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Tear inflammation related indexes after cataract surgery in elderly patients with type 2 diabetes mellitus
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作者 Jun Lv Cheng-Jian Cao +3 位作者 Wei Li Shuang-Le Li Jun Zheng Xiu-Li Yang 《World Journal of Clinical Cases》 SCIE 2023年第2期385-393,共9页
BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory medi... BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks. 展开更多
关键词 Type 2 diabetes mellitus elderly patients Cataract surgery Tear inflammation-related indicators Temporal changes Prognosis
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Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery
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作者 Jun-Ling Li Jin Zhao +2 位作者 Zhen-Feng Guo Chang Xiao Xuan Liu 《World Journal of Diabetes》 SCIE 2024年第6期1234-1241,共8页
BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical sign... BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice. 展开更多
关键词 Recombinant human epidermal growth factor Sodium hyaluronate eye drops Diabetic patients Dry eye syndrome after cataract surgery Therapeutic efficacy
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Effect of Nalmefene on Delayed Neurocognitive Recovery in Elderly Patients Undergoing Video-assisted Thoracic Surgery with One Lung Ventilation 被引量:6
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作者 Meng-yun LI Chao CHEN +2 位作者 Zheng gang WANG Jian-juan KE Xiao-bo FENG 《Current Medical Science》 SCIE CAS 2020年第2期380-388,共9页
The intravenous use of nalmefene has been found to exert neuroprotective effect in patients with severe traumatic brain injury and acute cerebral infarction;nonetheless,it is unknown whether nalmefene alleviates delay... The intravenous use of nalmefene has been found to exert neuroprotective effect in patients with severe traumatic brain injury and acute cerebral infarction;nonetheless,it is unknown whether nalmefene alleviates delayed neurocognitive recovery.Our purpose of the current research was to clarify the impact of nalmefene on delayed neurocognitive recovery in aged patients experiencing video-assisted thoracic surgery(VATS)with intraoperative use of one lung ventilation(OLV).The present study involved 120 paticents undergoing selective VATS,randomized to accept low-dose nalmefene(N1 group,n=40),high-dose nalmefene(N2 group,1n=40)or equal volume of physiologic saline(control group,1=40).A battery of neuropsychological tests were used to estimate cognitive function I day before surgery(o)and 10 days after surgery or before discharge(t).Regional cerebral oxygen saturation(rSO2)was detected 5 min before induction(t),5 min after induction(1),15 and 60 min after onset of OLV(62 and 13),and 15 min after termination of OLV(4).The plasma values of interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-a1 and adiponectin(ADP)were also detected prior to induction of anesthesia(T0),1 h,2 h and 6 h after surgery(TI,T2,T3).On 1,delayed neurocognitive recovery occurred in 5/40(12.5%)patients of NI group,in 5/40(12.5%)patients of N2 group and in 13/40(32.5%)patients of control group(P<0.05).There were no statistical differences in rSO2 among three groups at different time points.At Tl,T2 and T3,IL-1β,IL-6 and TNF-a values significantly increased and ADP value significantly decreased(P<0.05)in control group.In contrast,at TI,T2 and T3,IL-1β,IL-6 and TNF-a values decreased and ADP value decreased less in N1 and N2 groups(P<0.05).At TI,T2 and T3,IL-1β,IL-6 and TNF-a concentrations presented a trend of N2 group<N1 group<control group and ADP presented a trend of N2 group>Nl group>control group(P<0.05).The result of our present research supports the hypothesis that the perioperative intravenous treatment with nalmefene to VATS with OLV ameliorates postoperative cognitive function and decreases the incidence of delayed neurocognitive recovery,most likely by suppression of inflammatory responses. 展开更多
关键词 NALMEFENE one lung ventilation elderly patients delayed neurocognitive recovery perioperative neurocognitive disorders thoracic surgery
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Preventing Lower Extremity Deep Vein Thrombosis After Hip Fracture Surgery in Elderly Patients by Acupoint Application Combined with Pneumatic Compression Therapy 被引量:2
