[The applications and challenges of combined monitoring of macro/micro-circulation and mitochondrial homeostasis in early warning of perioperative organ injury].

Perioperative organ injury is a leading risk factor for mortality in surgical patients. Given the current limitations in the timeliness and accuracy of markers for perioperative organ injury, this article proposes a comprehensive early-warning assessment system that jointly monitors the macro-circulation, micro-circulation, and mitochondrial homeostasis. Macro-circulation monitoring allows for real-time evaluation of key indicators such as blood pressure and cardiac output, while micro-circulation monitoring aids in assessing the status of microvascular perfusion. Monitoring of mitochondrial homeostasis provides timely insights into cellular energy metabolism. These three facets are interconnected and collectively determine the balance between tissue oxygenation and energy supply and demand. This article will elucidate commonly used monitoring methods and clinically valuable assessment models within this system, offering theoretical and technical guidance to deepen our understanding of the pathological processes of perioperative organ injury, enhance surgical safety and success rates, and improve patient prognosis and quality of life. 围手术期器官损伤是手术患者死亡的主要危险因素。针对目前围手术期器官损伤标志物在时效性和准确性方面的局限，本文提出了大循环-微循环-线粒体稳态联合监测的围手术期器官损伤早期预警评估体系。大循环监测可实时评估血压和心输出量等关键指标，微循环监测有助于评估微血管灌注状态，线粒体稳态监测能够及时反映细胞能量代谢状态。这三个环节相互影响，共同决定了组织氧和能量的供需平衡。本文通过阐述联合监测体系的常用方法和具有临床转化价值的评估模型，为深入理解围手术期器官损伤病理过程、提高手术安全性和成功率、改善患者预后及生活质量提供理论支撑和技术指导。.