[Terminal care for elderly patients with dementia in two long-term care hospitals].
[Terminal care for elderly patients with dementia in two long-term care hospitals].
复制标题
两家长期护理医院老年痴呆症患者的临终护理[J].
DOI：
10.3143/geriatrics.41.99
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
A. Iguchi
中科院分区：
文献类型：
--
作者：
Y. Hirakawa;Y. Masuda;Takaya Kimata;K. Uemura;M. Kuzuya;A. Iguchi
人口老龄化的一个副产品是痴呆症患者急剧增加。本研究的目的是澄清日本长期护理医院中积极和姑息治疗、人工营养和镇静的使用情况。我们评估了 2001 年 1 月至 2002 年 12 月期间在名古屋及其周边地区两家长期护理医院死亡的 123 名 65 岁及以上老人的死亡情况。所有死者根据痴呆症诊断分为两组。从病历中收集了死者生命最后六个月的具体特征、痴呆症诊断、积极治疗（包括心肺复苏、插管、机械通气、全身抗生素的使用和输血）、姑息治疗（包括氧气、麻醉和非麻醉止痛药）、人工营养（包括高营养和管饲）和镇静的数据。除血管加压药的使用外，积极和姑息性干预措施的患病率随痴呆症的诊断没有显着变化。人工营养很普遍，两组患者都很少接受镇静剂。患有和不患有痴呆症的患者在末期接受了类似的治疗。需要对痴呆症的病程有更深入的了解，才能进一步讨论痴呆症患者的临终护理。还需要就如何治疗末期痴呆患者达成全国共识。
A byproduct of the aging of the population has been a dramatic rise in patients with dementia. The aim of the present study is to clarify the use of aggressive and palliative treatments, artificial nutrition and sedation in long-term care hospitals in Japan. We assessed 123 deaths in people aged 65 and older who died in two long-term care hospitals in and around Nagoya from January 2001 to December 2002. All deceased were divided into two groups according to their diagnosis of dementia. Data on the particular characteristics of the deceased, diagnosis of dementia, aggressive treatments (including CPR, intubation, mechanical ventilation, the use of systemic antibiotics and blood transfusion), palliative treatments (including oxygen, narcotic and nonnarcotic pain medication) artificial nutrition (including hyperalimentation and tube feeding) and sedation during the last six months of their lives were collected from medical charts. The prevalence of aggressive and palliative interventions did not vary significantly with the diagnosis of dementia except for the use of vasopressors. Artificial nutrition was prevalent and few patients received sedatives in either group. Patients with and without dementia received similar treatments in the end-stage. A greater understanding of the course of dementia is needed to further discussions on the terminal care of people with dementia. A national consensus on how to treat end-stage demented patients is also needed.