Table Of Content生命科学名著
Brocklehurst 老年医学与老年学
（原书第八版）
（下册）
Brocklehurst’s Textbook of Geriatric Medicine and
Gerontology
(Eighth Edition)
主 编 〔美〕Howard M. Fillit 〔加〕Kenneth Rockwood 〔英〕John Young
主 译 白小涓 李小鹰
60mm
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生命科学名著
Brocklehurst 老年医学与老年学
（原书第八版）
（下册）
Brocklehurst’s Textbook of Geriatric Medicine and
Gerontology
(Eighth Edition)
主 编 〔美〕Howard M. Fillit 〔加〕Kenneth Rockwood 〔英〕John Young
主 译 白小涓 李小鹰
北 京
1
图宇: 01-2017-4854 号
内容简介
{ Brocklehurst老年医学与老年学》是老年医学的经典著作，初版于 1973年，
由 JohnBrocklehurst主编，故此得名。 本译著为英文原书的第八版，是2017年出
版的最新版本。 全书分为4个部分:老年学、老年医学、 问题导向的老年医学、
医疗卫生健康系统和老年医学，共 132章。本书由国际资深老年医学专家倾力完
成，全面反映老年医学和老年学的基本理论和最新进展。 本书贯穿大量治疗手段
和指南，某些特殊老年相关疾病的论述中包含了统计表格及工作流程图，其中更
强调对衰弱的重视，各个章节均关注了不同领域与衰弱的联系和拓展，新增内容
包括老年医学技术、急诊和院前医疗、HIV和衰老，以及老年患者的个体化治疗、
远程医疗和环境构建。每章结尾处的"关键点"简明扼要地概括本章重点。
本书不似才从事老年学和老年医学工作的临床、教学和科研人员及研究生提
供重要指导，也非常适用于面对老年患者的其他专科医护人员、社区工作者及其
他老年社会工作者。
图书在版编目 (CIP) 数据
Brocklehurst老年医学与老年学:原书第8版:全2册/ (美) H.M. 菲利
特(Howard M. Fillit) , (加) K. 罗克伍德(Kenneth Rockwood) , (英)
J. 扬(JohnYoung)主编;臼小涓，李小鹰主译 北京:科学出版社，2020.11
(生命科学名著)
书名原文: Brocklehurst's Te汉tbook of Geriatric Medicine and Gerontology
(Eighth Edition)
ISBN 978-7-03-059837-0
1. ①B… 11. ①H… ②K…③J…④白… ⑤李… III. ①老年病学
N. ( R592
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责任编辑:岳浸宇 /责任校对:严 娜
责任印制:吴兆东 / 封面设计:刘新新
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ELSEVIER
Elsevier (Singapore) Pte Ltd.
3 Killiney Road, #08-01 Winsland House I, Singapore 239519
Tel: (65) 6349-0200; Fax: (65) 6733-1817
Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 8E
Copyright © 2017 by Elsevier, Ltd. All rights reserved.
Chapter 7 “Geroscience”: Felipe Sierra is in Public domain.
ISBN: 978-0-7020-6185-1
Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 8E by Howard M. Fillit, Kenneth Rockwood and
John Young was undertaken by China Science Publishing & Media Ltd. (Science Press) and is published by arrangement
with Elsevier (Singapore) Pte Ltd.
Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 8E by Howard M. Fillit, Kenneth Rockwood and
John Young由中国科技出版传媒股份有限公司（科学出版社）进行翻译，并根据中国科技出版传媒股份有限公司（科
学出版社）与爱思唯尔（新加坡）私人有限公司的协议约定出版。
《Brocklehurst老年医学与老年学》（原书第8版）（白小涓，李小鹰主译）
ISBN: 978-7-03-059837-0
Copyright © 2018 by Elsevier (Singapore) Pte Ltd. and China Science Publishing & Media Ltd. (Science Press).
