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Objective: To investigate the factors influencing small intestinal ischemia in elderly patients with incarcerated hernia. Methods: The clinical data of 105 elderly patients admitted for surgical procedures of incarcerated hernia at Department of General Surgery, Huadong Hospital between January 2014 and December 2021 were retrospectively analyzed. There were 60 males and 45 females, aged (86.1±4.3) years (range: 80 to 96 years). They were divided into normal group (n=55) and ischemic group (n=50) according to intraoperative intestinal canal condition. The t test, χ2 test and Fisher's exact probability method were used for the univariate analysis of the factors that influence intestinal ischemia in patients, and Logistic regression was used for multifactorial analysis. Results: In all patients, 18 patients (17.1%) had irreversible intestinal ischemia with bowel resection. Six patients died within 30 days, 3 cases from severe abdominal infection, 2 cases from postoperative exacerbation of underlying cardiac disease, and 1 case from respiratory failure due to severe pulmonary infection. The results of the univariate analysis showed that there were differences in gender, history of intussusception, duration of previous hernia, white blood cell count, neutrophil percentage, C-reactive protein, type of incarcerated hernia, and preoperative intestinal obstruction between the two groups (all P<0.05). The Logistic regression results showed that the short time to the previous hernia (OR=0.892, 95%CI 0.872 to 0.962, P=0.003), high C-reactive protein (OR=1.022, 95%CI 1.007 to 1.037, P=0.003), non-indirect incarcerated hernia (OR=10.571, 95%CI 3.711 to 30.114, P<0.01) and preoperative intestinal obstruction (OR=6.438, 95%CI 1.762 to 23.522, P=0.005) were independent risk factors for the development of intestinal ischemia in elderly patients with incarcerated hernia. Conclusions: The short duration of the previous hernia, the high values of C-reactive proteins, the non-indirect incarcerated hernia, and the preoperative bowel obstruction are influencing factors for bowel ischemia in elderly patients with incarcerated hernia. A timely operation is necessary to reduce the incidence of intestinal necrosis and improve the prognosis.
Subject(s)
Male , Aged , Female , Humans , Retrospective Studies , C-Reactive Protein , Intestinal Obstruction/etiology , Hernia, Inguinal/surgery , Mesenteric Ischemia/surgery , Ischemia/surgery , Herniorrhaphy/adverse effectsABSTRACT
OBJECTIVE: To analyze the application value of biological mesh in inguinal hernia patients aged from 18 to44 years old. METHODS: The clinical data of 127 patients with inguinal hernia admitted from January 2013 to December 2018 in Huadong Hospital Affiliated to Fudan University were analyzed retrospectively. Through the abdominal transverse fascia reinforcement with biological mesh(tTRB), it was to observe indicators during perioperative and followup periods, to explore the application value and treatment experience of biological mesh in young patients with inguinal hernia. RESULTS: All the 127 cases were successfully completed. There were obvious pain in 3 cases and scrotal edema in 3 cases. No other patients were found to have obvious discomfort. All patients had no complications such as recurrence, chronic pain and infection after 3 to 12 months of follow-up. CONCLUSION: The rational use of biological mesh to repair young and middle-aged patients with inguinal hernia is effective. The advantage is that the effect of mesh minimize the impact on long-term quality of life in young patients. At the same time, the risk of postoperative infection and chronic pain is effectively reduced by reinforcement of transverse fascia with biological mesh, which is worthy of further study.
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Objective To investigate the current status and influencing factors associated with the health literacy of the elderly. Methods 24 communities were randomly selected from Jinan City, and 1 201 elderly people were surveyed by the eHealth literacy scale. Univariate analysis was performed using the Chi-square test and multivariate analysis was performed using binary Logistic regression. Results The qualification rate of eHealth literacy among 1 201 older adults was 11.1%. Multivariate analysis showed that primary school education and below (OR=4.50, 95% CI:1.924-10.530, P=0.001), family pension (OR=3.08, 95% CI:1.326-7.165, P=0.009), poor self-rated health (OR=2.12, 95% CI:1.022-4.406, P=0.044), great self-rated life pressure (OR=4.09, 95% CI:1.686-9.938, P=0.002) were risk factors for eHealth literacy in the elderly; urban household registration (OR=0.52, 95% CI:0.337-0.815, P=0.004), the main person to taking care of grandchildren (OR=0.43, 95% CI:0.273-0.682, P<0.001 ), urban basic medical insurance or NCMS medical insurance (OR=0.22, 95% CI:0.047-0.998, P=0.05), commercial medical insurance (OR=0.10, 95% CI:0.019-0.552, P=0.008) and the parents being alive (OR=0.44, 95% CI:0.264-0.719, P=0.001) were protective factors for the elderly eHealth literacy . Conclusion The type of household registration, the level of education, the type of medical insurance, the way of caring for grandchildren, the way of providing for the elderly, the self-rated of health status, with the parents being alive, and the self-rated life pressure are the influencing factors of the eHealth literacy of the elderly.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle.</p><p><b>METHODS</b>From May 2009 to October 2013,12 patients with soft tissue defects combined with tendon and bone exposure in the foot and ankle were treated by lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle, including 9 males and 3 females with an average age of 37.5 years old ranging from 19 to 58 years. Ten cases had the soft tissue defects in the dorsum of foot and 2 in the ankle. The defect area of soft tissue was from 11 cm x 9 cm to 8 cm x 5 cm.</p><p><b>RESULTS</b>Twelve patients were follow-up for 3 to 12 months (averaged 7.3 months). The flaps of 9 cases were survived,the flaps edges of the other 3 cases were necrosis,and healed after dressing change. The flaps were slightly swelling without ulcer occurrence.</p><p><b>CONCLUSION</b>Lateral supramalleolar artery descending branch antidromic flap can repairing the damage by one-stage operation with advantage of dissection easy,rich blood supply without sacrifice of major artery.</p>