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[姑息治疗病房中神经疾病患者的多重疾病情况]

[Multimorbidity of neurological patients in palliative care units].

作者信息

Lorenzl S

机构信息

Klinik für Palliativmedizin und Neurologische Klinik, Klinikum Großhadernder LMU München, Marchinoninistr. 14, 81377, München, Deutschland,

出版信息

Nervenarzt. 2014 Apr;85(4):409-16. doi: 10.1007/s00115-013-3938-x.

Abstract

BACKGROUND

Multimorbidity in patients with neurological diseases needs enhanced attention. Especially the treatment with medication for comorbidities should be regularly evaluated and adapted to the current condition of the patient.

PROBLEM

The problem of how to deal with multimorbidity of neurological patients on palliative care units is discussed.

MATERIAL AND METHODS

This article gives a retrospective review of data and presentation of own results together with a discussion on basic knowledge and expert recommendations.

RESULTS

Multimorbidity of patients with neurological diseases depends on the underlying disease and age. Multimorbidity is often associated with polypharmacy which should be critically evaluated during palliative care treatment. Long-term pharmacological treatment often needs to be terminated as the side effects outweigh the benefits. Our own data show that patients leaving the palliative care unit often have a reduced amount of drugs compared to those who have died. Multimorbidity at the end of life includes dementia, delirium and epileptic seizures as well as symptoms associated with tube feeding. Artificial nutrition should be regarded as a form of pharmacological treatment and its usefulness at the end of life carefully evaluated.

摘要

背景

神经系统疾病患者的多重疾病状态需要更多关注。特别是针对合并症的药物治疗应定期评估,并根据患者当前状况进行调整。

问题

讨论了如何应对姑息治疗病房中神经系统疾病患者的多重疾病状态这一问题。

材料与方法

本文对数据进行回顾性分析,展示自身研究结果,并对基础知识和专家建议进行讨论。

结果

神经系统疾病患者的多重疾病状态取决于基础疾病和年龄。多重疾病状态常与多种药物联合使用相关,在姑息治疗期间应严格评估。由于副作用超过益处,长期药物治疗通常需要终止。我们自己的数据表明,与死亡患者相比,离开姑息治疗病房的患者用药量往往减少。临终时的多重疾病状态包括痴呆、谵妄和癫痫发作以及与管饲相关的症状。人工营养应被视为一种药物治疗形式,并仔细评估其在临终时的效用。

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