ผลของการสูงวัยต่อจมูกและโพรงอากาศข้างจมูก: สิ่งที่ทราบในปัจจุบันและการทบทวนวรรณกรรม
คำสำคัญ:
การสูงวัย; สูงอายุ; จมูก; การดมกลิ่น;จมูกผู้สูงวัย; จมูกอักเสบ; ไซนัสอักเสบบทคัดย่อ
ในช่วงทศวรรษที่ผ่านมา ปรากฏการณ์ของสังคมผู้สูงอายุได้กลายเป็นประเด็นหลักทั่วโลก รวมทั้งในประเทศไทย จุดประสงค์ของการทบทวนวรรณกรรมนี้เพื่อให้แพทย์ได้ทราบถึงความรู้ที่ทันสมัยในปัจจุบันเกี่ยวกับผลของการสูงวัยต่อจมูกและโพรงอากาศข้างจมูกในหลายๆ ด้าน ซึ่งการเปลี่ยนแปลงนี้สามารถพบได้ทั้งในผู้สูงอายุปกติและผู้สูงอายุที่เป็นโรคทางจมูก ความเสื่อมทางสรีรวิทยาของเยื่อบุจมูกในผู้สูงอายุก่อให้เกิดอาการคัดแน่นจมูก จมูกแห้ง มีสะเก็ดในจมูก น้ำมูกไหลลงคอ และกระแอมบ่อยๆ การเสื่อมถอยของระบบภูมิคุ้มกันทำให้ผู้สูงอายุมีแนวโน้มที่จะมีการติดเชื้อในจมูกได้ง่าย ซึ่งจะส่งเสริมทำให้มีการอักเสบในจมูกมากขึ้น นอกจากนี้ แพทย์ควรจะมีความตระหนักและระมัดระวังเกี่ยวกับการใช้ยาร่วมหลายขนาน (polypharmacy) ในผู้สูงอายุ เพื่อที่จะลดความเสี่ยงเกี่ยวกับอันตรกิริยาของยา (drug interaction) และผลข้างเคียง (side effect) ปัญหาการดมกลิ่นสามารถเกิดได้ทั้งในผู้สูงอายุปกติหรืออาจเป็นอาการนำของโรคทางระบบประสาทหลายโรค ความเข้าใจที่มากขึ้นเกี่ยวกับการเปลี่ยนแปลงของโพรงจมูกและไซนัสทั้งหมดนี้ จะนำไปสู่การวินิจฉัยและการดูแลรักษารวมถึงคุณภาพชีวิตของผู้ป่วยที่ดีขึ้น
เอกสารอ้างอิง
1. Situation of the Thai Elderly 2016. Foundation of Thai Gerontology Research and Development Institute, 2017.
2. Edelstein DR. Aging of the normal nose in adults. Laryngoscope 1996; 106(9 Pt 2): 1-25.
3. DelGaudio JM, Panella NJ. Presbynasalis. Int Forum Allergy Rhinol 2016; 6: 1083-7.
4. Agius AM, Smallman LA, Pahor AL. Age, smoking and nasal ciliary beat frequency. Clin Otolaryngol Allied Sci. 1998; 23: 227-30.
5. Jorissen M, Willems T, Van der Schueren B. Nasal ciliary beat frequency is age independent. Laryngoscope 1998; 108: 1042-7.
6. Ho JC, Chan KN, Hu WH, Lam WK, Zheng L, Tipoe GL, et al. The effect of aging on nasal mucociliary clearance, beat frequency, and ultrastructure of respiratory cilia. Am J Respir Crit Care Med 2001; 163: 983-8.
7. Busse PJ, Mathur SK. Age-related changes in immune function: effect on airway inflammation. J Allergy Clin Immunol 2010; 126: 690-9.
8. Proenca de Oliveira-Maul J, Barbosa de Carvalho H, Goto DM, Maia RM, Flo C, Barnabe V, et al. Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance. Chest 2013; 143: 1091-7.
