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Objective:To explore the influence of continuous quality improvement of nursing care on the compliance of senile patient with gastroscopy.Methods: 100 senile patients with gastroscopy were selected, and they were divided into control and improvement groups ( each group included 50 cases ) depended on the different time of hospitalization. The control group was treated with routine nursing quality method, while the improvement group was treated with continuous quality improvement method. A series of indicators in the endoscopic examination, such as the success rate of one time intubation, the used time, yes or no cough and other adverse reactions and the patient's satisfaction for nursing services were compared between the two groups.Results:After 5 months of continuous quality improvement nursing, the success rate of one time intubation in the improvement group was significantly higher than that in the control group, and the checking time of improvement group was significantly less than that of control group, the differences were statistically significant(t=7.162,t=6.61; P<0.01). Besides, on check process, the incidence of adverse reactions in the improvement group was significantly lower than that in the control group and the satisfaction of nursing service was significantly higher than that of the control group, the differences were statistically significant(x2=23.077,x2=10.699,P<0.01).Conclusion:The application of continuous quality improvement nursing for senile patients during gastroscopy can improve the success rate of one time intubation, shorten the gastroscopy time, reduce the incidence of adverse reactions, enhance compliance of gastroscopy and satisfaction for nursing service, and its clinical effect is obvious.
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Objective To explore the clinical manifestations ,risk factors and treatment of antibiotic asso-ciated diarrhea(AAD)in senile patients with severe bacterial pneumonia. Methods Retrospective analysis was made on senile patients of bacterial pneumonia combined with antibiotic associated diarrhea. Results There were 114 patients out of 572 cases had AAD. The incidence of AAD in these senile patients was 19.93%. There were 62.28% patients more than 80 years old. The incidence AAD was 37.3% with third generation cephalosporin treat-ment,28.6% penicillin with enzyme inhibitor treatment and 19.2% with carbopenems treatment. Conclusions The high risk factors of AAD in senile patients with bacterial pneumonia include patient′s age,and time, APACHE Ⅱ,category,combination therapyof antibacterial,and invasive operations. We should pay more atten-tion to AAD and related high risk factors when using these antibiotics in clinics. Rational selection and use of anti-bacterial are important measures to stop senile patients from ADD. Pharmaceutical care could help to optimize the treatment plan and reduce its adverse reaction of antibacterial in senile patients.
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Objective To explore the clinical manifestations ,risk factors and treatment of antibiotic asso-ciated diarrhea(AAD)in senile patients with severe bacterial pneumonia. Methods Retrospective analysis was made on senile patients of bacterial pneumonia combined with antibiotic associated diarrhea. Results There were 114 patients out of 572 cases had AAD. The incidence of AAD in these senile patients was 19.93%. There were 62.28% patients more than 80 years old. The incidence AAD was 37.3% with third generation cephalosporin treat-ment,28.6% penicillin with enzyme inhibitor treatment and 19.2% with carbopenems treatment. Conclusions The high risk factors of AAD in senile patients with bacterial pneumonia include patient′s age,and time, APACHE Ⅱ,category,combination therapyof antibacterial,and invasive operations. We should pay more atten-tion to AAD and related high risk factors when using these antibiotics in clinics. Rational selection and use of anti-bacterial are important measures to stop senile patients from ADD. Pharmaceutical care could help to optimize the treatment plan and reduce its adverse reaction of antibacterial in senile patients.