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from Elsevier (Singapore) Pte Ltd. Details on how to seek permission, further information about the
Elsevier’s permissions policies and arrangements with organizations such as the Copyright Clearance Center and the
Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by Elsevier (Singapore) Pte
Ltd. and China Science Publishing & Media Ltd. (Science Press) (other than as may be noted herein).
注 意
本译本由Elsevier (Singapore) Pte Ltd. 和科学出版社完成。相关从业及研究人员必须凭借其自身经验和知识对文
中描述的信息数据、方法策略、搭配组合、实验操作进行评估和使用。由于医学科学发展迅速，临床诊断和给药
剂量尤其需要经过独立验证。在法律允许的最大范围内，爱思唯尔、译文的原文作者、原文编辑及原文内容提供
者均不对译文或因产品责任、疏忽或其他操作造成的人身及/或财产伤害及/或损失承担责任，亦不对由于使用文
中提到的方法、产品、说明或思想而导致的人身及/或财产伤害及/或损失承担责任。
Printed in China by China Science Publishing & Media Ltd. (Science Press) under special arrangement with Elsevier
(Singapore) Pte Ltd. This edition is authorized for sale in the People’s Republic of China only, excluding Hong Kong SAR,
Macau SAR and Taiwan. Unauthorized export of this edition is a violation of the contract.
3
目 录
（上 册）
第1部分 老 年 学
对未来的展望 ··········································· 42
A篇 老年学介绍
第8章 衰老的遗传机制 ·································· 44
第1章 引言：衰老、衰弱和老年医学 ··················· 2 介绍 ······················································· 44
第2章 衰老的流行病学 ···································· 4 线粒体遗传学、氧化应激与衰老 ···················· 44
介绍 ························································· 4 染色体基因突变与衰老 ······························· 45
健康衰老 ··················································· 6 致谢 ······················································· 47
结论 ······················································· 10 第9章 衰老的细胞机制 ·································· 48
第3章 老年的未来 ········································ 11 介绍 ······················································· 48
炎症 ······················································· 48
改变人类寿命 ··········································· 11
细胞衰老 ················································· 49
生物医学正在改变衰老的进程 ······················· 12
大分子功能失调 ········································ 50
老年医学的未来 ········································ 15
祖细胞和干细胞功能障碍 ···························· 51
衰弱的未来研究 ········································ 15
干预方法 ················································· 52
致谢 ······················································· 15
第10章 早衰综合征：儿童早老症——洞悉正常
第4章 成功老龄化：百岁老人 ·························· 17
衰老 ················································ 54
百岁老人的人口学 ····································· 17
HGPS：疾病概述 ······································· 54
超高龄老人的报告 ····································· 17 分子遗传学和细胞生物学 ···························· 55
性别差异 ················································· 17 衰老与HGPS ············································ 58
成功老龄化 ·············································· 17 临床诊疗与护理 ········································ 60
表型相关性 ·············································· 19 致谢 ······················································· 60
家族相关性和遗传 ····································· 19 第11章 衰老的神经生物学：自由基应激
基因决定因素 ··········································· 20 及代谢途径 ······································· 62
全基因组测序 ··········································· 21 I. 衰老神经生物学中的亚硝化应激与
氧化应激 ··············································· 62
未来研究方向 ··········································· 21
神经退行性疾病中的蛋白质错误折叠 ·············· 63
B篇 老年生物学
活性氧和活性氮的生成 ······························· 63
第5章 进化学说和衰老机制 ····························· 24 蛋白质S-亚硝化与神经元细胞死亡 ················ 64
衰老的进化论 ··········································· 24 Ⅱ. 胰岛素代谢信号转导对衰老及神经
寿命遗传学 ·············································· 25 退行性疾病的影响 ··································· 67
人类早衰综合征 ········································ 26 胰岛素/胰岛素样生长因子信号转导通路
进化论的验证 ··········································· 26 和机体衰老 ··········································· 67
结论 ······················································· 27 其他代谢长寿通路在神经退行性改变中的作用 ·· 68
第6章 老年人群研究的方法学挑战 ···················· 29 致谢 ······················································· 69
介绍 ······················································· 29 第12章 衰老环境下的稳态应变和稳态应变超
结论 ······················································· 35 负荷 ················································ 71
第7章 老年科学 ··········································· 37 介绍 ······················································· 71
介绍 ······················································· 37 应激、稳态应变、稳态应变负荷和超负荷
衰老生物学研究的主要核心 ·························· 37 的定义 ················································· 71
老年科学 ················································· 40 应激反应的两面性——保护与损伤 ················· 71
i
目 录
