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Objective:To explore the mediating effect of self-regulation fatigue between acceptance of hearing impairment and work withdrawal behavior in young and middle-aged patients with sudden deafness, so as to provide reference for the formulation of intervention measures for job withdrawal behavior.Methods:A cross-sectional survey was conducted to facilitate the selection of 326 young and middle-aged patients with sudden deafness who were treated in the Department of Otolaryngology, Head and Neck Surgery in the First Affiliated Hospital and the Second Affiliated Hospital of Air Force Military Medical University of the Chinese PLA from February 2021 to January 2022. The survey was carried out by general information questionnaire, the Revised Acceptance Disability Scale, the Self-Regulatory Fatigue Scale, and the Work Withdrawal Behavior Scale. Structural equation model method was used to analyze the mediating effect.Results:The acceptance of hearing impairment score in young and middle-aged patients with sudden deafness was (59.82 ± 10.99) points, the self-regulation fatigue score was (60.38 ± 8.84) points, and the work withdrawal behavior score was (39.06 ± 6.51) points. Self-regulation fatigue was negatively correlated with acceptance of hearing impairment ( r=-0.541, P<0.01). Work withdrawal behavior was negatively correlated with acceptance of hearing impairment ( r=-0.488, P<0.01), and was positively correlated with self-regulation fatigue ( r=0.587, P<0.01). Self-regulation fatigue played a partial mediating effect between the acceptance of hearing impairment and work withdrawal in young and middle-aged patients with sudden deafness, and the mediating effect ratio was 56.30%. Conclusions:The acceptance of hearing impairment can not only directly affect the work withdrawal behavior of young and middle-aged patients with sudden deafness, but also indirectly affect their work withdrawal behavior through self-regulation fatigue. Medical staff should pay attention to the internal relationship between the acceptance of hearing impairment, self-regulation fatigue and work withdrawal behaviors, so as to improve the acceptance of hearing impairment of patients, relieve their self-regulation fatigue, and avoid the occurrence of work withdrawal behaviors.
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【Objective】 To investigate the association between remnant cholesterol (RC) and triglyceride and glucose (TyG) index in young and middle-aged patients with ischemic stroke. 【Methods】 A total of 268 patients were divided into two groups, namely low TyG index group (n=134) and high TyG index group (n=134). Characteristics of the study population and metabolism risk factors (TC, TG, HDL-C, LDL-C, UA) were collected from biochemical test results. Spearman correlation analysis was used to analyze the correlation between metabolism risk factors and TyG index. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for RC and TyG index. 【Results】 Compared with the low TyG index group, significant differences were observed for BMI, history of diabetes, history of hypertension, SBP, DBP, FBG, TC, TG, LDL-C, RC, UA, and TyG index in high TyG index group. No significant differences were observed in age, gender, smoking status, or drinking status, HDL-C between the two groups. Spearman correlation analysis indicated that significant linear associations were observed between BMI, SBP, DBP, FBG, TC, TG, HDL-C, LDL-C, RC, UA and TyG index. Logistic regression analysis revealed that the RC, BMI, hypertension, diabetes, TC, LDL-C, and UA were significantly associated with the risk of increased level of TyG index. After adjusted analysis by RC, BMI, hypertension, diabetes, TC, LDL-C, and UA, only RC was significantly associated with an increased risk of increased level of TyG index. 【Conclusion】 Remnant cholesterol was associated with an increased risk of elevated TyG index level in young and middle-aged patients with ischemic stroke.