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作者 Xing Fu Yan Cheng 《Proceedings of Anticancer Research》 2022年第2期6-9,共4页
Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the ... Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value. 展开更多
关键词 Acupoint application Traditional Chinese medicine Pneumatic compression therapy Minimally invasive surgery for hip fracture in elderly patients Lower extremity deep vein thrombosis
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Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients 被引量:11
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作者 Shoichi Fujii Mitsuo Tsukamoto +6 位作者 Yoshihisa Fukushima Ryu Shimada Koichi Okamoto Takeshi Tsuchiya Keijiro Nozawa Keiji Matsuda Yojiro Hashiguchi 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2016年第7期573-582,共10页
AIM: To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.METHODS: A meta-analysis was performed of a systematic search of studies on an electronic datab... AIM: To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.METHODS: A meta-analysis was performed of a systematic search of studies on an electronic database. Studies that compared laparoscopic colectomy(LAC) in elderly colorectal cancer patients with open colectomy(OC) were retrieved, and their short and long-term outcomes compared. Elderly people were defined as 65 years old or more. Inclusion criteria were set at: Resection of colorectal cancer, comparison between laparoscopic and OC and no significant difference in backgrounds between groups.RESULTS: Fifteen studies were identified for analysis. LAC was performed on 1436 patients, and OC performed on 1810 patients. In analyses of short-term outcomes, operation time for LAC was longer than for OC(mean difference = 34.4162, 95%CI: 17.8473-50.9851, P < 0.0001). The following clinical parameters were lower in LAC than in OC: Amount of estimated blood loss(mean difference =-93.3738, 95%CI:-132.3437 to-54.4039, P < 0.0001), overall morbidity(OR = 0.5427, 95%CI: 0.4425-0.6655, P < 0.0001), incisional surgical site infection(OR = 0.6262, 95%CI: 0.4310-0.9097, P = 0.0140), bowel obstruction and ileus(OR = 0.6248, 95%CI: 0.4519-0.8638, P = 0.0044) and cardiovascular complications(OR = 0.4767, 95%CI: 0.2805-0.8101, P = 0.0062). In analyses of long-term outcomes(median follow-up period: 36.4 mo in LAC, 34.3 mo in OC), there was no significant difference in overall survival(mean difference = 0.8321, 95%CI: 0.5331-1.2990, P = 0.4187) and disease specific survival(mean difference = 1.0254, 95%CI: 0.6707-1.5675, P = 0.9209). There was also no significant difference in the number of dissected lymph nodes(mean difference =-0.1360, 95%CI:-4.0553-3.7833, P = 0.9458).CONCLUSION: LAC in elderly colorectal cancer patients had benefits in short-term outcomes compared with OC except operation time. The long-term outcomes and oncological clearance of LAC were similar to that of OC. These results support the assertion that LAC is an effective procedure for elderly patients with colorectal cancer. 展开更多
关键词 LAPAROSCOPIC surgery Systematic review META-ANALYSIS COLORECTAL cancer elderly PATIENT
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Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy 被引量:3
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作者 Giannis Mountzios 《World Journal of Clinical Oncology》 CAS 2015年第1期7-15,共9页
Head and neck cancer(HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients old... Head and neck cancer(HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach. 展开更多
关键词 elderly patients Head and NECK cancer RADIOTHERAPY surgery CHEMOTHERAPY Molecular targeted agents
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Aortic valve stenosis: treatments options in elderly high-risk patients 被引量:4
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作者 Khalil Fattouch Sebastiano Castrovinci Patrizia Carita 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2016年第6期473-474,共2页
