Listen to the whole process of good sen how to manage Parkinson's disease patients throughout the process? Listen to the experts of West China Hospital!

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Multidisciplinary collaboration helps parkinson's disease patients manage

Parkinson's disease (PD) is a common neurodegenerative disease that begins insidiously and progresses slowly, and is clinically characterized by resting tremor, bradykinesia, rigidity, and postural gait disorders

As a province with a large population, Sichuan's disease cannot be ignored

The original intention of establishing a "one-stop clinic center"

It's all about the patient

As a neurodegenerative disease, Parkinson's disease symptoms are progressively worse, and both motor and non-motor symptoms seriously affect the patient's quality of life

Compared with the previous medical services, MDT has an incomparable advantage

The treatment of Parkinson's disease is a long-term process

All-round, multi-angle

All disciplines are working together to escort PD patients

Parkinson's disease has an insidious onset and requires early identification and early intervention
.

"As the main body of the treatment process of Parkinson's disease, neurologists will develop personalized diagnosis and treatment plans
for the individual characteristics of each patient.

Doctors should adjust the treatment plan at any time according to the severity of each patient, the age of onset, employment, physical feedback and other factors
.

Professor Shang Huifang pointed out
.

At the same time, Professor Shang Huifang also introduced in detail the surgical treatment of Parkinson's disease, the efficacy of drugs in the late stage of the disease is reduced, and after the motor complications that cannot be solved by adjusting the drugs, the neurologist will recommend that patients evaluate whether DBS
can be performed.

Professor Shang Huifang said, "First of all, the patient is evaluated in a preoperative comprehensive manner, mainly to assess the severity of the patient's motor symptoms and non-motor symptoms, and then the neurologist and the rehabilitation doctor discuss together to select which nuclei in the brain to intervene
.
"
After the operation, the patient was instructed to continue to take the drug, adjust the drug regimen in regular follow-up, and adjust the parameters
in the neurology and surgery combined with the program-controlled outpatient clinic.

”

Drug therapy is the most important treatment in the entire treatment process of Parkinson's
disease.

As the deputy director of the Department of Pharmacy, Professor Wu Fengbo said, "In the one-stop diagnosis and treatment center for Parkinson's disease, there is a great emphasis on precision medicine and personalized medicine
.

The goal is to accurately diagnose patients through modern theories and methods, and at the same time, at the right time, give the right drugs and use reasonable doses to achieve clinically individualized drug therapy
.

Most patients will fully benefit from drug treatment, and pharmacists need to constantly update their knowledge base and learn the latest guidelines in the one-stop treatment center to ensure that they can provide a more professional medication recommendation
for clinical diagnosis and treatment.

”

Professor Wu Fengbo also pointed out that "in the process of patient medication, it is necessary to carry out pharmacological monitoring of patients, record the patient's daily medication, record the type of medication, the time and dosage of medication, pay attention to the change of symptoms after taking the drug, but also need to record the common orthostatic hypotension, constipation, gastrointestinal and other adverse reactions of patients, and actively communicate with clinicians to clarify the patient's situation, targeted treatment of adverse reactions, or appropriate adjustment of medication plan
.
"
”

In addition, although the continuous improvement of the drug treatment and surgical treatment system has brought great benefits to most patients, there is another important link that is often overlooked, that is, rehabilitation
.

In this regard, Professor Li Cheng of the Rehabilitation Medicine Center said, "The purpose of rehabilitation treatment is to improve various functional disorders, improve functional independence and overall adaptability on the basis of drug treatment and surgical treatment, minimize secondary disorders and various complications, maximize the delay of disease progression, improve the ability to perform activities of daily living, and ultimately improve the quality of life of
Parkinson's disease patients.
"
”

Rehabilitation treatment should vary from person to person, and individual rehabilitation goals and targeted rehabilitation measures should be formulated according to the severity of the patient's condition and the types and extent of various functional disorders
present.

For early patients, self-management and promotion of a proactive lifestyle should be the mainstay, and for advanced patients, it is mainly to maintain the function of important organs such as the heart and lungs, while avoiding complications
such as pressure ulcers, joint contractures and venous thrombosis.

In addition, Professor Li Cheng also introduced in detail how Parkinson's patients can carry out home rehabilitation training
with the help of their families during the epidemic.

Whether in the early or late stages, people with Parkinson's disease can be affected
in all aspects of their daily lives because of motor or non-motor symptoms.

To this end, Professor Chen Dezhi, the nurse in charge, introduced the meticulous care of Parkinson's disease patients from the aspects of eating
, wearing, living and traveling.

In terms of diet, since the disease can damage the swallowing function, it is recommended that all patients with Parkinson's disease measure their weight regularly to ensure adequate nutritional intake, while paying attention to the type of food and the choice
of softness and hardness.

In terms of clothing, you need to pay special attention to fall prevention, and try to choose safety-oriented clothing
.

In terms of living, the toilet is installed with a toilet with a suitable height, and the anti-slip mat is installed as a sports handrail to avoid sharp turns
.

In terms of travel, you can choose an infrared crutch, avoid greeting the patient from behind when walking, and avoid sudden turns
due to balance dysfunction.

When a patient has emotional problems, as a family member, it is necessary to understand the patient, enlighten the patient, conduct psychological counseling for the patient, and encourage the patient to actively participate in social activities
.

Grow from "small buds" to "towering trees"

The future of the PD One-Stop Clinic is exciting

In October 2018, the Neurodegenerative Diseases Professional Group of the Department of Neurology of West China Hospital took the lead in establishing the Western Parkinson's Disease Prevention and Treatment Alliance covering 16 teaching hospitals in 9 provinces and cities in the west, and built a green channel for the rapid referral of difficult neurodegenerative diseases from grass-roots hospitals to West China Hospital, becoming the first neurogenetic degenerative disease and movement disorder diagnosis and treatment center
in the entire southwest region.

On April 11, 2021, the Parkinson's One-Stop Advanced Diagnosis and Treatment Center was officially established
.

Professor Shang Huifang said, "Through the MDT model, it is possible to achieve all-round disease management, so that patients can benefit the most, and at the same time, medical resources
can be saved.

This medical model needs to be constantly explored and improved
.

Through the continuous improvement of this model, the diagnosis and treatment capacity is further improved, and at the same time, other counterparts in the western region are leading the development
of a multidisciplinary cooperation model.

Constantly promote this MDT model to better serve the people
in the western region.

I am very much looking forward to the further expansion and improvement of the one-stop treatment center and exert greater strength
.

”

[1] Zhang Z X, Chen H, Chen S D, et al.
Chinese culture permeation in the treatment of Parkinson disease: a cross-sectional study in four regions of China[J].
BMC Res Notes, 2014,7:65.

[2] Warren O C, Kieburtz K, Rascol O, et al.
Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson's disease[J].
Mov Disord, 2013,28(8):1064-1071.