某區域醫院急診部門年長慢性阻塞性肺病與支氣管哮喘病人急性發作之處置現況

Intervention of Elderly Patient with Chronic Obstructive Pulmonary Disease or Bronchial Asthma Exacerbation in a Regional Hospital Emergency Department

江旺財(Wang-Tsai Chiang) ； 胡百敏(Pai-Min Hu) ； 吳清平(Chin-Pyng Wu) ； 曾柏昌(Po-Chang Tseng) ； 廖浩欽(How-Chin Liao)

《台灣急診專科醫師期刊》 1卷1期 (2009/12) Pp. 29-38

https://doi.org/10.29749/JTCEP.200912.0004

摘要

呼吸困難是年長病患求助急診部門的主要原因之一，慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)與支氣管哮喘(bronchial asthma, BA)是呼吸道疾病常見的相關診斷。本研究旨在探討急診部門一年各季節因呼吸困難求診之55歲以上病患，診斷為COPD與BA的罹病資料、診斷與處置情形。本研究以病歷回顧與電話訪談進行資料蒐集後發現，急診醫師對於COPD與BA病人的診斷無明確差異，兩種疾病的處置亦雷同；病人於後續照顧的門診追蹤或住院過程進行肺功能或其他測驗以確定診斷的比例亦不高，形成無差異的原因可能與本土語言特性有關。

關鍵字

年長者 ； 支氣管性哮喘 ； 慢性阻塞性肺病 ； 急診醫療

並列摘要

Dyspnea and shortness of breath (SOB) are common symptoms requiring emergency medical care. Most patients with airway diseases are related to chronic obstructive pulmonary disease (COPD) or bronchial asthma. The purpose of this study was to understand their clinical diagnoses and medical condition in Emergency Department (ED). The study population was patients who were above 55 year old and visited the regional hospital ED because of dyspnea or SOB and then diagnosed as COPD or asthma. The research methods were medical records review and telephone interview. The study found that the diagnoses and treatment of patients with COPD or bronchial asthma in ED were mixed up. And those patients rarely took pulmonary function test to develop the definite diagnoses, neither in their previous visit to the outpatient clinics nor during hospitalization. The treatments provided in the ED were also similar between these two diseases. The expression of native language might cause the indistinguishable situation. In summary, this study revealed that senior ED patients with COPD or bronchial asthma received indiscriminate diagnoses and treatment.

並列關鍵字

elderly patient ； bronchial asthma ； COPD ； emergency medical care