稳态应变负荷的检测 ·································· 72 骨骼 ······················································ 124
“压力负荷”——尤其是睡眠不足及其后果 ····· 73 软组织 ··················································· 126
大脑在应对压力中的关键作用 ······················· 73 骨与关节衰老的影响 ································· 126
应用于人体大脑 ········································ 73 未来 ······················································ 127
积极的情感、自尊和社会支持 ······················· 74 第21章 衰老与胃肠道系统 ····························· 128
不良早期生活经历的有害作用 ······················· 74 衰老的正常生理 ······································· 128
干预 ······················································· 75 成人胃肠疾病异常表现 ······························ 130
结论 ······················································· 75 老年人独特的肠胃问题 ······························ 131
第13章 衰老的神经内分泌学 ··························· 77 总结 ······················································ 132
女性神经内分泌衰老 ·································· 77 第22章 泌尿系统的衰老 ································ 134
男性神经内分泌衰老 ·································· 79 介绍 ······················································ 134
神经内分泌衰老和脑代谢：对神经退行性疾病 上尿路：肾和输尿管 ································· 134
的影响 ················································· 81 下尿路：膀胱和出口 ································· 135
致谢 ······················································· 82 第23章 内分泌系统的衰老 ····························· 139
历史综述 ················································ 139
C篇 老 年 医 学
激素改变 ················································ 140
第14章 衰弱：总体观点 ································· 84
结论 ······················································ 144
衰弱 ······················································· 84
第24章 衰老与血液 ······································ 146
衰弱的治疗 ·············································· 87
介绍 ······················································ 146
医疗保健系统中的衰弱································ 88
血细胞形成场所：骨髓和基质······················ 146
总结 ······················································· 89
造血干细胞 ············································· 147
第15章 衰老和损伤累积的临床意义 ·················· 90
淋巴组织的形成 ······································· 151
介绍 ······················································· 90
衰老与血细胞 ·········································· 151
基于老年综合评估的衰弱指数的发展 ·············· 93
免疫衰老和癌症 ······································· 152
第16章 衰老对心血管系统的影响 ····················· 98
第25章 衰老与皮肤 ······································ 154
衰老相关的血管结构改变 ····························· 98
介绍 ······················································ 154
衰老过程中的内皮功能································ 99
内源性衰老 ············································· 154
衰老动脉的硬化 ········································ 99
外源性衰老 ············································· 155
衰老过程对心脏结构的影响 ························· 100
表皮 ······················································ 156
静息状态下衰老心脏的心肌功能 ··················· 100
真皮 ······················································ 157
衰老心脏对运动的反应······························· 101
皮肤附属器 ············································· 159
总结 ······················································ 102
衰老的机制 ············································· 160
第17章 呼吸系统年龄相关性变化 ···················· 103
治疗和预防 ············································· 161
呼吸功能检测 ·········································· 103
结论 ······················································ 161
呼吸系统的衰老相关变化 ···························· 103
第26章 衰老的药理学 ··································· 162
第18章 老年人神经系统症状 ·························· 107
药物使用的流行病学 ································· 162
精神状态 ················································ 107
药代动力学改变 ······································· 163
颅神经功能 ············································· 108
药效学改变 ············································· 165
运动功能 ················································ 108
药物敏感性的改变 ···································· 165
结论性评价 ············································· 110
药物间相互作用 ······································· 165
致谢 ······················································ 111
总结 ······················································ 168
第19章 结缔组织与衰老 ································ 112
第27章 抗衰老药物 ······································ 170
结缔组织的特性 ······································· 112
抗衰老药物的简明历史 ······························ 170
衰老与结缔组织的性质······························· 117
青春的荷尔蒙之泉 ···································· 172
总结 ······················································ 121
抗氧化剂与衰老 ······································· 173
第20章 骨与关节的衰老 ································ 122
光老化 ··················································· 173
关节软骨 ················································ 122
