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[老年医学——一项跨学科挑战]

[Geriatrics - an interdisciplinary challenge].

作者信息

Nau Roland, Djukic Marija, Wappler Manfred

机构信息

Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, An der Lutter 24, 37075, Göttingen, Deutschland.

Institut für Neuropathologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland.

出版信息

Nervenarzt. 2016 Jun;87(6):603-8. doi: 10.1007/s00115-016-0114-0.

Abstract

The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e.g. general practitioners, internists, neurologists and psychiatrists). In the training for the subspecialty clinical geriatrics, these specialties enjoy equal rights. Recent efforts to establish a qualification as physician for internal medicine and geriatrics have initiated a discussion to make the suitability for qualification as a geriatrician dependent on the medical specialty. Geriatric patients benefit from multidisciplinary cooperation. Neurologists possess great expertise in the treatment of patients with dementia, depression, delirium, consequences of degenerative spinal cord diseases and vertebral bone fractures, stroke, Parkinson's syndrome, epileptic seizures, vertigo and dizziness, neuropathies, lesions of peripheral nerves and in the multimodal therapy of pain. To function in a position of responsibility in a geriatric department, neurologists need skills in general internal medicine. These are acquired either on a geriatric ward or during specialization as a neurologist by full time secondment to large neurological or interdisciplinary intensive care units.

摘要

在未来几十年里,老年患者的护理将持续对医疗保健系统构成挑战。通常情况下,老年患者患有多种疾病,疾病模式复杂,日常生活能力严重下降。由多专业老年医学团队提供治疗,主要目标是通过采用整体方法改善功能状态、社会环境中的生活质量和自主性。在德国,老年护理由来自各个医学专科的医生提供(如全科医生、内科医生、神经科医生和精神科医生)。在临床老年医学亚专业培训中,这些专科享有平等权利。最近为获得内科和老年医学医生资格所做的努力引发了一场讨论,即老年医学医生资格的适宜性是否应取决于医学专科。老年患者受益于多学科合作。神经科医生在治疗痴呆、抑郁、谵妄、退行性脊髓疾病和椎体骨折的后果、中风、帕金森综合征、癫痫发作、眩晕和头晕、神经病变、周围神经损伤以及疼痛的多模式治疗方面拥有丰富的专业知识。为了在老年医学科室担任负责职位,神经科医生需要具备普通内科技能。这些技能可以在老年病房获得,也可以在神经科医生专业化期间通过全职借调到大型神经科或跨学科重症监护病房获得。

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