Comerci G D
Adolescent/Young Adult Medicine Section, University of Arizona College of Medicine, Tucson.
Med Clin North Am. 1990 Sep;74(5):1293-310. doi: 10.1016/s0025-7125(16)30517-x.
The internist plays a critical role in the care of eating disorder patients, especially in the management of the life-threatening medical complications of these conditions. In anorexia nervosa, the immediate danger is related to the effects of voluntary starvation, including hypophosphatemia, bone marrow failure, cardiac decompensation, and shock. Patients with bulimia nervosa more often experience severe fluid and electrolyte abnormalities resulting in hypovolemia, secondary hyperaldosteronism, depletion of total body potassium, and cardiac arrhythmias. Immediate management of medical complication and correction of nutritional deficits are necessary before patients can benefit from psychotherapy. The need for continued involvement of the internist in the ongoing care of the eating disorder patient is stressed. The high mortality and the likelihood of chronicity without early intervention underscore the need for early recognition and skilled management of eating disorders.
内科医生在饮食失调患者的护理中起着关键作用，尤其是在处理这些病症危及生命的医学并发症方面。在神经性厌食症中，直接危险与自愿饥饿的影响有关，包括低磷血症、骨髓衰竭、心脏代偿失调和休克。神经性贪食症患者更常出现严重的液体和电解质异常，导致血容量不足、继发性醛固酮增多症、全身钾耗竭和心律失常。在患者能够从心理治疗中获益之前，必须立即处理医学并发症并纠正营养缺乏。强调内科医生需要持续参与饮食失调患者的持续护理。高死亡率以及未经早期干预可能出现慢性病的情况凸显了早期识别和熟练管理饮食失调的必要性。
