老年人群中的严重创伤。
Severe trauma in the geriatric population.
作者信息
Llompart-Pou Juan Antonio, Pérez-Bárcena Jon, Chico-Fernández Mario, Sánchez-Casado Marcelino, Raurich Joan Maria
机构信息
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Joan Maria Raurich, Servei de Medicina Intensiva, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain.
出版信息
World J Crit Care Med. 2017 May 4;6(2):99-106. doi: 10.5492/wjccm.v6.i2.99.
Abstract
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury. Under-triage is common in this population. Evaluation of frailty could be helpful to solve this issue. Appropriate triaging and early aggressive management with correction of coagulopathy can improve outcome. Limitation of care and palliative measures must be considered in cases with a clear likelihood of poor prognosis.
摘要
老年创伤是一个日益受到关注的问题。衰老导致细胞功能逐渐衰退，进而使其对损伤的反应能力下降。该人群常用的一些药物可能会掩盖或削弱对损伤的反应。跌倒构成创伤的最常见原因，也是该人群创伤相关死亡的主要原因。抗血小板药物和抗凝剂的广泛使用使跌倒情况变得复杂，尤其是在脑损伤患者中。在这一人群中，分诊不足很常见。评估虚弱程度可能有助于解决这一问题。进行适当的分诊并早期积极治疗，纠正凝血功能障碍，可改善预后。对于预后明显不良的病例，必须考虑限制治疗和采取姑息措施。
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