9. Kao CH, Jiang RS, Wang SJ, Yeh SH. Influence of age, gender, and ethnicity on nasal mucociliary clearance function. Clin Nucl Med 1994; 19: 813-6.
10. Yadav J, Ranga RK, Singh A. Effects of aging on nasal mucociliary clearance. Clinical Rhinology 2011; 4: 1-3.
11. Sahin Yilmaz AA, Corey JP. Rhinitis in the elderly. Curr Allergy Asthma Rep 2006; 6: 125-31.
12. Riedler KL, Shokrani A, Markarian A, Fisher LM, Pepper JP. Age-related histologic and biochemical changes in auricular and septal cartilage. Laryngoscope 2017; 127: E399-407.
13. Lee JW, McHugh J, Kim JC, Baker SR, Moyer JS. Age-related histologic changes in human nasal cartilage. JAMA Facial Plast Surg 2013; 15: 256-62.
14. Lindemann J, Sannwald D, Wiesmiller K. Age-related changes in intranasal air conditioning in the elderly. Laryngoscope 2008;118: 1472-5.
15. Kalmovich LM, Elad D, Zaretsky U, Adunsky A, Chetrit A, Sadetzki S, et al. Endonasal geometry changes in elderly people: acoustic rhinometry measurements. J Gerontol A Biol Sci Med Sci 2005; 60: 396-8.
16. Baptist AP, Nyenhuis S. Rhinitis in the Elderly. Immunol Allergy Clin North Am 2016; 36: 343-57.
17. Loftus PA, Wise SK, Nieto D, Panella N, Aiken A, DelGaudio JM. Intranasal volume increases with age: Computed tomography volumetric analysis in adults. Laryngoscope 2016; 126: 2212-5.
18. Wrobel BB, Bien AG, Holbrook EH, Meyer GE, Bratney NA, Meza J, et al. Decreased nasal mucosal
sensitivity in older subjects. Am J Rhinol 2006; 20: 364-8.
19. Mathur SK. Allergy and asthma in the elderly. Semin Respir Crit Care Med 2010; 31: 587-95.
20. Gruver AL, Hudson LL, Sempowski GD. Immunosenescence of ageing. J Pathol 2007; 211: 144-56.
21. Milgrom H, Huang H. Allergic disorders at a venerable age: a mini-review. Gerontology. 2014; 60: 99-107.
22. Gubbels Bupp MR. Sex, the aging immune system, and chronic disease. Cell Immunol 2015; 294: 102-10.
23. Franceschi C, Bonafe M, Valensin S, Olivieri F, De Luca M, Ottaviani E, et al. Inflamm-aging. An evolutionary perspective on immunosenescence. Ann N Y Acad Sci 2000; 908: 244-54.
24. Mari D, Mannucci PM, Coppola R, Bottasso B, Bauer KA, Rosenberg RD. Hypercoagulability in centenarians: the paradox of successful aging. Blood. 1995; 85: 3144-9.
25. Mari D, Mannucci PM, Duca F, Bertolini S, Franceschi C. Mutant factor V (Arg506Gln) in healthy centenarians. Lancet 1996; 347(9007): 1044.
26. Wikby A, Nilsson BO, Forsey R, Thompson J, Strindhall J, Lofgren S, et al. The immune risk phenotype is associated with IL-6 in the terminal decline stage: findings from the Swedish NONA immune longitudinal study of very late life functioning. Mech Ageing Dev 2006; 127: 695-704.
27. Franceschi C, Olivieri F, Marchegiani F, Cardelli M, Cavallone L, Capri M, et al. Genes involved in immune response/inflammation, IGF1/insulin pathway and response to oxidative stress play a major role in the genetics of human longevity: the lesson of centenarians. Mech Ageing Dev 2005; 126: 351-61.
28. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med 1999; 340: 115-26.
