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    November 03

    风烛残年

    古人的比喻恰如其分:高龄称风烛残年!昨日寒潮南下,许多老人便似残烛灯光,为寒风熄灭。我原本不明白这个道理,昨日傍晚,妻和岳母匆匆坐车赶回福建,依然没能与外婆最后照面,老人慈祥形象时时浮于眼前,好是伤感。今日病房一85岁老人跟我讲,昨天突然背痛的厉害,晚上痛得睡不着,还上了五六趟厕所,小便量也很多,一个晚上没睡。老人的苦诉,忽然让我贯通,这就是风烛残年啊:烛的外焰炽热,而内焰却冷,何况是残烛,油膏将尽,稍遇外界风吹,便会熄灭。老人平常体表温度较高,外周循环充盈,血液充溢体表(年老,交感神经张力退行性降低,外周血管扩张),当气温骤然降低,寒冷刺激激发交感神经兴奋,引起外周血管收缩,大量体表循环的血液涌入中枢,心脏负荷急剧增加,心力不足,或有基础性疾病的老人,无法迅速调节这个变化,进而引起循环衰竭。昨日病房老人,夜间小便量骤然增多,正是机体自救的表现,利尿正可以迅速降低循环负荷,救治心衰,说明老人身体尚有自救功能。临床医生们都有这个经验,冬至夜值班是最不太平的,老人能度过冬至夜的,一般都能熬过春节,并不是冬至夜小鬼当道,而是老人的身体无法承受节气的变化。
    所以各位子女们,当父母步入衰年,在节气变化前一定要做好老人生活安排,像这个突然降温,一定要保暖,要尽可能提高居室温度。当我们也步入衰年的时候,也一定要注意顺势保养,以顺应节气的变动!

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