In the last decades, a trend towards a worldwide aging has been reported and diseases which are common in the elderly people would have important implications in clinical practice. Aortic stenosis (AS) is perhaps th... In the last decades, a trend towards a worldwide aging has been reported and diseases which are common in the elderly people would have important implications in clinical practice. Aortic stenosis (AS) is perhaps the most common and most often cause of sudden death among valvular heart diseases. Its prevalence is low among adults aged 〈 60 years, but increases to almost 10% in adults ≥ 80 years.[2] Since the degenerative calcific disease represents the lead- ing cause of AS in developed countries, the improved understanding on its pathogenesis (atherosclerotic processes and/or skeleton key) may offer potentially new targets for preventing and inhibiting AS development and progres- sion.[3] Patients with AS are generally asymptomatic for a prolonged period and the development of symptoms is a critical point in the natural history. Indeed, the prognosis changes dramatically with the onset of symptoms of angina, 展开更多
关键词 Aortic valve stenosis elderly patients Minimaly invasive surgery Risck stratification Transcatheter aortic valve implantation
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Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly 被引量:2
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作者 Chengpeng Ran Guangwei Gong 《International Journal of Clinical Medicine》 2020年第3期101-110,共10页
Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the ... Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly. 展开更多
关键词 Enhanced Recovery after surgery elderly patients Advanced GASTRIC Cancer PERIOPERATIVE Period Clinical Application Research Progress
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Changes in the safety paradigm with percutaneous coronary interventions in the modern era:Lessons learned from the ASCERT registry 被引量:1
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作者 Alfredo E Rodríguez Carlos Fernández-Pereira Alfredo M Rodríguez-Granillo 《World Journal of Cardiology》 CAS 2012年第8期242-249,共8页
In the past,comparative effectiveness trials evaluating percutaneous coronary interventions(PCI),using either balloon angioplasty or bare metal stent(BMS) implantation,versus coronary artery bypass surgery(CABG) found... In the past,comparative effectiveness trials evaluating percutaneous coronary interventions(PCI),using either balloon angioplasty or bare metal stent(BMS) implantation,versus coronary artery bypass surgery(CABG) found similar survival rates at long-term follow-up with both revascularization strategies.Two major meta-analyses of these trials reported 5-and 6-year comparative effectiveness between PCI and CABG:one included only four trials that compared PCI with BMS implantation versus CABG whereas the largest one also included trials using balloon angioplasty.In these studies,the authors observed no survival differences between groups although a significant survival advantage was seen in diabetics treated with CABG and this benefit was also perceived in elderly patients.In both reports,number of involved vessels,presence of left anterior descending artery stenosis or poor left ventricular ejection fraction were no predictors of poor survival with PCI.Therefore,extent of the coronary artery disease(CAD) was not associated with poor outcome after PCI in the pre-drug eluting stent(DES) era.Recently,the ASCERT(Database Collaboration on the Comparative Effectiveness of Revascularization Strategies) registry found higher mortality rate with PCI in patients ≥ 65 years old in comparison with CABG,and advantages of surgery were seen in all subgroups including those at low risk.In this registry,PCI was accomplished by implantation of the first type of DES designs in 78% of cases.The intriguing observation of high mortality rate with PCI,including for non-diabetics and patients with two-vessel CAD,meaning a lack of clinical benefit with DES implantation,had not been seen previously.The study was not randomized,although its results are largely strengthened by its sample size.In this manuscript,the authors describe other registries and randomized trials reporting similar results supporting the findings of the aforementioned study and explore the reasons for these results,while also searching for potential solutions. 展开更多
关键词 PERCUTANEOUS CORONARY interventions CORONARY ARTERY BYPASS surgery Drug eluting STENTS CORONARY ARTERY disease elderly patients
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What are the benefits of a minimally invasive approach in frail octogenarian patients undergoing aortic valve replacement?
