本文選題：輸血治療 + 慢性貧血��； 參考：《中國全科醫(yī)學》2017年26期

【摘要】：背景目前尚沒有專門針對老年慢性貧血患者的輸血治療指南。在法國,當全科醫(yī)生認為必須對此類患者采用輸血治療時,會聯(lián)系醫(yī)院的�？漆t(yī)生為患者安排輸血。方法研究對象為20名法國全科醫(yī)生。對每名全科醫(yī)生對輸血方式的態(tài)度進行半結構化訪談。每場訪談均被錄音、記錄、按主題歸納,然后,由2名研究者對其進行分析和總結,并將所記錄的評論進行分類。結果全科醫(yī)生為此類患者進行輸血治療的標準為血紅蛋白水平8 g/dl及合并心臟病。此外,一些老年病,如認知障礙或不能自理,也被視為需要輸血治療,這是由于患者的體質過于虛弱,或其他有限的治療方法會導致患者預期壽命減少。由于擔憂患者可能因貧血而導致的死亡,也促使全科醫(yī)生采取輸血治療。對于輸血治療,全科醫(yī)生聽取了患者家屬的意見,但并沒有常規(guī)聽取患者意見。�？漆t(yī)生也很少參與到為患者的輸血治療中。全科醫(yī)生對是否采取輸血治療存在矛盾:一方面輸血可對患者產生較好療效,但另一方面,由于療效短暫,輸血治療價值不大。結論為老年慢性貧血患者是否采取輸血治療需考慮多方因素,但全科醫(yī)生更傾向于獨自做出決策,有時會參考患者家屬意見。提前制定護理計劃能有助于患者參與治療決策。
[Abstract]:Background there are no guidelines for blood transfusion therapy for elderly patients with chronic anemia. In France, when a general practitioner deems it necessary to treat such patients with blood transfusions, they contact hospital specialists to arrange blood transfusions for patients. Methods Twenty French general practitioners were studied. A semi-structured interview was conducted on each GP's attitude towards blood transfusion. Each interview was recorded, summarized according to the topic, and then analyzed and summarized by two researchers, and the recorded comments were classified. Results the standard of blood transfusion for these patients was hemoglobin level 8 g/dl and heart disease. In addition, some geriatric diseases, such as cognitive impairment or inability to take care of themselves, are also considered to require blood transfusion treatment because patients are too weak or other limited treatments can lead to reduced life expectancy. Fears that patients may die from anaemia have also prompted general practitioners to take blood transfusions. For blood transfusion, the general practitioner listened to the patient's family, but did not routinely listen to the patient. Specialists are also rarely involved in the treatment of blood transfusions for patients. On the one hand, blood transfusion can produce better effect on patients, but on the other hand, because of the short curative effect, the value of blood transfusion treatment is not great. Conclusion in elderly patients with chronic anemia, many factors should be considered, but general practitioners tend to make decisions on their own, and sometimes refer to the opinions of the family members of the patients. Early care planning can help patients participate in treatment decisions.
【分類號】：R556

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