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髋部骨折合并痴呆患者的多学科老年康复治疗

[Multidisciplinary geriatric rehabilitation in the patient with hip fracture and dementia].

作者信息

Romero Pisonero Elena, Mora Fernández Jesús

机构信息

Sección de Geriatría, Hospital La Fuenfría, Madrid, España.

Servicio de Geriatría, Hospital Clínico San Carlos, Madrid, España.

出版信息

Rev Esp Geriatr Gerontol. 2019 Jul-Aug;54(4):220-229. doi: 10.1016/j.regg.2018.11.001. Epub 2018 Dec 31.

Abstract

Hip fracture and dementia rates increase with age, and both groups of patients suffer increased morbidity and mortality and functional impairment. The management of these patients is a challenge for the orthogeriatric and rehabilitation team process, as despite the evidence on the benefit, the results analysed are still worse than in patients without cognitive impairment. For this reason, and due to the limitation in health resources, many of them have problems in accessibility to them, or are limited to a less intense rehabilitation. There are insufficient studies on the best rehabilitation interventions in this group of patients, but it is suggested: 1) to use a multidisciplinary rehabilitation model adapted to the patient with dementia, and 2) to redefine results of the rehabilitation of these patients not only in terms of functional improvement, without highlighting other concepts, such as quality of life, decrease in complications or improved social support.

摘要

髋部骨折和痴呆症的发病率随年龄增长而上升,这两类患者的发病率、死亡率以及功能障碍均有所增加。对这些患者的管理是老年骨科和康复团队工作流程中的一项挑战,因为尽管有证据表明康复有益,但分析结果显示,与无认知障碍的患者相比,这些患者的康复效果仍较差。因此,由于卫生资源有限,许多此类患者在获得康复治疗方面存在问题,或者只能接受强度较低的康复治疗。目前针对这类患者最佳康复干预措施的研究不足,但建议如下:1)采用适合痴呆症患者的多学科康复模式;2)重新定义这些患者的康复结果,不仅要关注功能改善,还应重视其他方面,如生活质量、并发症减少或社会支持改善等。

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