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作者 Yusuf S Abdullahi Leonidas V Athanasopoulos +5 位作者 Marco Moscarelli Roberto P Casula Giuseppe Speziale Khalil Fattouch Sebastiano Castrovinci Thanos Athanasiou 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2016年第6期514-516,共3页
A best evidence topic was devised in light of a structured protocol. What is the advantage of (minl"mally invasive) approach in (frail patients) undergoing (aortic valve replacement)? In cardiac outpatient cl... A best evidence topic was devised in light of a structured protocol. What is the advantage of (minl"mally invasive) approach in (frail patients) undergoing (aortic valve replacement)? In cardiac outpatient clinic you review an 85-year old male with severe aortic valve stenosis, low left ventricular ejection fraction and creatinine clearance of less than 50 mL/min. Other comorbidities include treated pulmonary hypertension, mild cognitive impairment, marked limitation of ordinary physical activity and depression. You resolve to determine whether to recommend mim'mally invasive or conventional aortic valve replacement (AVR) or transcathe- ter aortic valve implantation (TAVI), however you are not sure of the differences of the impact of frailty on preopera- tive risk for each approach; hence you investigate the best evidence on the topic. 展开更多
关键词 Aortic valve stenosis elderly patients Minimally invasive surgery Transcatheter aortic valve implantation
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Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study
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作者 Fulvio Tagliabue Morena Burati +5 位作者 Marco Chiarelli Luca Fumagalli Angelo Guttadauro Elisa Arborio Matilde De Simone Ugo Cioffi 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2020年第6期287-297,共11页
BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically challenging.Robotic surgery has be... BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically challenging.Robotic surgery has been introduced to overcome this technical limitation,but it is related to high costs.To maximize the benefits of such surgery,only selected patients are candidates for this technique.In addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative complications.AIM To investigate the outcomes of RRH vs LRH with regard to age and comorbidities.METHODS We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September 2019.The surgical procedures were performed according to standardized