Schneiderman H
University of Connecticut School of Medicine, Farmington 06030-3940.
Conn Med. 1993 May;57(5):317-24.
The aged patient presents challenges to the examining physician. Some of these relate to inefficient historical information transfer, reduced mobility, increased disease burden, cognitive and sensory alterations, and confusing background changes in the prevalence and interpretation of physical signs that would be unequivocally abnormal in the younger adult. This review suggests techniques to overcome these difficulties. Descriptions of methods of improving evaluation and interpretation are grouped into the following categories: general appearance and vital signs; skin; head and neck; respiratory and cardiovascular systems; abdomen, rectum and genitalia; musculoskeletal system; hands and fett; and neurologic and mental status evaluations. Several newly recognized signs are also described. The extra time, effort and ingenuity required for examination of the aged patient are richly repaid by enhanced diagnosis.
老年患者给接诊医生带来了挑战。其中一些挑战涉及病史信息传递效率低下、行动不便、疾病负担加重、认知和感觉改变，以及体征的患病率和解释方面令人困惑的背景变化，而这些体征在年轻成年人中无疑是异常的。本综述提出了克服这些困难的技巧。改善评估和解释方法的描述分为以下几类：一般外观和生命体征；皮肤；头颈部；呼吸和心血管系统；腹部、直肠和生殖器；肌肉骨骼系统；手和足；以及神经和精神状态评估。还描述了一些新发现的体征。通过加强诊断，为检查老年患者所花费的额外时间、精力和智慧得到了丰厚的回报。