29. Eikelenboom P, Veerhuis R. The importance of inflammatory mechanisms for the development of Alzheimer's disease. Exp Gerontol. 1999; 34: 453-61.
30. Enright PL, Kronmal RA, Higgins MW, Schenker MB, Haponik EF. Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study. Chest 1994; 106: 827-34.
31. Pinto JM, Jeswani S. Rhinitis in the geriatric population. Allergy Asthma Clin Immunol 2010; 6: 10.
32. Meltzer EO. The prevalence and medical and economic impact of allergic rhinitis in the United States. J Allergy Clin Immunol 1997; 99(6 Pt 2): S805-28.
33. Simola M, Holopainene E, Malmberg H. Changes in skin and nasal sensitivity to allergens and the course of rhinitis; a long-term follow-up study. Ann Allergy Asthma Immunol 1999; 82: 152-6.
34. Di Lorenzo G, Leto-Barone MS, La Piana S, Ditta V, Di Fede G, Rini GB. Clinical course of rhinitis and changes in vivo and in vitro of allergic parameters in elderly patients: a long-term follow-up study. Clin Exp Med 2013; 13: 67-73.
35. Derby L, Maier WC. Risk of cataract among users of intranasal corticosteroids. J Allergy Clin Immunol 2000; 105: 912-6.
36. Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol 2011; 127(1 Suppl): S1-55.
37. Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137: 358-68.
38. Reh DD, Mace J, Robinson JL, Smith TL. Impact of age on presentation of chronic rhinosinusitis and outcomes of endoscopic sinus surgery. Am J Rhinol 2007; 21: 207-13.
39. Cho SH, Kim DW, Lee SH, Kolliputi N, Hong SJ, Suh L, et al. Age-related increased prevalence of asthma and nasal polyps in chronic rhinosinusitis and its association with altered IL-6 trans-signaling. Am J Respir Cell Mol Biol 2015; 53: 601-6.
40. Cho SH, Hong SJ, Han B, Lee SH, Suh L, Norton J, et al. Age-related differences in the pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol 2012; 129: 858-60 .
41. Stevens WW, Lee RJ, Schleimer RP, Cohen NA. Chronic rhinosinusitis pathogenesis. J Allergy Clin Immunol 2015; 136: 1442-53.
42. Colclasure JC, Gross CW, Kountakis SE. Endoscopic sinus surgery in patients older than sixty. Otolaryngol Head Neck Surg 2004; 131: 946-9.
43. Ramadan HH, VanMetre R. Endoscopic sinus surgery in geriatric population. Am J Rhinol 2004; 18: 125-7.
44. Hummel T, Kobal G, Gudziol H, Mackay-Sim A. Normative data for the "Sniffin' Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 2007; 264: 237-43.
45. Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, et al. Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 2000; 257: 205-11.
46. Schubert CR, Fischer ME, Pinto AA, Klein BEK, Klein R, Cruickshanks KJ. Odor detection thresholds in a population of older adults. Laryngoscope 2017; 127: 1257-62.
47. Zhang C, Wang X. Initiation of the age-related decline of odor identification in humans: A meta-analysis. Ageing Res Rev 2017; 40: 45-50.
48. Kern DW, Wroblewski KE, Schumm LP, Pinto JM, Chen RC, McClintock MK. Olfactory function in Wave 2 of the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci 2014; 69 (Suppl 2): S134-43.
49. Doty RL, Shaman P, Applebaum SL, Giberson R, Siksorski L, Rosenberg L. Smell identification ability: changes with age. Science 1984; 226(4681): 1441-3.
50. Doty RL, Kamath V. The influences of age on olfaction: a review. Front Psychol 2014; 5: 20.
51. Wilson RS, Yu L, Bennett DA. Odor identification and mortality in old age. Chem Senses. 2011; 36: 63-7.
52. Gopinath B, Sue CM, Kifley A, Mitchell P. The association between olfactory impairment and total mortality in older adults. J Gerontol A Biol Sci Med Sci 2012; 67: 204-9.