其他原因 ················································ 174
ii
目 录
结论 ······················································ 174 我们如何研究社会因素对健康的影响？ ·········· 191
成功老龄化 ············································· 192
D篇 心理和社会老年学
与健康的关系 ·········································· 192
第28章 正常认知性衰老 ································ 176
社会因素影响健康的机制 ··························· 194
智力与衰老 ············································· 176
衰弱、排斥和“代理人的沉默” ··················· 195
与认知功能相关的生活方式因素 ··················· 180
政策的影响和干预的潜力 ··························· 195
健康因素 ················································ 181
结论 ······················································ 196
结论 ······················································ 182
第31章 衰老人格与自我：多样性和健康问题 ····· 197
第29章 社会老年学 ······································ 183
人格阶段和自我发展 ································· 197
介绍 ······················································ 183
人格的社会认知方法 ································· 200
老年人的“问题” ···································· 183
总结和未来方向 ······································· 201
理论方法：功能主义与结构功能主义的关系 ···· 184
第32章 生产性老龄化 ··································· 204
增加预期寿命和降低发病率：一个黄金时期 ···· 184
介绍 ······················································ 204
机遇时代：成功老龄化和第三年龄段 ············· 185
美国生产性老龄化的描述 ··························· 204
晚年生活中的不平等：连续性和影响 ············· 186
老年人从事生产活动的前提 ························ 206
结论性评价 ············································· 187
老年人从事生产活动的重要性······················ 207
第30章 老年人社会脆弱性 ····························· 189
总结 ······················································ 208
背景和定义 ············································· 189
第2部分 老 年 医 学
A篇 老年患者的评估 诊疗及护理模式 ······································· 243
教育和培训 ············································· 243
第33章 疾病在老年人中的表现 ······················· 211
未来的研究领域 ······································· 243
疾病在老年人中的非特异性临床表现 ············· 211
第38章 多维老年评估项目的结果评价 ·············· 245
常见疾病在老年人中的不典型表现 ················ 215
老年评估结果和生活质量的判定 ··················· 246
结论 ······················································ 217
标准化评估系统 ······································· 246
第34章 多维老年评估 ··································· 218
个体化结果评估和以患者为中心的诊疗
老年评估的简史 ······································· 218
及护理 ················································ 247
老年评估的组织结构和流程 ························· 219
结论 ······················································ 248
老年评估程序的有效性······························· 222
致谢 ······················································ 248
结论 ······················································ 223
附录 ······················································ 250
第35章 实验诊断学和老年医学：对于老年人
不仅仅是参考区间 ····························· 225 B篇 心血管系统
介绍 ······················································ 225
第39章 慢性心力衰竭 ··································· 270
结论 ······················································ 229
流行病学 ················································ 270
第36章 老年患者的社会评估 ·························· 230
病程与预后 ············································· 270
社会评估与老年综合评估的关系 ··················· 230
心衰的病因 ············································· 271
执行日常生活活动能力的功能 ······················ 230
病理生理学 ············································· 271
社会功能和评估工具的各个方面 ··················· 231
心衰的诊断 ············································· 272
社会支持与照顾者负担······························· 233
心衰的治疗 ············································· 274
社会评估中的文化因素······························· 234
衰弱、肌少症与心衰 ································· 278
第37章 衰弱老年人的麻醉及手术 ···················· 236
其他疾病的相互作用 ································· 279
介绍 ······················································ 236
结论 ······················································ 281
衰弱的老年手术患者 ································· 236
第40章 冠状动脉疾病的诊断和治疗 ················· 282
老年患者手术与麻醉的注意事项 ··················· 238
临床表现 ················································ 282
手术转归 ················································ 239
识别与未识别的心肌梗死 ··························· 282
老年患者和手术流程 ································· 239
诊断技术 ················································ 283
术中和术后注意事项 ································· 242
冠状动脉危险因素 ···································· 284
iii
目 录
稳定型心绞痛的治疗 ································· 286 肢体动脉疾病 ·········································· 355
急性冠脉综合征 ······································· 287 腹主动脉瘤 ············································· 357
第41章 衰弱老年心脏病患者诊疗及护理中的 颈动脉疾病 ············································· 359
实际问题 ········································· 292 慢性静脉功能不全 ···································· 360
