Objective To investigate the surgicalmethod and perioperative treatment for senile lumbar disease accompanied by internal disease. Methods From June 2000 to December 2003,the complete neurological and physical examinations were performed on the patients before operation, as treatment of internal diseases could improve the patients’ conditions. Lumbar operations were performed on 125 patients, among whom 23 had simple lumbardisc herniation, 13 had lumbar spine stenosis, 81 had lumbar disc herniation with lumbar spine stenosis, and 8 had spondylolisthesis.The JOA score was 116±2.5. There were 3 patients undergoing fenerstration+discectomy, 16 undergoing semilaminectomy+discectomy,82 undergoing total-laminectomy+disectomy, 5 undergoing total-laminectomy+disectomy+pedicle fixation, 11 undergoing lamina decompression+nerve-root pathyway decompression, and 8 undergoing pedicle screw fixation+bone graft and fusion in spondylolisthesis. Results With an effective medical treatment, the internal disease produced little effect on the operation. Improved functions and bone fusions were observed after- operation. According to the JOA standards, the average alleviation rate was 87.9%. Conclusion Early neurological examination and proper treatment of internal diseases are the keys to the successful operation on the senile patients with lumbar disease. Radiological data are important in avoidance of mistaken diagnosis.
Objective To investigate the effect of treatment with proximal femoral nail (PFN) on femur intertrochanteric fractures in the old. Methods A retrospective study of 62 patients with femur intertrochantericfractures treated with PFN from October 2001 to September 2003 was carried out.The data of operative time, blood loss, intraoperative complications, wound drainage, postoperative complications, healing time, and hip function were recordedand compared with previous literature so as to evaluate the effect. Results All patients were followed up for 8-22 month(13.6 months on average). Intraoperative fracture occurred again in 2 cases. Two patients died of brain embolism and pulmonary infection respectively. Heterogeneous ossification occurred in 2 cases. Hip varus occurred in 1 case. Extra hip anteversion occurred in 1 case. The effect of other cases was satisfactory. The operative time was 76.5±29.1 min, the mean blood loss was 385.7±98.4 ml, the wound drainage was 45.5±21.7 ml, and the healing time was 13.2±3.8 weeks. According to the Sanders post-trauma hip function assessing system, the excellent and good rate was 89.6%. Conclusion The application of PFN is characterized by short operative time, less blood loss, stable fixation, so it is an effective way to treat femur intertrochanteric fracture in the old.
摘要:目的:探討老年人梗阻性大腸癌的圍手術期處理。方法:回顧性分析2003年至2008年間71例60歲以上老年人梗阻性大腸癌的圍手術期處理情況。 結果:術前發現并存病者43例,術中出現并發癥19例,術后發生并發癥37例得,除5例死亡外,均得到有效控制,死亡原因與并存疾病有關。結論:加強圍手術期處理,積極治療并存疾病,老年人梗阻性大腸癌的治療同樣能取得滿意的效果。Abstract: Objective:To study the perioperative measures for the aged patients with Obstructive Colorectal Cancer. Methods: Seventyone cases above 60 years with Obstructive Colorectal Cancer were analysed retrospectively on their individual accompanied diseases and perioperative treatments, from 2003 to 2008.Results: Fortythree cases of them had suffered from other diseases. Midoperative complications occurred in 19 cases. Postoperative complications occurred in 37 cases. Except 5 cases of death, complications occurring in others cases were well controlled. The death causes mainly were correlated with accompanied chronic diseases. Conclusion: Strengthen care, active management of other chronic diseases are important significantly for senile patients with colorectal carcinoma to get satisfied outcome.
Objective To systematically review the prevalence of depression in rural Chinese population aged 60 and above from 2010 to 2023. MethodsThe CNKI、WanFang Data、VIP、CBM、PubMed、Embase and Cochrane Library databases were electronically searched to collect cross-sectional studies on the prevalence of depression of elderly populations in rural China from January 2010 to March 2023. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. ResultsA total of 23 cross-sectional studies with a total sample of 34 916 cases and 11 308 depression patients were included. The meta-analysis results showed that the prevalence of depression in rural Chinese population was 31.02% (95%CI 26.10% to 36.16%). Subgroup analysis showed that the prevalence was higher among females than males; the GDS-30 scale had the highest detection rate, followed by the CES-D-10 and GDS-15 scales; the prevalence was higher in the Midwest than in the East; and the prevalence was higher in surveys conducted after 2015 than in 2015 and before. In addition, the prevalence of depression was higher in the rural elderly population aged 70 and above, non-married, illiterate or semi-literate, with poor self-rated health status, living alone, in poor economic status, with chronic diseases, and with low social activity. ConclusionThe prevalence of depression is high among the rural elderly population in China, and there are significant disparities in the prevalence of different characteristics of the elderly. These differences should be given more attention to improve the mental health of the rural elderly population. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo discuss the demands for nursing knowledge among family caregivers for elderly people, in order to provide a basis for nurses to provide effective education for these people.
MethodsBetween May and June 2012, a questionnaire which contained the condition of demands for nursing knowledge and the burden of care was used to investigate 1 600 family caregivers for the elderly people.
ResultsThe caregivers had a demand for nursing knowledge, which may include the knowledge on medicine, disease and caregiving. The demand for knowledge was correlated with relationship between the caregivers and care recipients, health condition of the caregivers and care burden.
ConclusionThe demands for nursing knowledge are higher in those who have spouse and high burden of care, without disease and symptom; we should pay more attention on them and take measures to reduce their burden of care.
ObjectiveTo evaluate whether laparoscopic repair for perforated peptic ulcer o ers elderly patients an improved outcome compared with conventional open surgery.
MethodsFrom May 2008 to December 2013, clinical data of 163 elderly patients ( ≥ 60 years) who underwent laparoscopic or open repair of perforated peptic ulcer disease were analyzed retrospectively in our hospital. Ninety-one patients received laparoscopic repair and 72 received conventional open repair. The primary end points that were evaluated were total operative time, searching time, nasogastric tube utilization, intravenous fluid requirement, total time of abdominal drainage and urinary catheter usage, time taken to return to normal gastrointestinal motility, percentage of intravenous/intramuscular opiate use, off-bed time, and total in-patient hospital stay. The second end points were morbidity.
ResultsThere was a significant diTherence in total operative time in patients who had undergone laparoscopic repair and open repair [(67.9±3.6) minutes vs. (97.8±5.2) minutes]. There was a significant decrease in the time that the nasogastric tube (2.1 days vs. 3.1 days), urinary catheter (2.3 days vs. 3.7 days) and abdominal drain (2.2 days vs. 3.8 days) were required during the postoperative period. Patients who had undergone laparoscopic repair also required less intravenous fluids (2.4 days vs. 4.1 days) and returned to normal gastrointestinal motility [(32.1±1.5) hours vs. (58.4±4.8) hours] and off-bed time significantly earlier than those who had undergone open repair (2.1 days vs. 3.5 days). There was significantly less requirement for intravenous/intramuscular opiate analgesia in patients who had undergone laparoscopic repair (4.7% vs. 45.6%). In addition, patients who had undergone laparoscopic repair required a shorter in-patient hospital stay (4.1 days vs. 5.3 days). Moreover, morbidity of laparoscopic repair was much lower than open repair (3.3% vs. 16.7%).
ConclusionLaparoscopic repair is a viable and safe surgical option for elderly patients with perforated peptic ulcer disease and should be considered for all patients.
