艾滋病患者的临界护理
R M Wachter1, J M Luce, P C Hopewell
1Medical Service, San Francisco, General Hospital Medical Center, University of California 94143-0862.
JAMA
|January 22, 1992
概括
获得性免疫缺陷综合征 (艾滋病) 患者的重症监护,特别是那些患有肺囊性肺炎 (PCP) 和呼吸衰竭的患者,显示生存率有所改善. 关于生命支持的决定应该考虑个人的临床状况和患者的愿望.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 获得性免疫缺陷综合征 (艾滋病) 在重症监护机构中提出了复杂的挑战.
- 由于肺囊性肺炎 (PCP) 的呼吸衰竭是艾滋病患者密集护理的常见迹象.
研究的目的:
- 审查艾滋病患者重症监护的临床和伦理问题.
- 评估需要重症监护的艾滋病患者的治疗结果和治疗策略.
主要方法:
- 系统审查已发表的关于艾滋病患者重症监护的研究和摘要.
- 包括已记录的艾滋病毒/艾滋病的结果研究,并排除疑似病例.
- 与现场专家进行商.
主要成果:
- 患有PCP引起的呼吸衰竭的艾滋病患者的存活率显著提高,从0-14%提高到36-55%.
- 对PCP的有效治疗方法包括静脉注射的三甲-硫甲或 pentamidine 与辅助性皮质类固醇.
- 患有艾滋病且因其他病症需要重症监护的患者通常有更好的预后.
结论:
- 对艾滋病患者的临床护理,特别是PCP,并不是徒劳的.
- 治疗决策应根据临床背景和患者偏好进行个性化.
- 需要进一步的研究,以了解改善生存趋势并确定预测因素.
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