53. Kalmey JK, Thewissen JG, Dluzen DE. Age-related size reduction of foramina in the cribriform plate. Anat Rec 1998; 251: 326-9.
54. Rawson NE, Gomez G, Cowart BJ, Kriete A, Pribitkin E, Restrepo D. Age-associated loss of selectivity in human olfactory sensory neurons. Neurobiol Aging 2012; 33: 1913-9.
55. Doty RL. Olfaction in Parkinson's disease and related disorders. Neurobiol Dis 2012; 46: 527-52.
56. Marin C, Vilas D, Langdon C, Alobid I, Lopez-Chacon M, Haehner A, et al. Olfactory Dysfunction in Neurodegenerative Diseases. Curr Allergy Asthma Rep 2018; 18: 42.
57. Hawkes C. Olfaction in neurodegenerative disorder. Adv Otorhinolaryngol 2006; 63: 133-51.
58. Doty RL. Olfactory dysfunction in neurodegenerative diseases: is there a common pathological substrate? Lancet Neurol 2017; 16: 478-88.
2. Edelstein DR. Aging of the normal nose in adults. Laryngoscope 1996; 106(9 Pt 2): 1-25.
3. DelGaudio JM, Panella NJ. Presbynasalis. Int Forum Allergy Rhinol 2016; 6: 1083-7.
4. Agius AM, Smallman LA, Pahor AL. Age, smoking and nasal ciliary beat frequency. Clin Otolaryngol Allied Sci. 1998; 23: 227-30.
5. Jorissen M, Willems T, Van der Schueren B. Nasal ciliary beat frequency is age independent. Laryngoscope 1998; 108: 1042-7.
6. Ho JC, Chan KN, Hu WH, Lam WK, Zheng L, Tipoe GL, et al. The effect of aging on nasal mucociliary clearance, beat frequency, and ultrastructure of respiratory cilia. Am J Respir Crit Care Med 2001; 163: 983-8.
7. Busse PJ, Mathur SK. Age-related changes in immune function: effect on airway inflammation. J Allergy Clin Immunol 2010; 126: 690-9.
8. Proenca de Oliveira-Maul J, Barbosa de Carvalho H, Goto DM, Maia RM, Flo C, Barnabe V, et al. Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance. Chest 2013; 143: 1091-7.
9. Kao CH, Jiang RS, Wang SJ, Yeh SH. Influence of age, gender, and ethnicity on nasal mucociliary clearance function. Clin Nucl Med 1994; 19: 813-6.
10. Yadav J, Ranga RK, Singh A. Effects of aging on nasal mucociliary clearance. Clinical Rhinology 2011; 4: 1-3.
11. Sahin Yilmaz AA, Corey JP. Rhinitis in the elderly. Curr Allergy Asthma Rep 2006; 6: 125-31.
12. Riedler KL, Shokrani A, Markarian A, Fisher LM, Pepper JP. Age-related histologic and biochemical changes in auricular and septal cartilage. Laryngoscope 2017; 127: E399-407.
13. Lee JW, McHugh J, Kim JC, Baker SR, Moyer JS. Age-related histologic changes in human nasal cartilage. JAMA Facial Plast Surg 2013; 15: 256-62.
14. Lindemann J, Sannwald D, Wiesmiller K. Age-related changes in intranasal air conditioning in the elderly. Laryngoscope 2008;118: 1472-5.
15. Kalmovich LM, Elad D, Zaretsky U, Adunsky A, Chetrit A, Sadetzki S, et al. Endonasal geometry changes in elderly people: acoustic rhinometry measurements. J Gerontol A Biol Sci Med Sci 2005; 60: 396-8.
16. Baptist AP, Nyenhuis S. Rhinitis in the Elderly. Immunol Allergy Clin North Am 2016; 36: 343-57.
17. Loftus PA, Wise SK, Nieto D, Panella N, Aiken A, DelGaudio JM. Intranasal volume increases with age: Computed tomography volumetric analysis in adults. Laryngoscope 2016; 126: 2212-5.