techniques.The primary clinical outcome of the study was the length of hospital stay(LOS)measured in days.Secondary outcomes were time to first flatus(TFF)and time to first stool evacuation.The robotic technique was considered the exposure and the laparoscopic technique was considered the control.Routine demographic variables were obtained,including age at time of surgery and gender.Body mass index and American Society of Anesthesiologists physical status were registered.The age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were recorded.Post-operative follow-up was 180 d.RESULTS LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,P<0.001;median 4(IQR 3-5)vs 5(IQR 4-6.5)d,P=0.005,respectively.Following multivariable analysis,the robotic technique was confirmed to be predictive of significantly shorter hospitalization and faster restoration of bowel function;in addition the dichotomous variables of age over75 years and ACCI more than 7 were significant predictors of hospital stay.No outcomes were significantly associated with Clavien-Dindo grading.Sub-group analysis demonstrated that patients aged over 75 years had a longer LOS(median6-IQR 5-8-vs 7-IQR 6-12-d,P=0.013)and later TFF(median 2-IQR 1-3-vs 3-IQR 2-4-d,P=0.008),while patients with ACCI more than 7 were only associated with a prolonged hospital stay(median 7-IQR 5-8-vs 7-IQR 6-14.5-d,P=0.036).CONCLUSION RRH is related to shorter LOS when compared with the laparoscopic approach,but older age and several comorbidities tend to reduce its benefits. 展开更多
关键词 Right hemicolectomy Robotic surgery Laparoscopic surgery elderly patients COMORBIDITY Hospital stay
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石杉碱甲对老年患者腹部手术后认知功能障碍的双盲研究 被引量:6
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作者 裘卫东 杨建英 +3 位作者 申屠燕琴 陈亮 郑汉光 楼小侃 《解放军药学学报》 CAS 2009年第3期222-224,共3页
目的研究石杉碱甲对老年患者腹部手术后认知功能障碍的影响。方法收集行择期腹部手术的老年患者100例,ASAⅠ~Ⅱ级,年龄65岁~86岁,无神经、精神系统疾病史。治疗组患者50例,麻醉前静脉注射石杉碱甲注射液0.2mg,对照组50例注射等容量(1... 目的研究石杉碱甲对老年患者腹部手术后认知功能障碍的影响。方法收集行择期腹部手术的老年患者100例,ASAⅠ~Ⅱ级,年龄65岁~86岁,无神经、精神系统疾病史。治疗组患者50例,麻醉前静脉注射石杉碱甲注射液0.2mg,对照组50例注射等容量(1mL)的生理氯化钠溶液。观察两组患者术前、术后8、12、24h、术后1周的认知功能,采用简易智能状态检查法(Mini-Mental State Examination,MMSE)测试,观察两组患者术后认知功能障碍、术后谵妄的发生情况及苏醒时间。结果两组患者术前MMSE评分无显著差异;与术前比较,对照组术后各时间点的MMSE评分均下降(P<0.05),治疗组于术后1、12、24h下降(P<0.05),但术后1周与术前无显著差异(P>0.05);两组间比较治疗组术后各时点的MMSE评分均高于对照组(P<0.05)。术后认知功能障碍和术后谵妄的发生率治疗组明显低于对照组(P<0.05)。苏醒时间两组间无显著性差异(P>0.05)。结论围术期应用石杉碱甲注射液可减少老年患者全麻术后认知功能的损害,降低术后认知功能障碍的发生。 展开更多
关键词 石杉碱甲 老年 腹部手术 术后认知功能障碍
