摘要:目的:探讨老年人梗阻性大肠癌的围手术期处理。方法:回顾性分析2003年至2008年间71例60岁以上老年人梗阻性大肠癌的围手术期处理情况。 结果:术前发现并存病者43例,术中出现并发症19例,术后发生并发症37例得,除5例死亡外,均得到有效控制,死亡原因与并存疾病有关。结论:加强围手术期处理,积极治疗并存疾病,老年人梗阻性大肠癌的治疗同样能取得满意的效果。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 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.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.
目的:探讨血清铁蛋白（SF）、红细胞参数（红细胞计数RBC、血红蛋白HGB、红细胞体积MCV）及炎症标志物（白细胞计数WBC、纤维蛋白原FIG、血沉ESR）与老年代谢综合征（MS）的关系。方法:148例老年人,依据MS组分数量多少分为MS0（无MS组分）、MS1～2（有1～2个MS组分）和MS3～5（有3～5个MS组分）三组。测定三组的血SF、空腹血糖FPG、甘油三酯TG、高密度脂蛋白胆固醇HDL-C、RBC、HGB、MCV、WBC、FIG及ESR水平,并进行分析。结果:老年女性及非吸烟老年男性MS组SF、RBC、HGB、WBC及ESR均较MS0组高。老年女性的SF、WBC与腰围,SF、RBC、HGB、WBC与MS组分数量,SF与RBC,均呈正相关。老年非吸烟男性的WBC与TG,HGB与MS组分数量,MCV与BMI及腰围,FIG与BMI,呈正相关。老年人HGB与DBG、TG呈正相关；与HDL-C呈负相关。结论:SF水平与MS发展相关,MS组分数量增加与聚集、超重与肥胖,可能促进体内感染状态。有MS的老年男女,常呈现低度感染状态,但同时又有一定的铁储备及相对稳定的造血机能；无MS的老年男女造血功能倾向减退。老年男性吸烟者较非吸烟者易呈现感染状态,并具有较低的铁储备。
ObjectivesTo investigate and analyze the activities of daily living status and influencing factors for the elderly of long-term care in Shangrao City of Jiangxi Province, and provide a basis for Shangrao City to carry out long-term care insurance for the elderly. MethodsCluster sampling was used to investigate the elderly aged 60 and over in 12 counties (cities, districts)of Shangrao, including the elderly general demographic characteristics and activity of daily living survey. ResultsA total of 1 087 elderly people were surveyed, with an average age of 77.75±8.12 and a total 70.6±21.4 score of activity of daily living. Comparing different age groups, the elder age group had a worse activity of daily living (P<0.001). Those with a higher education level had relatively poor activity of daily living (P<0.001), and those with spouse also had poor activity of daily living (P<0.05). Multiple linear regression analysis showed that age (P<0.001), education level (P<0.001), marital status (P<0.05) and income level (P<0.05) were important factors affecting the scores of activity of daily living of the elderly. ConclusionsAge, education level, marital status, low-income situation, chronic disease, and household registration are the main risk factors affecting the score of the long-term care of the elderly in daily life. The establishment of a long-term care insurance system should be based on chronic diseases, age, marital status and other factors to determine the corresponding long-term care standard scoring system and compensation standards.
Families are important venues for nutritional management of the elderly, and there is an increasing demand for continuous nutritional management services from hospital to home. It has been 7 years since the publication of the "Chinese expert consensus on home nutrition administration for the elderly (2017 edition)", and with the publication of more research evidence and the practice of home nutrition administration, there is an urgent need to update the 2017 edition of the consensus. A total of 35 recommendations or consensus opinions have been proposed in this consensus update, aiming to guide grassroots related professionals to provide scientific, reasonable and standardized home nutrition management services for the elderly population at home or in the community.
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.