出院率.
- 老年人发现手术并发症增加,包括语言障碍和心脏病发作,以及口头记忆力下降的风险.
结论:
- 手术对于耐药的老年人来说是一个安全有效的选择.
- 个体化评估至关重要,权衡手术风险与对控制和生活质量的潜在益处.
- 最少侵入性手术和神经调节为老年患者提供了不适合切除手术的替代方案.
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