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针刺复合小剂量硬膜外麻醉应用于老年下肢骨科手术的临床观察 被引量:8
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作者 冯秀玲 王昱 魏清琳 《兰州大学学报(医学版)》 CAS 2011年第2期48-50,54,共4页
目的探讨针刺复合小剂量硬膜外麻醉在老年下肢骨科手术中的麻醉效果和安全性。方法将60例拟进行下肢骨科手术的老年患者随机分为两组,单纯小剂量硬膜外麻醉组(A组)和针剌复合小剂量硬膜外麻醉组(B组),每组30例。比较两组硬膜外局麻用药... 目的探讨针刺复合小剂量硬膜外麻醉在老年下肢骨科手术中的麻醉效果和安全性。方法将60例拟进行下肢骨科手术的老年患者随机分为两组,单纯小剂量硬膜外麻醉组(A组)和针剌复合小剂量硬膜外麻醉组(B组),每组30例。比较两组硬膜外局麻用药量、麻醉效果,监测麻醉前、麻醉后30、60min各时点的心率、收缩压、舒张压、平均动脉压及血糖变化。结果麻醉效果Ⅰ级率A组为83%、B组为93%,两组比较差异有统计学意义(P<0.05);硬膜外腔首次用量A组较B组增加35.5%(P<0.01);在30、60min时A组心率较B组快(P<0.05);A组收缩压、平均动脉压在30、60 min时下降较B组明显(P<0.05或P<0.01);A组血糖水平在30、60min较术前增高(P<0.05)。结论针刺复合小剂量硬膜外麻醉可减少麻醉药用量,循环稳定,术中应激反应轻,可作为老年下肢骨科手术麻醉方法之一。 展开更多
关键词 针刺 硬膜外麻醉 老年患者 下肢骨科手术
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老年患者鼻内镜手术的麻醉处理 被引量:4
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作者 陈健 王芳 +1 位作者 王冰舒 王业贵 《临床和实验医学杂志》 2008年第7期51-51,55,共2页
目的总结老年患者行鼻内镜手术的麻醉方法。方法87例老年患者选择全麻插管手术治疗,术中用硝酸甘油+艾司络尔静脉点滴行控制性降压。结果术中控制性降压后,出血少,全组无心跳骤停和麻醉意外死亡,全麻效果好。结论麻醉实施和处理得当,可... 目的总结老年患者行鼻内镜手术的麻醉方法。方法87例老年患者选择全麻插管手术治疗,术中用硝酸甘油+艾司络尔静脉点滴行控制性降压。结果术中控制性降压后,出血少,全组无心跳骤停和麻醉意外死亡,全麻效果好。结论麻醉实施和处理得当,可使患者取得满意效果,使老年患者安全度过鼻内镜手术关。 展开更多
关键词 老年患者 鼻内镜手术 全身麻醉 控制性降压
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老年患者髋关节置换术的麻醉体会 被引量:4
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作者 王强 王增春 +1 位作者 王嵘 熊巍 《中国康复理论与实践》 CSCD 2002年第1期39-40,64,共3页
目的通过对髋关节置换术 (HJRS)两种常用麻醉方法的比较 ,为临床上选择最合理的麻醉方法提供依据。方法对34例接受连续硬膜外麻醉 (CEA)或静吸复合全麻 (CIIA)的患者进行回顾性研究 ,比较失血量、骨水泥反应及麻醉效果等项目。结果与结... 目的通过对髋关节置换术 (HJRS)两种常用麻醉方法的比较 ,为临床上选择最合理的麻醉方法提供依据。方法对34例接受连续硬膜外麻醉 (CEA)或静吸复合全麻 (CIIA)的患者进行回顾性研究 ,比较失血量、骨水泥反应及麻醉效果等项目。结果与结论CEA组较CIIA组骨水泥反应明显 ,失血量两者之间无明显差异 ,两种麻醉方法均能满足手术要求 ,但CIIA组操作及术中管理更为容易。尽管CEA与CIIA在麻醉安全性方面没有明显差异性 。 展开更多
关键词 老年患者 髋关节置换术 连续硬膜外麻醉 静吸复合全麻
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胸外科老年患者术后谵妄的临床分析 被引量:12
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作者 何准 张鹏 《天津医科大学学报》 2011年第3期398-400,共3页
目的:分析胸外科老年患者术后谵妄(POD)的发生率及相关危险因素。方法:对388例老年非心脏择期手术患者应用ICU谵妄诊断的意识状态评估法(CAM-ICU)进行POD评定,对肺部疾病组、食管疾病组及纵隔疾病组的POD发生率进行比较,并对食管疾病组... 目的:分析胸外科老年患者术后谵妄(POD)的发生率及相关危险因素。方法:对388例老年非心脏择期手术患者应用ICU谵妄诊断的意识状态评估法(CAM-ICU)进行POD评定,对肺部疾病组、食管疾病组及纵隔疾病组的POD发生率进行比较,并对食管疾病组中各危险因素进行分析。结果:食管疾病组POD的发生率为26.4%,明显高于肺部疾病组的7.0%和纵隔疾病组的2.3%。术前合并糖尿病、既往脑血管病史、手术时间长、术后中心静脉置管、术后鼻胃管留置时间长、术后鼻十二指肠管留置时间长以及术后SICU住院时间长是食管疾病患者POD的独立危险因素。结论:在胸外科老年病人的非心脏择期手术中,食管疾病患者POD的发生率显著高于其他疾病患者。术前合并糖尿病、既往脑血管病史的食管疾病患者是术后谵妄的易感人群,缩短手术时间、减少术后体内各管道的留置时间及SICU的住院时间可能会降低术后谵妄的发生率。 展开更多
关键词 胸外科 老年患者 术后谵妄 外科重症监护病房 食管疾病
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初次与再次斜视矫正手术中眼迷走神经反射发生率及严重性的临床研究 被引量:2