18. Wrobel BB, Bien AG, Holbrook EH, Meyer GE, Bratney NA, Meza J, et al. Decreased nasal mucosal
sensitivity in older subjects. Am J Rhinol 2006; 20: 364-8.
19. Mathur SK. Allergy and asthma in the elderly. Semin Respir Crit Care Med 2010; 31: 587-95.
20. Gruver AL, Hudson LL, Sempowski GD. Immunosenescence of ageing. J Pathol 2007; 211: 144-56.
21. Milgrom H, Huang H. Allergic disorders at a venerable age: a mini-review. Gerontology. 2014; 60: 99-107.
22. Gubbels Bupp MR. Sex, the aging immune system, and chronic disease. Cell Immunol 2015; 294: 102-10.
23. Franceschi C, Bonafe M, Valensin S, Olivieri F, De Luca M, Ottaviani E, et al. Inflamm-aging. An evolutionary perspective on immunosenescence. Ann N Y Acad Sci 2000; 908: 244-54.
24. Mari D, Mannucci PM, Coppola R, Bottasso B, Bauer KA, Rosenberg RD. Hypercoagulability in centenarians: the paradox of successful aging. Blood. 1995; 85: 3144-9.
25. Mari D, Mannucci PM, Duca F, Bertolini S, Franceschi C. Mutant factor V (Arg506Gln) in healthy centenarians. Lancet 1996; 347(9007): 1044.
26. Wikby A, Nilsson BO, Forsey R, Thompson J, Strindhall J, Lofgren S, et al. The immune risk phenotype is associated with IL-6 in the terminal decline stage: findings from the Swedish NONA immune longitudinal study of very late life functioning. Mech Ageing Dev 2006; 127: 695-704.
27. Franceschi C, Olivieri F, Marchegiani F, Cardelli M, Cavallone L, Capri M, et al. Genes involved in immune response/inflammation, IGF1/insulin pathway and response to oxidative stress play a major role in the genetics of human longevity: the lesson of centenarians. Mech Ageing Dev 2005; 126: 351-61.
28. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med 1999; 340: 115-26.
29. Eikelenboom P, Veerhuis R. The importance of inflammatory mechanisms for the development of Alzheimer's disease. Exp Gerontol. 1999; 34: 453-61.
30. Enright PL, Kronmal RA, Higgins MW, Schenker MB, Haponik EF. Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study. Chest 1994; 106: 827-34.
31. Pinto JM, Jeswani S. Rhinitis in the geriatric population. Allergy Asthma Clin Immunol 2010; 6: 10.
32. Meltzer EO. The prevalence and medical and economic impact of allergic rhinitis in the United States. J Allergy Clin Immunol 1997; 99(6 Pt 2): S805-28.
33. Simola M, Holopainene E, Malmberg H. Changes in skin and nasal sensitivity to allergens and the course of rhinitis; a long-term follow-up study. Ann Allergy Asthma Immunol 1999; 82: 152-6.
34. Di Lorenzo G, Leto-Barone MS, La Piana S, Ditta V, Di Fede G, Rini GB. Clinical course of rhinitis and changes in vivo and in vitro of allergic parameters in elderly patients: a long-term follow-up study. Clin Exp Med 2013; 13: 67-73.
35. Derby L, Maier WC. Risk of cataract among users of intranasal corticosteroids. J Allergy Clin Immunol 2000; 105: 912-6.
36. Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol 2011; 127(1 Suppl): S1-55.
37. Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137: 358-68.
38. Reh DD, Mace J, Robinson JL, Smith TL. Impact of age on presentation of chronic rhinosinusitis and outcomes of endoscopic sinus surgery. Am J Rhinol 2007; 21: 207-13.
