Appetite loss and fatigue all over the body - be careful of interstitial pneumonia
64-year-old grandmother Zhao suffered from swollen and painful joints of the proximal fingers and metacarpophalangeal joints of both hands more than 20 years ago. She diagnosed "rheumatoid arthritis" . More than 20 years ago, she went to a private clinic for massage, massage, plaster, small needle knife, oral hormones and painkillers. In the past two years, the swelling and pain in the joints of the joints of the joints of the joints of the joints of the hands were aggravated by oral immunotherapy. She consciously reduced the swelling and pain in the proximal, palm, fingers, wrists, and both ankles were relieved compared with the previous period, but she had recently experienced decreased appetite and fatigue. She was admitted to the hospital for "cause of fatigue to be checked".
admitted to the hospital to complete chest CT and other examinations. It was found that the patient's lungs were almost white, and he clearly diagnosed severe pneumonia, interstitial pneumonia type I respiratory failure , and his condition was critical.
With the careful adjustment of a series of treatment plans and the joint cooperation of medical staff in the department, Grandma Zhao's condition was gradually controlled, and various indicators showed a trend of improvement. The team actively attaches importance to issues such as increasing nutrition and immunity. After effective treatment and nursing, the patient's fatigue symptoms improved significantly after 8 days, and various indicators gradually improved. He was discharged from the hospital after consolidation of treatment.
According to Xue Hua, director of the ward of the Department of Geriatric Diseases, rheumatoid arthritis is an autoimmune disease . The drugs taken by rheumatoid patients often inhibit the abnormal expression of the patient's own immune system, causing the patient's own immune mechanism to be affected to a certain extent. If the patient is infected by bacteria at this time, pneumonia is likely to develop.
The elderly have no respiratory symptoms and do not have fever. How can we consider that it may be pneumonia?
"Many elderly people think that fever is sick. In fact, the temperature is only one of the symptoms of the disease. You cannot only focus on the temperature, but also on other situations." Director Xue Hua said that the onset of pneumonia in the elderly often has one of the following two manifestations:
The most common manifestations is the gradual deterioration of the patient's health status, including loss of appetite, Anorexia, burnout, urinary incontinence, dizziness, acute confusion, weight loss, and mental depression, these manifestations are not specific for pneumonia;
Another manifestations are the sudden worsening or slow recovery of underlying diseases, such as heart failure still recurs or worsens in appropriate treatment. When the pathogen of pneumonia is effectively controlled, other conditions of pathogenic bacteria will occur again, so the occurrence time and duration of pneumonia are difficult to determine.
The elderly should be vigilant and seek medical treatment in a timely manner.
Several major reasons why the elderly are prone to pneumonia
1. Lung structure and physiological functions deteriorate with ageing: The cough and swallowing reflexes of the elderly are deteriorated, the motor function of respiratory cilia is deteriorated, the number of alveolar macrophages and T cells is reduced, and the local and systemic immune function is reduced, resulting in the reduction of the ability of the elderly to remove pathogens. At the same time, as we grow older, the surface area of alveolar gradually decreases, and lung function decreases accordingly, resulting in respiratory failure in the elderly after lung infection in ;
2. Combined underlying diseases: Combined underlying diseases is an important risk factor for the elderly to suffer from pneumonia, and its importance even exceeds the age factor itself. Several studies have confirmed that chronic obstructive pulmonary disease , congestive heart failure, cerebrovascular disease, diabetes , and chronic kidney disease are important risk factors for lung infection.
3. Special types of pneumonia in the elderly - Inhaled pneumonia : The elderly are at high risk for inhaled pneumonia. Generally, inhaled pneumonia is bacterial pneumonia , and viral pneumonia is less. The most common one is streptococci infection with , and others such as anaerobic bacteria , etc.
- The first reason is choking and coughing when eating, dysphagia . Food that should have entered the esophagus enters the airway due to coughing and choking, and then goes to the lungs, which can easily cause inhalation pneumonia.