介绍 ······················································ 292 第47章 老年人静脉血栓栓塞 ·························· 363
老年人的治疗决策：需要考虑年龄因素吗？ ···· 292 介绍 ······················································ 363
将衰弱评估纳入临床决策 ···························· 293 结论 ······················································ 367
结论 ······················································ 297
C篇 呼 吸 系 统
第42章 高血压病 ········································· 299
第48章 哮喘和慢性阻塞性肺疾病 ···················· 370
介绍 ······················································ 299
气流阻塞性疾病 ······································· 370
流行病学 ················································ 299
老年人的哮喘 ·········································· 370
发病机制 ················································ 301
老年人的慢性阻塞性肺疾病 ························ 375
高血压并发症 ·········································· 302
第49章 非阻塞性肺疾病和胸部肿瘤 ················· 381
诊断与评估 ············································· 303
呼吸系统感染 ·········································· 381
高血压的药物治疗 ···································· 305
流感 ······················································ 381
降低血压的方法 ······································· 308
肺炎 ······················································ 382
总结 ······················································ 310
结核 ······················································ 382
第43章 瓣膜性心脏病 ··································· 312
非结核分枝杆菌感染 ································· 384
主动脉瓣狭窄 ·········································· 312
支气管扩张症 ·········································· 384
主动脉瓣反流 ·········································· 319
胸腔积液 ················································ 384
二尖瓣环钙化 ·········································· 322
气胸 ······················································ 385
二尖瓣狭窄 ············································· 325
间质性肺疾病 ·········································· 385
急性二尖瓣反流 ······································· 326
特发性肺纤维化 ······································· 386
慢性二尖瓣反流 ······································· 326
药物介导的间质性肺疾病 ··························· 386
三尖瓣反流 ············································· 327
结缔组织病 ············································· 386
三尖瓣狭窄 ············································· 327
结节病 ··················································· 387
肺动脉瓣反流 ·········································· 328
肺血管炎 ················································ 387
第44章 心律失常 ········································· 330
超敏性肺炎 ············································· 387
室性心律失常 ·········································· 330
职业相关肺疾病 ······································· 387
心房颤动 ················································ 333
肺癌 ······················································ 387
血栓栓塞性脑卒中的危险因素 ······················ 337
非小细胞肺癌 ·········································· 388
心房扑动 ················································ 339
小细胞肺癌 ············································· 389
房性早搏 ················································ 339
恶性间皮瘤 ············································· 390
室上性心动过速 ······································· 339
加速性房室节律 ······································· 339 D篇 神 经 系 统
阵发性房性心动过速伴房室阻滞 ··················· 340 第50章 痴呆的分类 ······································ 393
多源性房性心动过速 ································· 340 综述 ······················································ 393
缓慢性心律失常 ······································· 340 目前分类的局限性 ···································· 393
第45章 晕厥 ··············································· 343 痴呆的定义 ············································· 394
介绍 ······················································ 343 危险因素 ················································ 394
直立性低血压 ·········································· 347 与其他疾病相关的痴呆 ······························ 395
血管迷走神经性晕厥 ································· 349 鉴别诊断的临床检查特征 ··························· 398
餐后低血压 ············································· 350 痴呆的实验室研究 ···································· 399
颈动脉窦综合征和颈动脉窦高敏症 ················ 351 总结 ······················································ 400
总结 ······················································ 354 第51章 神经心理学在痴呆诊断和治疗中的应用 ·· 401
第46章 血管外科 ········································· 355 介绍 ······················································ 401
介绍 ······················································ 355 神经心理学评估的指征 ······························ 401
iv
目 录
优化诊断标准以检测轻度损伤 ······················ 401 定义和病因 ············································· 457
临床访谈 ················································ 402 智力障碍的流行病学与衰老 ························ 458
痴呆诊断的筛查与简易认知评估 ··················· 402 智力障碍患者的生物学衰老：综合征
测试结果用于指导治疗方案及作为研究结局 与非综合征 ······································· 459
