在家庭临终关怀下93岁的ESKD患者功能显著改善
Alster Talia1, Beizer Reshit1, Azulay Daniel1
1Hadassah University Medical Center, Jerusalem, Israel.
Case reports in nephrology
|April 28, 2025
概括
保守息治疗改善了93岁末期病患者的功能和生活质量. 这种在中东经常被忽视的方法,证明了显著的临床益处,挑战了关于息治疗的现有观念.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 老年病的医生 老年病的医生
- 抚慰性护理是一种缓解性护理.
背景情况:
- 一名93岁的男性患者患有末期脏病 (ESKD) 经历了严重的脏恶化,肌素7.6 mg/dL和GFR6.7 mL/min/1.73 m2.
- 该患者有前史因前列腺扩大和复发性感染而出现后阻塞,导致经常住院治疗.
- 优先考虑生活质量,患者选择了保守的管理,而不是延长生命的干预措施.
研究的目的:
- 报告以色列一位老年ESKD患者保守息治疗的结果.
- 评估息护理对这种特定患者群体功能和生活质量的影响.
- 挑战一种普遍的观念,即息治疗总是导致功能进一步下降.
主要方法:
- 患者在六个月内接受了全面的息治疗,包括定期的护士访问和医生咨询.
- 药物调整以评估生化参数的家庭血液测试为指导.
- 支持性家庭临终关怀已被纳入管理计划.
主要成果:
- 功能显著改善,肌素降至3.2 mg/dL,GFR增加至18.2 mL/min/1.73 m2.
- 电解质水平 (,) 稳定下来,患者不再需要再去急诊室.
- 临床改善包括增强认知,记忆,沟通和对外周围的有效管理.
结论:
- 保守的息治疗可以使老年ESKD患者的功能和生活质量显著改善.
- 这一案例凸显了缓和护理在中东老年人群中所带来的未被报道的好处,与其在北美得到的认可形成鲜明对比.
- 协调的息治疗和临终关怀可以积极影响临床结果,挑战ESKD对息治疗的负面看法.
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