合并症患者的处理特点。从一个家庭医生的角度来看这个问题

None Вовк К.В., None Власенко О.О., None Шерстюк Л.Л., None Шумова Н.В., None Кратенко Г.С., None Резніченко О.Г.
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引用次数: 0

摘要

在当今的现实中,家庭医生越来越多地面临着合并症患者。此外,随着人们预期寿命的增加,这个问题变得越来越大,而且种类繁多。合并症可降低患者对治疗的依从性,包括由于使用多组分治疗方案,这反过来又导致治疗有效性的降低。在这方面,有必要对药物相互作用最小的治疗方案进行个体化选择。这就对家庭医生提出了一定的条件,要求他们不断改进对所有治疗专业的最新方案和治疗方案的研究。这篇文章提出了一个临床病例的合并症患者的病理心血管和消化系统。诊断和治疗算法的选择是基于现代乌克兰和国外的建议。重点放在心脏和胃肠危险因素的分层,以及根据临床动态选择质子泵抑制剂的策略。通过一个具体的临床实例,展示了一种算法,在考虑现有方法和建议的情况下,在不同的病理发展情况下选择对合并症患者的诊断和治疗。研究表明,合并症的问题给医生留下了许多问题,往往需要主治医生的广泛知识,有时还需要多学科的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CHARACTERISTICS OF THE MANAGEMENT OF A COMORBID PATIENT. LOOKING AT THE PROBLEM FROM THE EYES OF A FAMILY DOCTOR
In the realities of today, family doctors are increasingly faced with comorbid patients. Moreover, with an increase in the life expectancy of people, this problem becomes large and infinitely diverse. Comorbidity can reduce patient adherence to treatment, including due to the use of multicomponent therapy regimens, which, in turn, leads to a decrease in the effectiveness of the treatment. In this regard, there is a need for individual selection of therapeutic regimens with minimal drug interactions. This imposes certain conditions on the family doctor in terms of continuous improvement in the study of the latest protocols and treatment regimens of all therapeutic specialties. This article presents a clinical case of a comorbid patient with pathology of the cardiovascular and digestive systems. The choice of a diagnostic and treatment algorithm was based on modern Ukrainian and foreign recommendations. Emphasis is placed on the stratification of both cardiac and gastroenterological risk factors, and the strategy for choosing proton pump inhibitors depending on the clinical dynamics. On a specific clinical example, an algorithm for choosing the diagnosis and treatment of a comorbid patient under different scenarios of pathology development, taking into account existing approaches and recommendations, is demonstrated. It has been shown that the problem of comorbidity leaves many questions for practitioners and often requires broad knowledge from the attending physician, and sometimes a multidisciplinary approach.
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来源期刊
Pharmacy World & Science
Pharmacy World & Science 医学-药学
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