的判定指标 ·········································· 408 年龄相关疾病：综合征和非综合征模式 ·········· 459
老年人神经心理学评估面临的挑战 ················ 408 老年智力障碍患者的健康评估······················ 461
总结 ······················································ 408 交流沟通 ················································ 463
第52章 阿尔茨海默病 ··································· 410 健康促进 ················································ 463
疾病的病理与发病机制······························· 410 智力障碍和衰弱 ······································· 463
流行病学与遗传机制 ································· 411 第58章 癫痫 ··············································· 465
临床诊断标准 ·········································· 412 介绍 ······················································ 465
临床评价 ················································ 413 定义 ······················································ 465
治疗 ······················································ 418 流行病学 ················································ 465
致谢 ······················································ 419 分类 ······················································ 465
第53章 血管性认知障碍 ································ 421 癫痫发作 ················································ 467
历史综述和术语 ······································· 421 癫痫综合征 ············································· 468
流行病学 ················································ 421 诊断 ······················································ 468
病因和病理生理学 ···································· 422 鉴别诊断 ················································ 469
血管性认知障碍的分类······························· 425 其他考虑 ················································ 470
血管性和神经退行性疾病的重叠与相互影响 ···· 425 病因学 ··················································· 471
临床表现 ················································ 426 检查 ······················································ 472
诊断标准 ················································ 427 抗癫痫药物治疗 ······································· 472
神经精神症状 ·········································· 429 癫痫的影响 ············································· 475
神经病理学 ············································· 429 癫痫患者相关服务 ···································· 475
疾病进展 ················································ 430 研究领域 ················································ 475
预防 ······················································ 430 第59章 头痛与面部疼痛 ································ 477
治疗 ······················································ 430 介绍 ······················································ 477
第54章 额颞叶变性 ······································ 432 原发性头痛疾病 ······································· 477
介绍 ······················································ 432 面部神经痛 ············································· 481
流行病学 ················································ 432 持续特发性面部疼痛 ································· 483
临床表现 ················································ 432 颈部疾病引起的头痛 ································· 483
神经病理 ················································ 433 鼻窦疾病与口腔疾病 ································· 484
遗传学 ··················································· 434 血管性疾病与头痛 ···································· 484
诊断性检查 ············································· 435 颅内肿瘤 ················································ 486
治疗策略 ················································ 436 低脑脊液容量性头痛综合征 ························ 486
第55章 谵妄 ··············································· 438 药物诱发的头痛 ······································· 486
介绍 ······················································ 438 头痛与眼病 ············································· 487
谵妄与痴呆：病理生理学 ···························· 440 多方面原因导致的头痛 ······························ 487
未来的方向 ············································· 443 头痛的诊断方法 ······································· 488
第56章 老年精神疾病 ··································· 445 第60章 脑卒中：流行病学和病理机制 ·············· 490
介绍 ······················································ 445 脑卒中的流行病学 ···································· 490
老年人抑郁与焦虑 ···································· 445 脑卒中的预防 ·········································· 493
精神病性障碍 ·········································· 448 脑卒中的病理机制 ···································· 494
老年人的人格障碍 ···································· 453 第61章 脑卒中：临床表现、管理及服务体系 ····· 496
酒精相关精神障碍 ···································· 454 介绍 ······················································ 496
结论 ······················································ 456 定义 ······················································ 496
第57章 老年智力障碍 ··································· 457 脑卒中类型 ············································· 496
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目 录
