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小肠阻塞和脆弱:一个系统的审查

Aiman Ibrahim¹, Joseph Froud¹, Maria Lauda Tomasi²

¹Gastrointestinal Surgery Department, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.

European geriatric medicine

|March 5, 2026

目的:

探讨衰弱在小肠梗阻（SBO）背景下的意义，并识别所使用的衰弱筛查工具。在老年衰弱患者中，小肠梗阻的外科决策为急诊外科团队带来独特挑战，常导致临床管理的差异。保守治疗常可成功，但衰弱患者典型的生理与功能储备下降需要以综合老年评估（CGA）为指导的个体化治疗。

方法:

遵循PRISMA原则，于2025年7月在PubMed、Scopus、Cochrane、Web of Science、Embase和CINAHL数据库中系统检索相关文献。纳入研究为探讨成人小肠梗阻患者 frailty（衰弱）状况的研究。两名评审员独立筛选文献标题、摘要及全文。

结果:

去除重复文献后，共筛选了1109条记录，对31篇全文文章进行了评审，其中6项研究符合纳入标准。衰弱患者始终表现出比非衰弱患者更高的死亡率和更长的住院时间。四项研究将衰弱与较差的临床结局相关联，另有四项研究发现老年或衰弱患者存在手术延迟现象。最大规模的研究（约50,000例患者）表明，干预延迟会增加30天死亡率，且该效应独立于混杂因素。

结论:

新兴数据强调了在老年小肠梗阻患者中进行衰弱筛查和综合老年评估（CGA）的重要性。识别出衰弱程度最高且风险最大的患者，可能有助于及时作出个体化的临床决策。未来的研究应明确对衰弱患者早期手术是否可改善预后，并为衰弱老年人群小肠梗阻的管理制定针对性指导方案。

Registration Number:

PROSPERO 2025 CRD420251231786.

关键词:

临床脆弱度量表临床脆弱度量表紧急的一般外科手术.脆弱性脆弱性脆弱性年龄较大的成年人.小肠阻塞小肠阻塞外科手术的结果

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