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作者 袁菁 汪锐 胡维琨 《临床眼科杂志》 2019年第6期549-551,共3页
目的探讨初次与再次老年斜视矫正手术中眼迷走神经反射发生率以及后果,分析引起眼迷走神经反射的原因,予以预防。方法选取老年斜视患者81例,其中初次手术42例作为Ⅰ组,再次手术39例作为Ⅱ组,对两组患者眼迷走神经反射发生率以及后果进... 目的探讨初次与再次老年斜视矫正手术中眼迷走神经反射发生率以及后果,分析引起眼迷走神经反射的原因,予以预防。方法选取老年斜视患者81例,其中初次手术42例作为Ⅰ组,再次手术39例作为Ⅱ组,对两组患者眼迷走神经反射发生率以及后果进行统计,分析两组患者引起眼迷走神经反射的原因。结果Ⅰ组眼迷走神经反射发生率为38. 10%,发生频率为(1. 88±0. 11)次/例,Ⅱ组分别为89. 74%和(3. 46±0. 20)次/例,Ⅰ组患者因眼迷走神经反射发生而停止手术(1. 25±0. 13)次/例,心率下降(12. 38±1. 05)次/min,术后恶心发生率为30. 95%,Ⅱ组分别为(3. 10±0. 22)次/例、(18. 97±1. 13)次/min和58. 97%,上述数据Ⅰ组均明显低于Ⅱ组,两组比较有统计学意义(P <0. 05)。引起Ⅰ组患者眼迷走神经反射的原因以牵拉肌肉为主,占83. 33%,而Ⅱ组患者以探查、组织分离以及暴露术野为主,分别占26. 45%、28. 10%、22. 31%。两组比较差异有统计学意义(P <0. 05)。结论与初次手术相比,再次接受斜视矫正手术的患者更容易在术中出现眼迷走神经反射,且因眼迷走神经反射而停止手术、心率下降以及术后恶心呕吐者也明显多于初次手术患者。在术前应与患者进行充分沟通,手术中轻柔操作,需要时可以使用阿托品缓解症状。 展开更多
关键词 老年 斜视矫正术 眼迷走神经反射 眼心反射
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急诊Ⅰ期手术治疗高龄梗阻性大肠癌56例体会 被引量:1
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作者 刘钦志 刘彪 +3 位作者 王斌 吉成岗 周岳平 沈其猷 《岭南急诊医学杂志》 2005年第1期48-49,共2页
目的:探讨高龄大肠癌并急性梗阻Ⅰ期手术的可行性。方法:回顾性分析研究56例高龄梗阻性大肠癌的临床资料。结果:56例病人中无手术死亡病例,仅1例发生吻合口瘘,伤口感染7例。结论:Ⅰ期切除肠吻合术在高龄急性梗阻性大肠癌中应用是可行的。
关键词 高龄 梗阻性大肠癌 Ⅰ期手术治疗 急诊 急性梗阻 体会 人中 目的 可行性
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保乳手术疗效及其患者生存质量评估 被引量:2
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作者 庞钊 《实用癌症杂志》 2014年第3期324-326,332,共4页
目的探讨保乳手术对老年乳腺癌患者的疗效及其生存质量评估。方法 180例早期乳腺癌患者,其中56例患者行保乳手术,63例患者行标准根治术,61例患者行改良根治术。结果保乳手术组具有住院时间较短、手术时间较短、术中出血量少等优势,与根... 目的探讨保乳手术对老年乳腺癌患者的疗效及其生存质量评估。方法 180例早期乳腺癌患者,其中56例患者行保乳手术,63例患者行标准根治术,61例患者行改良根治术。结果保乳手术组具有住院时间较短、手术时间较短、术中出血量少等优势,与根治术组(标准根治术组+改良根治术组)相比有统计学差异(P<0.0001);三组患者生存率、远处转移、术后复发等方面比较均无统计学差异(P>0.05);保乳术组患者心理因子、躯体因子、精神因子和社会支持因子四个方面均显著优于标准根治术组和改良根治术组患者(P<0.05);术后乳房外观及美容效果保乳术组与标准根治术及改良根治术相比有显著统计学差异(P<0.05)。结论早期乳腺癌患者保乳手术近期疗效较满意,严格把握相关手术指征、规范切除和术后放化疗等是保乳手术成功的关键。 展开更多
关键词 乳腺癌 保乳手术 放化疗 老年
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青年食管癌与中老年食管癌外科诊治的比较研究
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作者 陈宇 《莆田学院学报》 2012年第5期26-28,共3页
分析青年与中老年食管癌患者的临床特征及外科治疗效果。回顾性分析49例青年和98例中老年食管癌患者的临床资料。结果:青年食管癌占同期食管癌的6.55%,两组患者在性别比例、肿瘤病变部位、病理类型、分化程度等差异无统计学意义(P>0.... 分析青年与中老年食管癌患者的临床特征及外科治疗效果。回顾性分析49例青年和98例中老年食管癌患者的临床资料。结果:青年食管癌占同期食管癌的6.55%,两组患者在性别比例、肿瘤病变部位、病理类型、分化程度等差异无统计学意义(P>0.05);在术后病理分期、根治性切除率、术后并发症发生率上差异均有统计学意义(P<0.05);青年组与中老年组的手术死亡率分别为0.0%和2.0%,两组生存率差异无统计学意义(P>0.05)。结果表明,青年人食管癌肿瘤病期偏晚,手术切除率更低,术后并发症发生率及手术死亡率优于中老年组,两者在生存预后差别无统计学意义。 展开更多
关键词 青年患者 中老年患者 食管癌 外科治疗 预后
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