| 特集名 | 超高齢化社会に向けた大腸内視鏡検査 | |
|---|---|---|
| 題名 | 超高齢者大腸内視鏡検査のrisk management | |
| 発刊年月 | 2015年 01月 | |
| 著者 | 中川 義仁 | 藤田保健衛生大学消化管内科 |
| 著者 | 平田 一郎 | 藤田保健衛生大学消化管内科 |
| 【 要旨 】 | 超高齢者は併発症が他の年代よりも高く，とくに心血管系や脳血管疾患の合併率が高く，抗凝固療法がなされている症例も多い．大腸腫瘍が見つかることも多い． 当院では超高齢者に対する大腸内視鏡のrisk managementのため，(1) 基本的に入院とする，(2) 本人確認やタイムアウトを徹底する，(3) セデーションや抗コリン剤を使用しない，(4) 検査中も検査後も全身状態の把握に留意する，(5) 上級医が中心となって検査し無理をしない，(6) 病院全体でrisk managementに取り組む，といったことを心がけている． |
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| Theme | Colonoscopy for the super-elderly | |
|---|---|---|
| Title | Risk management for colonoscopy in extremelyelderly patients | |
| Author | Yoshihito Nakagawa | Department of Gastroenterology, Fujita Health University School of Medicine |
| Author | Ichiro Hirata | Department of Gastroenterology, Fujita Health University School of Medicine |
| [ Summary ] | Japan is becoming a super-aged society. The need for colonoscopy for extremely elderly patients has increased in our hospital. However, extremely elderly patients experience many complications. This is especially true of the oldest individuals having cardiovascular disease and/or cerebrovascular disease. For this reason, many of the oldest were prescribed anti-coagulants. Many suffer from colorectal tumors. Many elderly patients return for follow-ups at higher rates than do other age groups, because they are at high-risk. We introduce the concept of risk management and the current state of colonoscopic treatment for the very elderly as practiced in our hospital. It is necessary to carefully conduct pre-operative evaluations for extremely elderly patients. The oldest patients often require hospitalization. Monitoring of vital signs is needed. It is necessary to carefully monitor the physical condition of elderly patients after colonoscopies. The administration of anti-cholinergic agents and sedation must also be carried out very carefully for these individuals. All forms of risk management for colonoscopy are very important for very elderly patients. Guidelines for colonoscopy for the oldest patients must be adapted to individual hospitals and clinics. |
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