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Objective To investigate the clinical value of early endoscopic intervention in diagnosis and treatment of acute nonvariceal upper gastrointestinal bleeding (ANVUGIB). Methods A retrospective analysis was performed of 150 senile patients with ANVUGIB who were intervened by early endoscopy or selective endoscopy from Janurary 2015 to September 2015. The causes of ANVUGIB were analyzed. The diagnosis rates, success rates of hemostasis, rates of rebleeding, surgery, hemostatic time, blood transfusion volume, hospitalization time, hospitalization cost were compared in early endoscopy group and selective endoscopy group. The quality of life was compared between the two groups by NHP after the patients left hospital for three months. Results Peptic ulcer, gastric cancer, acute hemor-rhagic gastritis were the three major causes of ANVUGIB. The diagnosis rate and successful hemostasis rates of early endoscopy group were significantly higher than that in selective endoscopy group ( < 0.05). The rates of rebleeding and surgery were significantly lower, the blood transfusion volume was reduced, hospitalization time were shorten, and hospitalization cost were lower in early endoscopy group ( < 0.05). The quality of life of early endoscopy group was statistically higher than that in selective endoscopy group ( < 0.05). Conclusion Early endoscopic intervention is safe, effective and identify hemorrhage cause fast in diagnosis and treatment in senile patients with ANVUGIB. It is worthy of widespread promoting.
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Objective To investigate traditional Chinese medical emotional intervention on the cognition function of senile patients after abdominal surgery. Methods Seventy senile patients having elective abdominal operation were randomized into intervention group and control group, 35 cases in each group. The control group received routine peri-operative nursing, and the intervention group was given routine peri-operative nursing and emotional intervention based on the theory of traditional Chinese medicine. The cognition function was evaluated with mini-mental state examination (MMSE) on preoperative day 1, postoperative day 3 and 7, and serum S100βprotein level was detected before operation and on postoperative day 7. Results (1)Time for recovery from general anesthesia in the intervention group was much shortened as compared with that of the control group(P0.05). (3) On postoperative day 7, serum S-100β protein level in the two groups was increased as compared with that before treatment(P0.05). Conclusion Traditional Chinese medical emotional intervention has an effect on shortening time for recovery from general anesthesia and decreasing POCD incidence, but has no effect on POCD incidence and serum S100βprotein level on postoperative day 7.
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Objective To observe the effect of tongue-drawing at lateral position in nasogastric intubation for senile patients with conscious disorders. Methods One hundred senile patients with conscious disorders were randomly divided into observation group and control group with 50 cases in each group. The patients in the control group were given routine nasogastric intubation while those in the observation group were given nasogastric intubation by tongue drawing at the lateral position. The two groups were compared in terms of success rate of intubation, the rate of adverse reactions and intubation effects. Result Compared with the control group, the observation group showed significantly higher in one-time intubation success rate , comfort rate and lower rate of adverse reaction (all P<0.01). Conclusions The nasogastric intubation by tongue-drawing at lateral position is superior to the routine intubation. It can improve the success rate of one-time intubation, decrease the rate of adverse reactions and relieve the pains of patients.
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OBJECTIVE:To systematically review the efficacy and safety of escitalopram versus paroxetine in treatment of se-nile patients with depression in China,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP,Wanfang database,CBM database,randomized controlled trials(RCT)of escitalopram(test group)versus paroxetine (control group) in the treatment of senile patients with depression in China were collected. After quality evaluation and data ex-tract,Meta-analysis was performed by using Rev Man 4.2 statistics software. RESULTS:A total of 14 RCT were included,involv-ing 1 148 patients. Results of Meta-analysis showed there was no significant difference in the cure rate[OR=1.20,95%CI(0.93, 1.53),P=0.16],significant effective rate[OR=1.23,95%CI(0.94,1.61),P=0.12],the incidences of headache[OR=0.81,95%CI (0.40,1.65),P>0.05],the incidences of tachycardia [OR=0.37,95%CI(0.09,1.52),P>0.05],the incidences of insomnia [OR=1.26,95%CI(0.33,4.82),P>0.05] and the incidences of tremor [OR=0.31,95%CI(0.04,2.24),P>0.05] between test group and control group;the incidences of xerostomia[OR=0.50,95%CI(0.31,0.80),P<0.05],the incidences of nausea[OR=0.49,95%CI (0.36,0.66),P<0.05],the incidences of sweating [OR=0.31,95%CI(0.15,0.62),P<0.05],the incidences of constipation[OR=0.31,95%CI(0.15,0.64),P<0.05],the incidences of dizziness[OR=0.38,95%CI(0.20,0.72),P<0.05] and the incidences of an-orexia[OR=0.45,95%CI(0.21,0.99),P<0.05] in test group were significantly lower than control group,there were significant dif-ferences in 2 groups. CONCLUSIONS:The efficacy of escitalopram and paroxetine is similar in the treatment of senile patients with depression,however,the safety of escitalopram is better than paroxetine. Due to the limit of methodological quality and sam-ple size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.