脑卒中和短暂性脑缺血发作的临床表现 ·········· 497 外周神经病变 ·········································· 535
脑卒中的检查 ·········································· 498 神经性跛行与椎管狭窄 ······························ 537
脑卒中服务体系 ······································· 502 炎性肌病（肌炎） ···································· 537
第62章 脑卒中的长期照护 ····························· 504 包涵体肌炎 ············································· 539
脑卒中照护途径 ······································· 504 药物引起的肌痛和肌病 ······························ 539
长期康复 ················································ 504 内分泌和代谢性肌病 ································· 540
预测模型 ················································ 505 运动神经元病/肌萎缩侧索硬化 ····················· 541
脑卒中后并发症 ······································· 506 重症肌无力 ············································· 541
养老院居住者 ·········································· 507 第66章 颅内肿瘤 ········································· 545
脑卒中幸存者的家庭护理员 ························· 507 介绍 ······················································ 545
职业康复 ················································ 507 临床表现 ················································ 545
可能的服务模式 ······································· 507 诊断 ······················································ 546
第63章 自主神经系统疾病 ····························· 509 分类 ······················································ 546
自主神经系统生理学的基本概念 ··················· 509 治疗 ······················································ 548
测量自主神经功能的方法 ···························· 510 结论 ······················································ 549
衰老对于自主神经心血管控制各组分的影响 ···· 512 第67章 脊髓和神经根性疾病 ·························· 551
衰老影响自主神经对压力的反应 ··················· 514 颈神经根病和脊髓病 ································· 551
老年人自主神经系统疾病 ···························· 514 脊髓压迫 ················································ 553
直立性低血压的管理 ································· 518 脊髓血管病 ············································· 554
总结 ······················································ 520 脊髓损伤 ················································ 554
第64章 帕金森病及其他运动障碍 ···················· 522 佩吉特病 ················································ 555
强直综合征 ············································· 522 腰椎退行性疾病的神经系统并发症 ················ 555
帕金森病 ················································ 522 第68章 中枢神经系统感染 ····························· 558
多动性运动障碍 ······································· 529 细菌性脑膜炎 ·········································· 558
第65章 神经肌肉疾病 ··································· 531 局部病变、慢性脑膜炎和脑炎······················ 560
神经肌肉疾病患者的管理 ···························· 531
（下 册）
E篇 肌肉骨骼系统 关节周围骨折 ·········································· 588
假体周围骨折 ·········································· 589
第69章 老年人关节炎 ··································· 566
老年人骨折的预防 ···································· 590
介绍 ······················································ 566
骨折随访 ················································ 590
骨关节炎 ················································ 566
老年医学科-骨科的共同诊疗及护理 ··············· 590
痛风 ······················································ 571
结论 ······················································ 591
软骨钙化 ················································ 572
第72章 肌少症 ············································ 592
风湿性多肌痛/巨细胞性动脉炎 ····················· 573 可操作性定义 ·········································· 592
类风湿性关节炎 ······································· 574 流行病学 ················································ 593
脊柱关节病 ············································· 576 病因 ······················································ 593
第70章 代谢性骨病 ······································ 578 结局 ······················································ 595
介绍 ······················································ 578 治疗和干预 ············································· 596
骨质疏松 ················································ 578 结论 ······················································ 598
骨软化症 ················································ 583
F篇 胃 肠 病 学
佩吉特病 ················································ 584
第73章 胰腺 ··············································· 601
第71章 老年骨科学 ······································ 587
介绍 ······················································ 587 背景 ······················································ 601
骨质疏松 ················································ 587 胰腺肿瘤 ················································ 602
老年人创伤 ············································· 587 急性胰腺炎 ············································· 607
麻醉注意事项 ·········································· 588 慢性胰腺炎 ············································· 609
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