透過您的圖書館登入
IP:44.192.38.143
  • 期刊

老年人的感染症概論

Overview of Infectious Diseases in the Elderly

摘要


感染症是導致老年人住院及失能的主要原因之一,也是造成大部份疾病末期死亡的主要原因之一。老年人由於器官生理機能的退化、免疫功能的衰退、慢性疾病的盛行率增加、營養不良以及侵入性的醫療處置等,不僅使得老年人較年輕人有更多的感染機會、更嚴重程度的病情、治療反應不如預期,而且使得病情更易急速惡化、易發生併發症及後遺症,故死亡率亦較年輕人為高。此外老年人罹患感染症時,其外表症狀常與實際病變嚴重度不成比例,且常表現出不典型或非特異性的症狀或徵象,再加上溝通不良以及病史不易收集,使得早期診斷與治療更加困難。 在感染症的治療上,因老化的生理狀態改變,抗生素的藥理動態會受到影響,包括藥物的吸收、分佈、結合、代謝、排出,進而影響療效;此外老年病患原有慢性疾病以及同時服用多種藥物的影響,都會增加藥物交互作用及副作用的產生;再加上老年人本身對藥物的瞭解、接受度以及服藥順從性的差異等,均需在選擇抗生素前做審慎的考量。 老年人感染症的處置,預防勝於治療。需定期的健康檢查,以期能早期發現疾病早期治療,且需維持活躍的生活型態、注意個人衛生、適度的營養、運動及休閒,並盡量避免住至安養機構。此外,對於慢性疾病的控制及避免不必要的用藥、管路放置及侵入性的處置,再加上老人流行性感冒、肺炎鏈球菌及破傷風白喉等疫苗的預防注射,均有助於降低老年人感染症的發生率、後遺症及死亡率。

關鍵字

老年人 感染症

並列摘要


Infection is one of the most common reasons for hospitalization, disability, and mortality in the elderly. The actual demise of many patients with any form of end-stage illness is very likely to be caused by infection. Age-related reduced physiologic capacity, immune dysfunction, growing vulnerability to chronic diseases, malnutrition, as well as poor tolerance to invasive diagnostic and therapeutic procedures, all may contribute to increased susceptibility and severity of infections, delayed or poor response to antimicrobial therapy, and higher rates of adverse reactions to treatment in the elderly. Diagnosis and treatment may also be delayed because of the difficulty in communication and history taking, and atypical and nonspecific clinical manifestations of infections in this population. Physiologic changes related to advanced age may significantly affect the absorption, distribution, plasma protein binding, metabolism, and treatment effect of the antimicrobials. Common in the elderly, comorbidity and polypharmacy can further increase the chances of drug interactions and the toxicity of antimicrobials. In addition, patients' understanding of and adherence to the prescribed antimicrobials should also be considered when prescribing for the elderly. Prevention works better than treatment in managing geriatric infectious diseases. The elderly should be encouraged to receive routine health examination, maintain active life -styles, promote personal hygiene, improve nutrition intake, get regular exercise, and avoid institutionalization. Moreover, effective control and medical management of chronic diseases, elimination of unnecessary medications, catheters, and invasive procedures, together with vaccination against influenza, pneumococcus, and tetanus and diphtheria, are helpful in reducing complications, morbidity and mortality of infections in the elderly.

並列關鍵字

the aged the elderly infection

被引用紀錄


劉秀娟(2013)。老人在社區及長照機構細菌感染抗藥性的實證研究〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2013.00002
何香毅(2012)。晚期肝癌住院病人嚴重藥物不良反應預測因子與存活之探討〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2012.01935
陳岳君(2016)。檢視曾接受安寧療護之失智老人死亡前一年醫療利用情形:回溯性研究〔碩士論文,長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-2508201603072300
林明秀(2017)。高齡嚴重頭部外傷病患出院一年預後之相關因素探討〔碩士論文,長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-2207201723212500

延伸閱讀


國際替代計量