39. Cho SH, Kim DW, Lee SH, Kolliputi N, Hong SJ, Suh L, et al. Age-related increased prevalence of asthma and nasal polyps in chronic rhinosinusitis and its association with altered IL-6 trans-signaling. Am J Respir Cell Mol Biol 2015; 53: 601-6.
40. Cho SH, Hong SJ, Han B, Lee SH, Suh L, Norton J, et al. Age-related differences in the pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol 2012; 129: 858-60 .
41. Stevens WW, Lee RJ, Schleimer RP, Cohen NA. Chronic rhinosinusitis pathogenesis. J Allergy Clin Immunol 2015; 136: 1442-53.
42. Colclasure JC, Gross CW, Kountakis SE. Endoscopic sinus surgery in patients older than sixty. Otolaryngol Head Neck Surg 2004; 131: 946-9.
43. Ramadan HH, VanMetre R. Endoscopic sinus surgery in geriatric population. Am J Rhinol 2004; 18: 125-7.
44. Hummel T, Kobal G, Gudziol H, Mackay-Sim A. Normative data for the "Sniffin' Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 2007; 264: 237-43.
45. Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, et al. Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 2000; 257: 205-11.
46. Schubert CR, Fischer ME, Pinto AA, Klein BEK, Klein R, Cruickshanks KJ. Odor detection thresholds in a population of older adults. Laryngoscope 2017; 127: 1257-62.
47. Zhang C, Wang X. Initiation of the age-related decline of odor identification in humans: A meta-analysis. Ageing Res Rev 2017; 40: 45-50.
48. Kern DW, Wroblewski KE, Schumm LP, Pinto JM, Chen RC, McClintock MK. Olfactory function in Wave 2 of the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci 2014; 69 (Suppl 2): S134-43.
49. Doty RL, Shaman P, Applebaum SL, Giberson R, Siksorski L, Rosenberg L. Smell identification ability: changes with age. Science 1984; 226(4681): 1441-3.
50. Doty RL, Kamath V. The influences of age on olfaction: a review. Front Psychol 2014; 5: 20.
51. Wilson RS, Yu L, Bennett DA. Odor identification and mortality in old age. Chem Senses. 2011; 36: 63-7.
52. Gopinath B, Sue CM, Kifley A, Mitchell P. The association between olfactory impairment and total mortality in older adults. J Gerontol A Biol Sci Med Sci 2012; 67: 204-9.
53. Kalmey JK, Thewissen JG, Dluzen DE. Age-related size reduction of foramina in the cribriform plate. Anat Rec 1998; 251: 326-9.
54. Rawson NE, Gomez G, Cowart BJ, Kriete A, Pribitkin E, Restrepo D. Age-associated loss of selectivity in human olfactory sensory neurons. Neurobiol Aging 2012; 33: 1913-9.
55. Doty RL. Olfaction in Parkinson's disease and related disorders. Neurobiol Dis 2012; 46: 527-52.
56. Marin C, Vilas D, Langdon C, Alobid I, Lopez-Chacon M, Haehner A, et al. Olfactory Dysfunction in Neurodegenerative Diseases. Curr Allergy Asthma Rep 2018; 18: 42.
57. Hawkes C. Olfaction in neurodegenerative disorder. Adv Otorhinolaryngol 2006; 63: 133-51.
58. Doty RL. Olfactory dysfunction in neurodegenerative diseases: is there a common pathological substrate? Lancet Neurol 2017; 16: 478-88.
ดาวน์โหลด
เผยแพร่แล้ว
2019-05-07
รูปแบบการอ้างอิง
1.
Ngaotepprutaram P, Lumyongsatien J. ผลของการสูงวัยต่อจมูกและโพรงอากาศข้างจมูก: สิ่งที่ทราบในปัจจุบันและการทบทวนวรรณกรรม. SRIMEDJ [อินเทอร์เน็ต]. 7 พฤษภาคม 2019 [อ้างถึง 12 ธันวาคม 2025];34(3):303-9. available at: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/187804
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