照顾患有慢性阻塞性肺病的老年人
Terri R Fried1, Carlos A Vaz Fragoso, Michael W Rabow
1Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA. terri.fried@yale.edu
JAMA
|September 27, 2012
概括
在老年患者中治疗慢性阻塞性肺病 (COPD) 需要超出标准指南的个性化护理. 临床医生必须解决并发症,缓解症状和终身规划,以获得更好的结果.
科学领域:
- 老年医学 老年医学
- 肺部病理学 肺部病理学
- 内部医学 内部医学
背景情况:
- 慢性阻塞性肺病 (COPD) 显著影响老年人,带来诸如高症状负担和医疗保健需求等挑战.
- 诸如心力衰竭和焦虑等并发症可以使老年COPD患者的呼吸衰竭和呼吸障碍恶化.
- 现有的临床指导方针可能无法充分解决COPD老年患者的复杂需求,包括功能衰退和终身护理.
研究的目的:
- 突出应用现行COPD指南对老年患者的挑战和局限性.
- 强调需要一个全面的方法来管理老年人COPD的需要.
主要方法:
- 审查现有的文献和临床指南,对老年人COPD管理.
- 一个81岁的男性患者的病例研究分析,该患者患有严重的COPD恶化和呼吸衰竭.
主要成果:
- 随机对照试验可能低估了老年COPD患者的不良事件风险.
- 目前的指导方针往往侧重于疾病修饰疗法,可能忽视了诸如症状管理和功能衰退等关键方面.
- 一个案例说明了管理并发症的复杂性和老年COPD护理标准方案的局限性.
结论:
- 在老年人中有效管理COPD需要通过个性化治疗决定来补充基于指南的护理.
- 临床医生应优先考虑COPD老年患者的症状缓解,功能状态和积极的生命终端护理计划.
- 考虑并发症和患者特异性风险的整体方法对于改善老年COPD患者及其家人的生活质量至关重要.
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