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@#Objective To compare the perioperative results of hybrid coronary revascularization (HCR), off-pump coronary artery bypass (OPCAB) and percutaneous coronary intervention (PCI) in elderly patients with three-vessel coronary artery disease involving left anterior descending (LAD) branch and explores the safety of surgery. Methods We prospectively enrolled patients with coronary heart disease over 65 years who were admitted to General Hospital of People’s Liberation Army from January 2018 to September 2019. Coronary angiography results were all three-vessel lesions involving the anterior descending artery. After preoperative examination and assessment by the cardiovascular team, all patients were suitable for OPCAB or PCI treatment. According to the patient’s preference, HCR, OPCAB or PCI were performed. The preoperative baseline data and perioperative results were collected, and SPSS 22.0 was used for statistical analysis. Results A total of 110 patients met the criteria and were included in the study, 28 in the HCR group, 45 in the OPCAB group, and 37 in the PCI group, with an average age of 71.4±5.6 years. There was no statistical difference in the preoperative baseline data of patients among the three groups. The intubation time (P=0.039), perioperative drainage volume (P<0.001), blood transfusion (P=0.021) in the HCR group were lower than those in the OPCAB group. There was no statistical difference in the main organ adverse events (MOAE, P=0.096) and in-hospital mortality (P=0.784) among the three groups of patients. The use of antibiotics in the PCI group was significantly lower than the other two groups (P<0.001). Conclusion HCR combines the advantage of CABG and PCI including proved long-term patency rate with left internal mammary artery-LAD grafting, less trauma and superior long-term patency with PCI in non-LAD territory. Compared with OPCAB and PCI, there is no increase in perioperative major organ adverse events and in-hospital mortality. It is a safe and reliable minimally invasive myocardial revascularization technique for elderly patients with three-vessel coronary artery disease involving the anterior descending artery.
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OBJECTIVE： To investigate the effects of rosuvastatin on in-stent restenosis in middle-aged patients with acute coronary syndrome（ACS）after percutaneous coronary intervention （PCI）. METHODS： Totally 400 middle-aged ACS patients underwent PCI were selected from Xuchang Central Hospital during Mar. 2016 to Apr. 2017， and then divided into control group and observation group according to random number table， with 200 patients in each group. Both groups were given conventional drugs for secondary prevention of coronary heart disease. Control group were given Clopidogrel hydrogen sulfate tablets 75 mg， once a day+Aspirin enteric-coated tablets 100 mg， once a day+Atorvastatin calcium tablets 20 mg， once at bed time every day orally after PCI. Observation group was given Clopidogrel hydrogen sulfate tablets 75 mg， once a day+Aspirin enteric-coated tablets 100 mg， once a day+Rosuvastatin calcium tablets 10 mg， once at bed time every day orally after PCI. Both groups were treated for consecutive 12 months. The serum levels of TG， TC， LDL-C， hs-CRP and IL-35 were recorded in 2 groups before surgery， 1， 3， 6 and 12 months after surgery； in-stent minimum lumen diameter （MLD） was observed immediately after surgery and 12 months after surgery. The occurrence of in-stent restenosis， major adverse cardiovascular events （MACE） and adverse drug reaction （ADR） were recorded. RESULTS： Totally 14 patients dropped out from control group and 18 from observation group， and 368 patients completed the study. Before surgery and immediately after surgery， there was no statistical significance in the serum levels of TG， TC， LDL-C， hs-CRP IL-35 or MLD （P＞0.05）. One day after surgery， the levels of hs-CRP were increased significantly in 2 groups， compared with before surgery （P＜0.05）. One， three， six and twelve months after surgery， the serum levels of TG， TC， LDL-C and hs-CRP were decreased significantly in 2 groups， while the levels of IL-35 were increased significantly， compared with before surgery； and the serum levels of TG and TC （1 and 3 months after surgery）， LDL-C （3 and 6 months after surgery） and hs-CRP （1 month after surgery） in observation group were significantly lower than control group； the level of IL-35 in observation group （1 month after surgery） was significantly higher than control group （P＜0.05）. Twelve months after surgery， MLDs of 2 groups were decreased significantly， and observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of in-stent restenosis or the total incidence of MACE and ADR between 2 groups after surgery （P＞0.05）. CONCLUSIONS： Rosuvastatin can effectively improve the levels of blood lipid and inflammatory factor in meddle-aged patients with ACS after PCI， and its effect is better than that of atorvastatin. The drug can delay in-stent restenosis after PCI in these patients， which is better than the effect of atorvastatin. At the same time， rosuvastatin can not increase the risk of MACE and ADR with good safety.
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BACKGROUND: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups. METHODS: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ‘middle-aged’(45–64 years) and ‘old-aged’(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized. RESULTS: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups. CONCLUSION: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.