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Objective To investigate the effect of nursing intervention on bowel cleaning of patients with senile constipation during electronic bowel preparation for colonoscopy.Methods Forty patients with senile constipation undergoing routine bowel preparation for colonoscopy were treated with nursing intervention.The bowel cleaning effect and the satisfaction degree after bowel cleaning were assessed. Results The qualification rate of bowel cleaning reached 92.5%,and the excellence rate of cleaning comfort 95.0%.Conclusion The pertinent nursing intervention to the elderly patients with constipation undergoing electronic colonoscopy may improve the rate of cleaning the bowels as well as their level of comfort so that the patients can live smoothly through the electronic colonoscopy.
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Objective To reduce the feasibility of combining the two fall assessment scales in nursing patients..Methods Two nurses were assigned to conduct the assessments among 60 senile patients using Morse assessment scale and Hendrich Ⅱassessment scale to screen patients with high-risk fall.Result The number of high-risk patients using Morse assessment scale was larger than that using Hendrich II assessment scale(P<0?05) Conclusions The combined use of Morse fall assessment scale and HendrichⅡfall assessment scale may make up the shortcomings of each other,assess the risk factors and predict the high risk factors.
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OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens from lower respiratory tract in senile patients. METHODS The sputum and lower respiratory tract secretion in the senile patients with lower respiratory tract infection were collected nearly five years,and identified.The drug sensitivity test,the results of examination were judged according to NCCLS standard. RESULTS The Gram-negative bacilli accounted for 79.5%.The Gram-positive bacteria accounted for 20.5%.The predominant pathogens were Pseudomonas aeruginosa(19.6%),coagulase-negative Staphylococci(CNS)(18.7%),and acinetobacter lwoffi(11.6%).The resistant bacteria were markedly increasing. CONCLUSIONS The Gram-negative bacilli are the major pathogens in the senile deceased patients.The incidence of CNS infection is markedly increasing.The isolating rate of meticillin-resistant CNS is 100.0%.
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Objective To investigate the effect of family nursing intervention on family function and negative affect of bod-ridden senile patients. Methods 60 elderly bed-ridden patients were ran-domly divided into the observation group and the control group with 30 patients in each. Traditional nurs-ing was used as intervention method for the control group, while OPT (outcome present state testing mod-el) was chosen in the observation group. Questionnaires family care index (APGAR), activities of daily living scale (ADL), anxiety rating scale (SAS), geriatrie depression scale (GDS) and life satisfaction in-dex A (LSIA) were used to assess the nursing effect before and after the intervention using,X2 and t test. Results One year after the intervention, the score of each scale in the observation group was better than that of the control group. Conclusions Combination of OPT model with familial cooperation to give cor-responding nursing intervention for bed-ridden senile patients can effectively increase their family function, enhance the activity of daily life, relieve patients" negative emotion, raise their quality of life, all of these possess positive premotive effect on the life significance of patients.
