ABSTRACT
Objective:To investigate the effect of intraoperative body temperature on prognosis of elderly patients with strangulated small bowel obstruction.Methods:The clinical data of 113 elderly patients with strangulated small intestinal obstruction and perform partial resection and anastomosis admitted to the Affiliated Hospital of Southwest Medical University from December 2017 to June 2022 were retrospectively analyzed. The ROC curve was used to analyze the relationship between the intraoperative body temperature(T) and the prognosis of patients, so as to obtain the optimal cutoff point (Ta). According to the relationship between T and Ta, all patients were divided into hypothermia group (33 cases) (T<Ta) and hyperthermia group (80 cases)(T ≥ Ta), and the differences in prognosis between the 2 groups were compared and Logistic regression was applied to analyze the influence of prognostic factors.Results:The optimal cutoff value (Ta ) of ROC curve was 36.45℃. The incidence of postoperative complications in hypothermia group was 60.6% (20/33), higher than 6.3%(5/80) in hyperthermia group ( χ2=40.06, P<0.01). Multivariate analysis by Logistic regression revealed that enteric perforation and lower intraoperative body temperature were risk factors for surgical prognosis ( OR=9.874, 95% CI 1.260-77.400; OR=69 865.637, 95% CI 90.799-53 758 097.700, both P<0.05). Conclusions:Intraoperative body temperature was a factor affecting surgical prognosis in elderly patients with strangulated small bowel obstruction. The temperature lower than 36.45 ℃ during the operation indicated that the patients were more prone to complications and had worse prognosis. Intensive temperature management was required intraoperatively in elderly patients, and nursing interventions such as warming and heating blankets were necessary.
ABSTRACT
Objective To study the blood pressure control and its influencing factors in community standardized management of hypertension patients,to provide basis for clinical diagnosis and treatment.Methods 120 hypertension patients with community standardized management were selected as study group,another 120 hypertension patients were selected as control group.The blood pressure control was compared between the two groups,and the influencing factors were analyzed.Results The systolic and diastolic blood pressur before treatment between the two groups had no statistically significant differences (all P >0.05).The systolic blood pressure,diastolic blood pressure after admin-istration of the study group were (129.4 ±3.2)mmHg,(87.5 ±2.8)mmgHg,which in the control group were (138.3 ±10.1 )mmHg,(95.7 ±4.3 )mmHg,the differences were statistically significant compared with before treatment (t =9.478,9.074,8.278,8.687,all P <0.05),the differences between the two groups were statistically significant (t =7.654,7.061,all P <0.05).Logistic regression analysis showed that age,body mass index,obesity, smoking,blood pressure level,taste and triglyceride were the influencing factors of blood pressure control (OR =20.564,0.995,0.746,1.092,0.749,1.153,0.854,all P <0.05).Conclusion Community standardized management can enhance the effect of blood pressure control,age,body mass index,obesity,blood pressure level,smoking and so on are the influencing factors.