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Humans , Ambulatory Care , Cohort Studies , Continuity of Patient Care , Health Policy , Hospitalization , National Health Programs , Organisation for Economic Co-Operation and Development , Primary Health CareABSTRACT
Hepatocellular carcinoma (HCC) is the third most common cancer in the digestive system based on survey of domestic cancer incidence, and the ratio of elderly aged 65 or older is expected to rise steadily, leading to a higher incidence of total hepatocellular carcinoma. The most important thing in treating these older patients with HCC is to assess the benefits and risks of the treatment in advance. In other words, the benefit of treatment should be greater than the reduction of survival period or maladjustment due to treatment. Based on these perspectives, we examined how the detailed treatment of hepatocellular carcinoma differs from that of general treatment in elderly patients. In conclusion, older age was not a definite prognostic factor of survival risk-benefit comparison in the most treatment modalities. However it should be carefully considered and approached about possible complications in treating HCC in elderly patients.
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Aged , Humans , Aging , Carcinoma, Hepatocellular , Digestive System , Incidence , Risk AssessmentABSTRACT
Objective To explore the effect of lidocaine with intravenous infusion on the postoperative inflammatory factors and cognitive dysfumction for elderly patients undergoing spinal operation.Method 80 elderly patients undergoing spinal operation in Central hospital of Baoji were enrolled from Janua-y 2015 to January 2016,of which patients divided into two groups randomly,control group (n =40) accepted routine general anesthesia,and study group (n =40) adopted intravenous lidocaine based on the patiems in control group,comparing the MMSE score and the incidence of postoperative cognitive dysfunction (POCD) with before operation,detecting and analyzing the difference of inflammatory and immunity factors.Results The MMSE score of the study group after three days of operation was significantly lower than that of the control group,the difference was statistically significant (P ＜ 0.05).The incidence of POCD in the study group was significantly lower than that in the control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IgA,IgM and IgG in the study group after seven days of operation were significantly higher than those in the control group,the difference was statistically significant (P ＜ 0.05).After three days and seven days postoperatively,the serum levels of interleukin-6 (IL-6) in the study group were significantly lower than those in the control group,the difference was statistically significant (P ＜ 0.05).And there was no significance of TNF-α between two groups at any time point.Conclusions Intravenous lidocaine for patients undergoing spinal operation could inhibit the inflammatory response,improve the function of immunity,and decrease the incidence of POCD,which deserved popularization in clinic.
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Objective To explore the effect of lidocaine with intravenous infusion on the postoperative inflammatory factors and cognitive dysfumction for elderly patients undergoing spinal operation.Method 80 elderly patients undergoing spinal operation in Central hospital of Baoji were enrolled from Janua-y 2015 to January 2016,of which patients divided into two groups randomly,control group (n =40) accepted routine general anesthesia,and study group (n =40) adopted intravenous lidocaine based on the patiems in control group,comparing the MMSE score and the incidence of postoperative cognitive dysfunction (POCD) with before operation,detecting and analyzing the difference of inflammatory and immunity factors.Results The MMSE score of the study group after three days of operation was significantly lower than that of the control group,the difference was statistically significant (P ＜ 0.05).The incidence of POCD in the study group was significantly lower than that in the control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IgA,IgM and IgG in the study group after seven days of operation were significantly higher than those in the control group,the difference was statistically significant (P ＜ 0.05).After three days and seven days postoperatively,the serum levels of interleukin-6 (IL-6) in the study group were significantly lower than those in the control group,the difference was statistically significant (P ＜ 0.05).And there was no significance of TNF-α between two groups at any time point.Conclusions Intravenous lidocaine for patients undergoing spinal operation could inhibit the inflammatory response,improve the function of immunity,and decrease the incidence of POCD,which deserved popularization in clinic.
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Objective To investigate the current situation of prediabetic self-efficacy of middle aged and elderly prediabetes and its influencing factors. Method Unified questionnaires were used to investigate the self-efficacy of 234 prediabetes and its influencing factors. Results The total scores of self-efficacy in the middle-aged and elder prediabetes were at moderate level. The score of the older patients was significantly higher than that of the middle aged (P<0.01). Multiple regression analysis showed that marital status and disease knowledge were main factors impacted their self-efficacy of the middle aged and family history of diabetes and the disease knowledge were the main factor affecting the self-efficacy of the elderly prediabetes. Conclusions The self-efficacy of middle-aged and elderly prediabetes is at middle level. Nurses need to enhance the knowledge of the prediabetic patients, attaching more attention to those not in marriage and those without history of diabetes so as to strengthen their self-efficacy.
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Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.