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To preliminarily determine the appropriate dosage of carboplatin (CBP) at AUC of 5 mg·Ml-1·min-1 in the combination chemotherapy for Chinese senile patients with non-small cell lung cancer (NSCLC). Thirty-five Chinese senile patients with NSCLC in advanced stage (Ⅲ/Ⅳ) were given 96 cycles of combination chemotherapy. Chemotherapy schedules included Taxol+CBE Gemzar+CBP and NVB+CBP. The dose of CBP was at 5 mg·mL-1·min-1 of area under the concen- tration-time curve (AUC). Side effects and quality of life were observed before and after the chemo- therapy. Myelosuppression was severe and commonly observed. Grade 3/4 of granuiocytopenia was found in 47.9% (46/96) of the patients and grade 3/4 of thrombocytopenia was noted in 28.1% (27/96) of the subjects. However, other side effects were slight. The mean score of quality of life (QOL), ac- cording to the criteria of QOL for Chinese cancer patients had reduced 6.8. At 5 mg·mL-1·min-1 by AUC, the hematological toxicity of CBP was severe and it had some negative effects on the QOL. The administration of CBP at 5 mg·mL-1·min-1 by AUC may be too high for Chinese senile patients with non-small cell lung cancer.
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OBJECTIVE To investigate the distribution and drug resistanc of nosocomial infection pathogens from lower respiratory tract in senile patients in different season.METHODS The sputum samples from lower respiratory tract infection in senile patients in two years,were collected to identify pathogens and drug sensitivity test j udged according to NCCLS standard.RESULTS The gram-negative bacilli accounted for 85.7%.The gram- posutive bacilli accounted for 14.3%.The predominant pathogens were Pseudomonas aeruginosa(20.3%),Kleb- siella pneumoniae(14.5%),Acinetobacter lwof fi(9.8%),coagulase-negative staphylococci(9.0%).The distribution and antibiotic-resistanc of main pathogens had different characteristics in different season. CONCLUSIONS Understanding the characteristics of local pathogen spectruma and the antibiotic-resistanc of main pathogens in different season were signincant on prevention and therapy of the lower respiratory tract infection in senile patients.
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OBJECTIVE To study the distribution and drug resistance of nosocomial infection pathogens isolated from of lower respiratory tract in senile patients and preventive control measures.METHODS The sputum and lower respiratory tract secretion of 594 senile patients were cultured to detect pathogens which were confirmed by routine methods.Disk diffusion test was used to analyze drug resistance.RESULTS Pseudomonas aeruginosa was the top one(21.2%).The drug resistance of Gram-negative organisms were the highest.Extensive-spectrum beta-lactamase(ESBLs) were tested out with 38.2% occurrence.CONCLUSIONS Strictly control in every step of procedures could reduce nosocomial infection.
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OBJECTIVE To study the distribution and drug resistance supervision of infection pathogens of Gram-negative bacterial pneumonia in lower respiratory tract of senile patients and draft preventive and control measures.METHODS The sputum and lower respiration secretion of 368 senile patients were cultured to detect pathogens which were confirmed by routine methods.The disk diffusion test was adopted to analyze drug resistantce.RESULTS Pseudomonas aeruginosa rated the top one,reached 25.0%;the drug resistance supervision manifested that the resistant rates of Gram negative organisms to the routine drugs were high except for Haemophilus influenzae.And extensive-spectrum beta-lactamases(ESBLs) occurred with rate of 30.2%.CONCLUSIONS It is very necessary for clinical microbiology department to detect pathogens of lower respiratory tract pneumonia among senile patients and then to give reasonable advice for medicine in time.
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Objective To sum up the clinical experience of operative management of tibia plateau fracture in senile patients. Methods 35 cases of senile tibia plateau fracture were treated with different ways of internal fixation, including screw, cannulated compression screw, L shaped plate, and T shaped plate. Results All the 35 cases were followed up and the time ranged from 6 months to 2 years. X ray films showed that the anatomical reduction was reached and the fractures healed in 33 cases. The final results were rated according to Merchant criteria: excellent in 22 cases, good in 9 cases, fair in 2 cases and poor in 2 cases. The excellent and good rates were 85.7%. Conclusions Operation on senile patients with tibia plateau fracture should be performed early so as to reconstruct the articular surface. Rigid fixation and bone transplantation are impartment means to avoid plateau collapse, and early functional exercise can reduce postoperative complications.
