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Jingdong book

老年病防治与护理

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Books Fitness & Health Health in the elderly

Jingdong book

老年病防治与护理

Name: 老年病防治与护理
Brand: Jingdong book
SKU: 3120035611
Price: 27.15 USD
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随着医学、经济的发展，人们生活水平的提高，人类寿命得到普遍延长。社会老龄化趋势的日益明显，老龄人口的逐渐增多，如何改善老年人精神生活、预防疾病、促进健康、提高生存质量，备受老年朋友及家人的关注。由于老年身体机能日趋衰退，中年时期的疾病隐患，进入老年阶段后会不断地暴露出来，如高血压病、冠心病、脑血管病、高脂血症、慢性支气管炎、糖尿病、口腔疾患等。这些疾病严重地危害着老年人的身体健康，不但造成患者本人行动上的不便和痛苦，而且还会给家庭、子女和社会增加不少负担。因此，开展老年病防治知识教育、适应老年人的特点，迫切需要一本指导老年人医疗护理及自我保健的书籍。《老年病防治与护理》分为十三章、七十七节，从老年病的预防、治疗和护理等方面分别给予具体指导。内容丰富，层次清楚，利于学习，易于掌握，是一本较为全面的论述老年病防治、护理的著作。

Catalogue

第一章总论
第一节老年人年龄的划分
第二节老年人的生理变化
第三节老年人的心理变化
第四节影响老年人寿命的因素
第五节老年人疾病的特点
第六节老年人疾病防治
第七节老年人用药

第二章老年常见急症的救护
第一节心搏骤停患者的急救
第二节窒息患者的抢救
第三节脑出血患者的抢救
第四节休克患者的抢救
第五节高热患者的抢救
第六节昏迷患者的抢救
第七节一氧化碳中毒患者的抢救
第八节骨折患者的抢救
第九节大咯血患者的抢救

第三章老年呼吸系统疾病防治与护理
第一节急性上呼吸道感染
第二节老年慢性支气管炎
第三节老年性支气管哮喘
第四节老年支气管扩张症
第五节慢性肺炎
第六节老年肺栓塞
第七节老年睡眠呼吸暂停综合征
第八节老年呼吸衰竭
第九节老年阻塞性肺气肿
第十节肺癌
第十一节老年慢性肺源性心脏病

第四章老年循环系统疾病防治与护理
第一节老年高血压病
第二节老年动脉粥样硬化
第三节高脂血症
第四节老年冠心病
第五节老年心律失常
第六节老年脑动脉硬化症
第七节老年心力衰竭

第五章老年消化系统疾病防治与护理
第一节老年胃食管反流病
第二节食管癌
第三节老年溃疡病
第四节老年慢性胃炎
第五节胃癌
第六节肝硬化
第七节直肠癌
第八节老年便秘
第九节老年消化道出血

第六章老年内分泌代谢系统疾病防治与护理
第一节老年糖尿病
第二节老年甲状腺疾病

第七章老年泌尿系统疾病防治与护理
第一节老年前列腺肥大症
第二节老年人泌尿系统感染

第八章老年血液系统疾病防治与护理
第一节老年贫血
第二节老年脑出血
……
第九章老年神经系统疾病防治与护理
第十章老年精神疾病防治与护理
第十一章老年骨关节疾病防治与护理
第十二章老年人常见口腔疾病防治与护理
第十三章老年常见妇科疾病防治与护理

Book Abstract

肺炎按解剖部位可分为大叶性、小叶性和间质性肺炎。大叶性肺炎是指整个肺叶的实变，亦可以是肺段的浸润和实变。小叶性肺炎常有细支气管，终末细支气管及其远端的肺泡的炎症、实变呈两侧小片分布，以下叶多见。间质性肺炎的炎症以间质为主，有肺泡壁的增生和间质水肿。
一、病因分类
肺炎根据病因可分为细菌性肺炎、病毒性肺炎、支原体肺炎、真菌性肺炎、其他病原体及理化因素所致的肺炎。这里主要介绍细菌、病毒、支原体及真菌性肺炎。
二、临床表现
（一）肺炎球菌肺炎
肺炎球菌肺炎是肺炎链球菌所致的急性肺部感染，患者表现突发的寒战、高热、胸痛、咳嗽和血痰等症状。
1.病因病理肺炎链球菌为革兰染色阳性球菌，菌体外有荚膜，荚膜为多糖体，具有特异抗原性，致病毒力强。
本病好发于冬春季节，40%～70%的健康人鼻咽部带有肺炎球菌。进入呼吸道后，被呼吸道免疫机制清除。导致呼吸道免疫机制减弱的因素，如呼吸道感染、受寒、创伤及老年人免疫功能低下等，在黏膜肺泡内及纤毛运动中繁殖而致病，其病理过程如下。
（1）充血期：侵入肺泡的细菌生长繁殖，首先引起该处肺泡毛细血管扩张、充血、肺泡内水肺和浆液渗出。
（2）红肝变期：肺泡内渗出纤维蛋白、中性粒细胞和大量红细胞，外观似肝。
（3）灰肝变期：实变的肺泡内充满大量白细胞并且吞噬细菌，出现巨噬细胞，病变处外观呈灰色。
（4）消散期：大量白细胞破坏之后，游离的溶蛋白酶加速肺泡内渗出物的溶解，溶解的渗出物部分被吸收、部分被咳出，肺泡重新充气，病变消散。只有极少数患者肺泡内纤维蛋白吸收不完全，甚至有成纤维细胞形成，导致实变的纤维化，形成机化性肺炎。
2.临床表现
（1）典型症状与体征：①寒战、高热。半数以上患者有寒战高热，体温骤升至39℃～40℃，多呈稽留热，伴有头痛，全身肌肉酸痛，脉速、呼吸急促。②胸痛。胸痛出现较早，为炎症波及胸膜所致。呈尖锐的刺痛，随咳嗽或深呼吸而加重，取患侧卧位或呼吸浅速可减轻。疼痛有时可放射至上腹部等。③咳嗽、咳痰。咳嗽频繁，出现黏液性脓痰，部分患者因肺内毛细血管充血，红细胞渗出、破坏形成典型铁锈色痰。④呼吸困难。当病变范围广泛时，可因缺氧而出现呼吸困难和发绀。⑤消化道症状。部分患者可出现明显的消化道症状，如食欲缺乏、恶心呕吐、腹胀、腹泻甚至黄疸。早期肺部体征无明显异常，仅有呼吸音减低及胸膜摩擦音。肺实变时叩诊浊音，触诊语颤增强及支气管呼吸音。消散期可闻及湿性哕音，上腹部压痛。
（2）并发症：老年人由于各系统免疫功能低下，易引起感染性休克及神经系统并发症。感染性休克状态患者主要表现为血压下降、四肢厥冷、多汗、口唇发绀、脉细弱、少尿或无尿等。神经系统突出表现为烦躁不安、神志模糊、谵妄、昏迷等；少数患者可出现中毒性心肌炎，偶见脓胸、渗出性胸膜炎等并发症。
（二）葡萄球菌肺炎
葡萄球菌肺炎是由葡萄球菌所引起的急性肺部感染，病情较重，常伴有化脓性并发症，病死率较高。
1.病因葡萄球菌是革兰染色阳性球菌，主要分为金黄色葡萄球菌和表皮葡萄球菌两类。致病能力与葡萄球菌产生的血浆凝固酶、溶血毒素、杀白细胞素等有关。葡萄球菌侵入肺部有两个途径：一是呼吸道感染；二是血源感染。各种年龄均可发病，50岁以上的中老年人多见。
2.临床表现葡萄球菌肺炎起病急骤，呼吸道感染者常有感冒症状为先导，如发热、头痛、全身酸痛和干咳，继之高热、寒战、胸痛，脓性痰量多，带血丝或呈粉红色乳状。病情严重者可早期出现周围循环衰竭。原有慢性肺部病变者，起病缓慢，有咳嗽、高热和脓痰。
查体可闻散在的细湿性哕音。辅助检查可见白细胞计数增多（可达50×109/L），中性粒细胞比例增加，且有中毒颗粒及核左移现象。肺部X线显示肺段或肺叶实变，或呈小叶样浸润，其中有单个或多发液气囊腔。X线阴影的易变性，表现为一处炎性浸润消失，而在另一处出现新的病灶，为金黄色葡萄球菌肺炎的另一重要特征。
（三）克雷白杆菌肺炎
克雷白杆菌肺炎也称肺炎杆菌肺炎，是由肺炎克雷白杆菌引起的急性肺部炎症，多见于老年、营养不良、慢性酒精中毒、慢性支气管炎、肺部疾病及全身衰竭的患者。该菌耐药菌株不断增加，且产生超广谱酶，成为防治中的难点。
1.病因肺炎克白杆菌为革兰阴性杆菌，有荚膜，常存在人体上呼吸道及肠道。当机体抵抗力降低时，经呼吸道进入肺内引起大叶或小叶融合性实变，以上叶较多见。病灶中渗出液黏稠而重，致使叶间隙下坠。细菌具有荚膜，在肺泡内生长繁殖时引起组织坏死、液化，形成单个或多发性脓肿。若病变累及胸膜或心包，可引起脓胸及心包积液、积脓。病灶的纤维组织增生活跃，易于机化，形成纤维素性胸膜炎，可早期发生粘连。
2.临床表现本病多见于老年男性，起病急，高热、咳嗽、胸痛，可有发绀、气急、心悸、畏寒，痰多呈黏稠脓性，带血或呈砖红色胶冻状。胸部X线常呈多样性，肺叶或小叶实变，有多发性蜂窝状肺脓肿，叶间隙下坠。该病预后效果差，病死率高。老年体弱患者有急性肺炎、中毒症状严重，且有血性黏稠痰者，应考虑本病。
……

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