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Objective To study the clinical effect of the treatment of patients with bronchial dilation in the treatment of patients with the combination.MethodsWenzhou Hospital of integrated traditional Chinese and Western Medicine in March 2013~July 2015 diagnosed and treated with bronchial dilation and infection of 72 cases of elderly patients, according to the random number table method is divided into the study group and the control group, each group of 36 people.Two groups were given conventional intervention of bronchial dilation.The control group in the conventional intervention based on the given first cell risperidone sulbactam sodium and ambroxol intravenous injection treatment.The study group in the control group on the basis of the implementation of the whole treatment plan based on bronchial alveolar lavage and local administration of rice.Compared with the two groups, the main symptoms and signs of the total improvement time, blood gas indicators before and after treatment.ResultsThe study group cough sputum, fever and chest X-ray shadow the significant remission time were significantly faster than that of the control group (P<0.05).After treatment, two groups above the index of blood gas analysis were group than before treatment significantly improved (P<0.05) study group on each index improved significantly better than the control group (P<0.05).ConclusionAged bronchiectasis infection patients given according to for etimicin plus bronchoalveolar lavage can be more significant to promote the improvement of patients with respiratory symptoms and signs, curb inflammation.At the same time, the index of blood gas and respiratory function in patients with more significant.
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Objective To analyze and summarize the short-term clinical efficacy and surgical points of transurethral columnar balloon dilation of prostate for middle-aged and high-risk prostatic hyperplasia patients.Methods A total of 30 patients with benign prostatic hyperplasia(BPH) admitted to our department from March 2016 to December 2016 was retrospectively analyzed,including 9 middle-aged patients(less than 60 years old) and 21 high-risk patients with various underlying diseases(more than 80 years old).Transurethral columnar balloon dilation of prostate was adopted and performed in accordance with standard operation process.Results All 30 patients were operated successfully by extending their prostate at the direction of 12 o'clock to the fat layer with short operation time and less amount of bleeding.The complication rate was 6.7％ (2/30),and the catheter was removed smoothly after the operation.After 1 month and 6 months follow-up,the international prostate symptom score(IPSS),quality of life score(QOL),maximum urinary flow rate(Qmax),residual urine(RUV) and other indicators were analyzed and were statistically significant(P＜0.05).Conclusion Transurethral columnar balloon dilation of prostate is an effective and supplemental method for the treatment of BPH in middle-aged and high-risk patients.
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Objective To study the effect of nasal decontamination on clinical index of elderly patients with long -term indwelling nasogastric tube.Methods 89 elderly patients with long -term indwelling nasogastric tube were randomly divided into nasal decontamination group and routine treatment group.The sputum culture positive rate of bacterial and the incidence of pulmonary complications,pharyngitis,sinusitis of the two groups were observed. Results Sputum Staphylococcus aureus positive rates in the nasal decontamination group and conventional group were 13.043% (6 cases)and 39.535% (17 cases)respectively,the difference was significant(χ2 =8.139,P =0.004).The incidence rates of pulmonary infection in the nasal decontamination group and conventional group were 4.348% (2 cases)and 18.605% (8 cases)respectively,the difference was significant(χ2 =4.529,P =0.033). The incidence rates of pharyngitis in the nasal decontamination group and conventional group were 10.870%(5 cases)and 37.209% (16 cases) respectively,the difference was significant (χ2 =8.553,P =0.003 ). Conclusion Nasal decontamination can decrease the positive rate of sputum bacterial culture,the incidence of pulmonary infection and pharyngitis in elderly patients with long -term indwelling nasogastric tube.For its efficacy and safety,it deserves clinical application.
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Objective To evaluate the effects of edaravone on postoperative delirium in aged patients following total hip -re-placement surgery . Methods Two hundred and forty-six patients undergoing unilateral hip replacement surgery were randomly divided into edaravone group and control group .Patients in the edaravone group were intravenous injected with edaravone 30 mg before anesthesia induction, whereas patients in the control group received the same volume of saline solution .On preoperative day 1 and postoperative day 1, confusion assessment was applied to evaluate the consciousness of patients .The length of hospital stay , incidence of myocardial infarc-tion, stroke, pulmonary embolism, pneumonia and transfusion volume were also recorded .Also, the levels of plasma malondialdehyde ( MDA) superoxide dismutase ( SOD) , neuron-specific enolase ( NSE) and S100βprotein ( S100β) were measured on the preoperative and postoperative day 1. Results There was no difference in the length of hospital stay , the incidence of perioperative acute pulmonary embolism, myocardial infarction and stroke (P>0.05).POD was significantly lower in the edaravone group than the control group (P0.05).On the postoperative day 1, plasma levels of MDA and NSE were significantly lower in the edaravone group than the control group (P<0.05). Conclusion Edar-avone can reduce the incidence of POD in aged patients following total hip-replacement surgery .