- The second reason is that some elderly people have poor digestive ability and do not choke after eating food, but they are prone to reflux, which can lead to inhalation pneumonia. If the elderly have poor digestive ability or have gastroesophageal reflux , it is recommended to raise the pillow slightly when sleeping at night.
- The third reason is that the oral cavity is an important source of bacteria that causes lung infection. For example, when sleeping at night, the elderly are choked by saliva. Because the elderly's swallowing ability is weakened, they will not have reflex coughs, and these bacteria may enter the airway.
Expert Profile
Xuehua
Chief Physician
Director of the Second Ward of the Geriatric Department of Xianyang First People's Hospital
Currently in the Xianyang Branch of Shaanxi Province of Respiratory and Tuberculosis Branch of the Chinese Medical Association, member of Shaanxi Branch of the Chinese Medical Association, member of Shaanxi Branch of the Chinese Anti-Cancer Association, member of the First Youth Committee of the Lung Cancer Professional Committee of the Shaanxi Anti-Cancer Association, member of the Standing Committee of the Respiratory Diseases Professional Committee of the Shaanxi Health Association, member of the General Medicine Professional Committee of the Shaanxi Health Association, member of the Chest Wall Surgery Professional Committee of the Shaanxi Health Association, and member of the Xianyang Respiratory Disease Diagnosis and Treatment Quality Control Center.
is mainly engaged in clinical diagnosis and treatment of respiratory medicine and intensive care units. Proficient in the modern technology of diagnosis, treatment, critical surveillance and treatment of various respiratory diseases. I have accumulated rich experience in the diagnosis of respiratory problems and the treatment of critical illnesses, and have profound attainments in the prevention and treatment of asthma , COPD and respiratory infection . The main research directions are the molecular biology and intervention of pulmonary hypertension ; the molecular basis and treatment of bronchial asthma airway remodeling. More than 10 academic papers have been published in domestic and foreign academic journals, including 2 SCIs, and won 2 third prizes of Xianyang Science and Technology Progress Award.
Geria Department 2 Ward
Geria Department 12th floor in the inpatient building of Ward 2nd in the Geria Department 2, there are 5 doctors, 3 associate chief physicians, and 2 attending physicians, all with postgraduate degree or above. There are 13 nursing staff and 19 beds open. The department has a medical team with superb medical technology and rich nursing experience. It has accumulated rich clinical experience in the diagnosis and treatment of common and difficult diseases in the elderly, nursing and medical care, and has good efficacy in cardiovascular system diseases, cerebrovascular diseases, respiratory diseases, and multi-organ system diseases in the elderly. All medical staff in the department adhere to the three-minded principles of "love, filial piety and responsibility", provide high-quality medical services to doctors and patients, and strive to create a comfortable medical environment for the elderly and the families to rest assured.
Diagnosis and treatment scope:
1, coronary heart disease , hypertension , acute and chronic cardiovascular exhaustion, especially various cardiovascular system diseases such as hypertension and critical illness and chronic heart failure.
2. Cerebral arteriosclerosis, cerebral infarction , cerebral hemorrhage , senile dementia , vascular dementia and other senile cerebrovascular diseases.
3. Treatment and nursing after tracheostomy and inhalation pneumonia, chronic obstructive pulmonary disease, heart disease, acute and chronic respiratory failure, bronchial asthma, treatment and nursing after tracheostomy.
IV. Metabolic syndrome, Diabetes in the elderly and its acute and chronic complications, hyperthyroidism and hypothyroidism and other endocrine and metabolic diseases.
5, reflux esophagitis , peptic ulcer , senile constipation and other digestive system diseases.
6. Multi-organ system diseases such as multi-organ system in the elderly, bedsores in the elderly, hospice in the elderly, hospice in the elderly, etc.
Source: Xianyang First People's Hospital
Editor: ZMY
