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从医院姑息治疗安全过渡到家庭肠外营养的多学科检查表:来自阿布扎比艾因的案例研究

Multidisciplinary Checklist for Safe Transitions to Home Total Parenteral Nutrition From Hospital-Based Palliative Care: A Case Study From Al Ain, Abu Dhabi.

作者信息

Shanbhag Nandan M, Aljawamis Dina F, Araki Mehad, Abdelbari Noor A

机构信息

Oncology/Palliative Care, Tawam Hospital, Al Ain, ARE.

Oncology/Radiation Oncology, Tawam Hospital, Al Ain, ARE.

出版信息

Cureus. 2023 Aug 11;15(8):e43350. doi: 10.7759/cureus.43350. eCollection 2023 Aug.

DOI:10.7759/cureus.43350
PMID:37577268
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10421964/
Abstract

We present a complex case of a multimorbid elderly patient admitted with septic shock, suspected to be secondary to aspiration pneumonia, who subsequently developed an intestinal obstruction due to an ileocecal junction mass. Despite conservative management, the patient's clinical status deteriorated and required comprehensive palliative care. This case highlights the challenges in managing patients with multimorbidities, the importance of a multidisciplinary approach, and the central role of palliative care in the setting of advanced disease. We demonstrate the effectiveness of the above method to safely transit an elderly male with a recent diagnosis of colon cancer with malignant intestinal obstruction, initiated on total parenteral nutrition (TPN). This study emphasizes the successful implementation of an innovative, multidisciplinary checklist for managing elderly palliative care patients on home total parenteral nutrition (HTPN) in Al Ain, Abu Dhabi. The collaborative approach adopted by the multidisciplinary team (MDT), coupled with comprehensive staff training, patient and caregiver education, and ongoing monitoring and support, facilitated the seamless integration of HTPN into the patient's care plan. The positive outcomes observed in this case underscore the potential of such tailored interventions to bridge the existing gap in HTPN implementation within the region, thus improving the quality of life and overall well-being of elderly patients requiring specialized nutrition support.

摘要

我们介绍了一例复杂的多病老年患者病例,该患者因感染性休克入院,怀疑继发于吸入性肺炎,随后因回盲部肿物出现肠梗阻。尽管采取了保守治疗,但患者的临床状况仍恶化,需要全面的姑息治疗。该病例凸显了管理多病患者的挑战、多学科方法的重要性以及姑息治疗在晚期疾病中的核心作用。我们展示了上述方法在安全转运一名近期诊断为结肠癌并伴有恶性肠梗阻的老年男性患者方面的有效性,该患者开始接受全胃肠外营养(TPN)治疗。本研究强调了在阿联酋阿布扎比艾因成功实施一种创新的多学科清单,用于管理接受家庭全胃肠外营养(HTPN)的老年姑息治疗患者。多学科团队(MDT)采用的协作方法,加上全面的员工培训、患者及护理人员教育以及持续的监测和支持,促进了HTPN无缝融入患者的护理计划。该病例中观察到的积极结果强调了此类针对性干预措施在弥合该地区HTPN实施方面现有差距的潜力,从而提高需要特殊营养支持的老年患者的生活质量和整体健康水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/3a47a89e603b/cureus-0015-00000043350-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/4ee649c19f48/cureus-0015-00000043350-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/0eaf27065927/cureus-0015-00000043350-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/e3a1da7bb1bc/cureus-0015-00000043350-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/3a47a89e603b/cureus-0015-00000043350-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/4ee649c19f48/cureus-0015-00000043350-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/0eaf27065927/cureus-0015-00000043350-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/e3a1da7bb1bc/cureus-0015-00000043350-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a131/10421964/3a47a89e603b/cureus-0015-00000043350-i04.jpg

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Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial.多模式预康复与术后康复对结直肠癌切除术后虚弱患者 30 天术后并发症的影响:一项随机临床试验。
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