周全性老年評估個案報告：腹部手術及併發症後的功能衰退

Functional Decline after Abdominal Operation and Complication of Intra-Abdominal Infection

陳強儀(Chiang-Yi Chen) ； 周曉禎(Hsiao-Chen Chou) ； 卜宜芝(Yi-Chin Bu) ； 余明錚(Ming-Tseng Yu) ； 徐濬婕(Chun-Chieh Hsu) ； 蔡慧玲(Hui-ling Tsai) ； 樹金忠(Chin-Chung Shu) ； 陳晉興(Jin-Shing Chen)

《台灣老年醫學暨老年學雜誌》 10卷1期 (2015/02) Pp. 42-53

https://doi.org/10.29461/TGG.201502_10(1).0004

摘要

面對人口結構老年化的趨勢，老年人的住院比例較高，發生併發症的情況也較多，面對接受手術治療的老年患者，如何給予他們較好的照護日益受到重視。老年患者在經歷手術治療及住院臥床休息之後，經常發生生活功能下降，主要原因與年齡、手術後臥床時間的長短、手術本身的影響、以及手術併發症有關。因此在手術治療前應謹慎評估手術治療的必要性和對患者的益處；手術之後，適當的營養評估及足夠的營養攝取，並盡可能的提早開始活動以降低臥床的時間，均有助於老年患者從術後狀態恢復，減少老年患者術後功能衰退的情形。本個案為一名82歲的女性患者，於腹部手術及併發症後有顯著的功能衰退，團隊透過周全性的老年評估，提供適當的介入改善，達到增進老年患者術後生活功能改善的目標。

關鍵字

周全性老年評估 ； 功能衰退 ； 營養 ； 手術 ； 傷口

並列摘要

In response to the ever-accelerating pace of population aging, greater and close attention needs to be directed to the elderly who have reported a higher proportion of hospitalization and subsequent complications than non-elderly adults. In particular, elderly patients often experience functional decline after undergoing a surgery during hospitalization. Postoperative functional decline is associated with age, duration of bed rest, surgery effects, and complications. Therefore, careful preoperative assessment on both the necessity and the benefits of operations planned for the elderly is of crucial importance, and postoperative care should be coupled with sufficient nutrition support to help facilitate early resumption of normal movement, reduce the duration of bed rest, and mitigate functional decline. In the case studied, comprehensive geriatric assessment was performed and further interventions applied to improve the daily activities and quality of life for an 82-year-old lady with obvious functional decline and complication of intra-abdominal infection after an abdominal surgery.

並列關鍵字

comprehensive geriatric assessment ； functional decline ； nutrition ； surgery ； wound