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Objective To compare the effect of Zhigancao Decoction and Zhenwu Decoction on hemodynamics, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and myocardial enzyme of elderly patients with chronic heart failure.Methods 40 elderly patients with chronic heart failure in the first affiliated hospital of the medical college, Shihezi university were selected and randomly divided into Zhigancao Decoction group (n=20) and Zhenwu Decoction group (n =20) .The both of two groups were given conventional treatment, then were treated with respective drug according to different groups with two courses, one course of two weeks.The hemodynamic, MMP-9, TIMP-1 and myocardial enzyme spectrum indexes of two groups were compared post-treatment.Results After treatment, the indexes of hemodynamics in two groups were improved, hemodynamic indexes of Zhigancao Decoction recovered better than those of Zhenwu Decoction (P<0.05) .The serum MMP-9, MMP-9/TIMP-1 of Zhigancao Decoction group were lower and TIMP-1 was higher than those of Zhenwu Decoction group (P<0.05).The myocardial enzyme indexes in both groups were lower post-treatment, and the above indexes in Zhigancao Decoction were lower than those in Zhenwu Decoction group (P<0.05) . Conclusion Zhigancao Decoction could obviously improve the symptoms of chronic heart failure in elderly patients, which has the guiding significant in the clinical treatment.
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Objective To investigate the correlations between social support and self efficacy of young and middle-aged patients with peritoneal dialysis. Method The status of social support and self-efficacy of 97 young and middle-aged patients undergoing peritoneal dialysis were investigated and the correlation were analyzed. Results The score on social was (28.0 ± 6.4), lower than the norm (P < 0.01). The score on self-efficacy was (2.38 ± 0.62). The level of confidence was lower in 28 cases (28.9%), high in 58 cases (59.8%), very high in 11 cases (11.3%). The self-efficacy was positively correlated with social support, subjective support and support utilization (all P<0.05). Conclusions The levels of social support and self-efficacy are lower than the norm in young and middle-aged patients undergoing peritoneal dialysis. The self-efficacy is positively correlated with social support including subjective support and support utilization, which indicates that improved social support is effective for the improvement of self-efficacy by providing patients with family and social support.
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PURPOSE: This study was to evaluate the characteristics of selective spinal anesthesia using 1 mg of bupivacaine combined with fentanyl or sufentanil in elderly patients undergoing transurethral resection of prostate. MATERIALS AND METHODS: Fifty-six patients were randomized into two groups. The Fentanyl group received 0.5% hyperbaric bupivacaine 0.2 mL+fentanyl 20 microg+5% dextrose 1.4 mL, and the Sufentanil group received 0.5% hyperbaric bupivacaine 0.2 mL+sufentanil 5 microg+5% dextrose 1.7 mL intrathecally. Intraoperative and postoperative characteristics were evaluated. Patient satisfaction was assessed postoperatively. RESULTS: Twenty-six patients in each group completed the study. The median peak sensory block level was similar between two groups, but sensory regression time was longer in the Sufentanil group than the Fentanyl group (p=0.017). All patients were able to move themselves to the bed without any aid when they arrived at the admission room. Pain scores were lower in the Sufentanil group than the Fentanyl group at postoperative 6, 12, and 18 hours (p=0.001). Compared to the Fentanyl group, the Sufentanil group required less postoperative analgesia (p=0.023) and the time to the first analgesic request was longer (p=0.025). Twenty-four of 26 patients (92.3%) in each group showed "good" satisfaction level. CONCLUSION: Selective spinal anesthesia using 1 mg of bupivacaine with fentanyl or sufentanil provided appropriate sensory block level with spared motor function for transurethral resection of the prostate in elderly patients. Intrathecal sufentanil was superior to fentanyl in postoperative analgesic quality.
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Aged , Aged, 80 and over , Humans , Male , Analgesics, Opioid/administration & dosage , Anesthesia, Spinal/methods , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Double-Blind Method , Drug Therapy, Combination , Fentanyl/administration & dosage , Injections, Spinal , Patient Satisfaction , Postoperative Period , Prospective Studies , Prostate/surgery , Sufentanil/administration & dosage , Time Factors , Transurethral Resection of Prostate , Treatment OutcomeABSTRACT
PURPOSE: This study was to evaluate the characteristics of selective spinal anesthesia using 1 mg of bupivacaine combined with fentanyl or sufentanil in elderly patients undergoing transurethral resection of prostate. MATERIALS AND METHODS: Fifty-six patients were randomized into two groups. The Fentanyl group received 0.5% hyperbaric bupivacaine 0.2 mL+fentanyl 20 microg+5% dextrose 1.4 mL, and the Sufentanil group received 0.5% hyperbaric bupivacaine 0.2 mL+sufentanil 5 microg+5% dextrose 1.7 mL intrathecally. Intraoperative and postoperative characteristics were evaluated. Patient satisfaction was assessed postoperatively. RESULTS: Twenty-six patients in each group completed the study. The median peak sensory block level was similar between two groups, but sensory regression time was longer in the Sufentanil group than the Fentanyl group (p=0.017). All patients were able to move themselves to the bed without any aid when they arrived at the admission room. Pain scores were lower in the Sufentanil group than the Fentanyl group at postoperative 6, 12, and 18 hours (p=0.001). Compared to the Fentanyl group, the Sufentanil group required less postoperative analgesia (p=0.023) and the time to the first analgesic request was longer (p=0.025). Twenty-four of 26 patients (92.3%) in each group showed "good" satisfaction level. CONCLUSION: Selective spinal anesthesia using 1 mg of bupivacaine with fentanyl or sufentanil provided appropriate sensory block level with spared motor function for transurethral resection of the prostate in elderly patients. Intrathecal sufentanil was superior to fentanyl in postoperative analgesic quality.
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Aged , Aged, 80 and over , Humans , Male , Analgesics, Opioid/administration & dosage , Anesthesia, Spinal/methods , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Double-Blind Method , Drug Therapy, Combination , Fentanyl/administration & dosage , Injections, Spinal , Patient Satisfaction , Postoperative Period , Prospective Studies , Prostate/surgery , Sufentanil/administration & dosage , Time Factors , Transurethral Resection of Prostate , Treatment OutcomeABSTRACT
Objective To explore the surgical treatment of cervical and upper thoracic esophageal carcinoma in patients aged 70 or ol-der. Methods A retrospective analysis were made among 68 patients who were over 70 years old, and all the patients have undergone stom-ach esophagus cervical anastomosis through esophageal carcinoma excision and regional lymph node cleaning. Results All the 68 patients have completed the surgery successfully, and they have recoveried well except 3 cases of death. And the main postoperative complication was cardiopulmonary complication and anastomotic fistula. Conclusion Operative treatment of ercervical and upper thoracic esophageal carcino-ma for elderly patients is characterized with highly difficulty and more complications. Stomach esophagus cervical anastomosis through 2-inci-sion with left chest and left neck could simplify the operative procedure, decrease the postoperative complication and improve the curative effect.
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PURPOSE: The purpose of this study is to evaluate the risk of sequential bilateral total knee arthroplasty (TKA) under 1 anesthesia in patients 75 years or older. MATERIALS AND METHODS: Patients aged 75 years or older who underwent sequential bilateral TKA (bilateral group, n=159) and unilateral TKA (unilateral group, n=159) between 2002 and 2012 were selected. All patients were evaluated for underlying medical diseases, such as cardiac, pulmonary, and renal problems, and high-risk patients were recommended to postpone the surgery. We compared the underlying diseases, major postoperative complications, and the length of hospital stay between bilateral and unilateral groups. RESULTS: The prevalence of underlying diseases of the bilateral group was 74.8% and major complications occurred in 6 patients (3.8%). The prevalence of underlying diseases of the unilateral group was 52.4% and complications were observed in 4 patients (2.4%). Although the complication rate of the bilateral group was slightly higher than that of the unilateral group, the difference was not statistically meaningful (p=0.204). The length of hospital stay was 21.9 days for the bilateral group and 24.9 days for the unilateral group. CONCLUSIONS: There was no significant difference in postoperative complications between groups. The result shows that bilateral TKA can be relatively safe compared with unilateral TKA in patients 75 years or older. However, careful selection of low-risk patients is advised.