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OBJECTIVE:To evaluate the clinical efficacy and adverse effects of mycobacterium bovis in combination with antituberculosis drugs for initially treated smear positive pulmonary tuberculosis(TB)in senile patients.METHODS:A total of 121 initially treated smear positive TB cases were assigned to receive 2HReZE/4HRe alone(control group,n=61)or in combination with Mycobacterium bovis(22.5 ?g,once in two weeks for 6 months started at the end of the second week,treatment group,n=60).RESULTS:At the end of the first and second month since treatment,the sputum negative conversion rates showed significant differences between the treatment group and the control group(63.9% and 86.9% respectively in treatment group vs.30.0% and 58.3%,respectively in control group)(P0.05).CONCLUSION:As compared with antituberculosis drugs alone,the concomitant use of mycobacterium bovis and antituberculosis drugs shortened the time for the sputum negative conversion,focal absorption on X-ray chest film and clinical symptom improvement in initially treated smear positive senile TB patients,and mycobacterium bovis is a satisfactory immunotherapeutic agent for TB and it can be used in combination with antituberculosis drugs for smear positive senile TB patients.
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The diagnosis of gastric cancer in young age group was sometimes missed .The operative risk in senile age group was high because of combined other organ diseases. We tried to determine the difference in their correct clinicopathologic features and the prognosis of young and senile patients with gastric cancer. Clinicopathologic characteristics and surgical results were compared in 40 senile gastric cancer patients who were aged 65 years or above, and in 48 young gastric cancer patients who were aged 40 years or less. In clinicopathologic features, the senile group was characterized by a high incidence of well differentiated adenocarcinoma and intestinal type by Lauren classification. The young age group was characterized by high incidence of undifferentiated type adenocarcinoma and diffuse type by Lauren classification . The others were unremarkable. When the survival rate was compared in all cases between young and senile group, the young age group showed a more favorable prognosis than the senile group, but without statistical difference ( P=0.0058 ) . Also, the survival rate according to UICC stage showed no statistical difference when the same stage of the two different groups were compared . Both group showed better survival in curative surgery cases than in noncurative surgery cases.Our findings ruled out any relationships between age and length of survival time in patients undergoing curative gastrectomy for gastric cancer.
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Humans , Adenocarcinoma , Classification , Diagnosis , Gastrectomy , Incidence , Prognosis , Stomach Neoplasms , Survival RateABSTRACT
To discuss the ethical factors influencing the standard diagnosis and treatment of sexual transmitted diseases(STDs) on special population including senile patients,pregnant and lying-in women and children.The senile patients with STDs had a decline of physiological function and might have foundational diseases,some of these patients had the psychological characteristics such as unclear talk,uncertain memory,stronger self-esteem,and had a decline of life quality.Therefore hte main ethical measures during the senile patients with STDs should include considering the pathophysiological and psychological characteristics,adopting individual diagnosis and treatment,making the skill of inquiring and physical examination,and attaching importance to the improvement of life quality.The main ethical measures during the pregnant and lying-in women with STDs should include attaching importance to the marriage examination and pregnant examination,finding potential STDs as soon as possible,and weighing potential medical risk.The main ethical measures during the children with STDs should include paying attention to the infection of family members or sex-aggression,making the protective medicine,doing well the propaganda and education,and making the children away from STDs.
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This article discusses the problems about Senile patients of loss tooth in the diagnosis and treatment,The problems main1y include:(1) moral responsibility is not strong when doctors are inquired;(2) it is not careful enough in diagnosis and treatment;(3)designing and makeing denture are not normative and characteristics of senile patients are not considered.The author brings forward some suggestions:(1) moral responsibility must be strong enough when inquiring history,treatment and diagnosising;(2)it must be careful enough and personality of patients may be respected when designing and make denture,meanwhile characteristic of senile patients must be considered;(3)life of senile patients should be respected and cherished and the quality of life should be attached importance to: