Objective Evidence-based medicine was used to make an individualized treatment plan for newly diagnosed prostatic hyperplasia in an elderly patient. Methods After clinical problems were discovered, evidence was collected from CBM, CNKI, The Cochrane Library, PubMed, EMBASE, ScienceDirect, Springer, and ProQuest databases according to our predefined search strategy. The search was done through 2008. The internal and external validity of the evidence was assessed. The evidence, combined with the patient value, was applied to the patient. Results A total of 39 systematic reviews involving 137 randomized controlled trials were identified. A rational treatment plan was made upon a critical evaluation of the data. After one year follow-up, the treatment protocol was proven correct. Conclusion The treatment efficacy in newly diagnosed prostatic hyperplasia in the elderly has been improved by determining an individualized treatment protocol according to evidence-based methods.
【摘要】 目的 探討優質護理活動中應用風險管理措施提高住院老年患者安全的作用和意義。 方法 對2010年2月-2011年3月開展優質護理活動實施風險管理后，其老年住院患者安全事件預防控制情況進行回顧分析。 結果 應用風險管理措施后老年住院患者的護理不良事件發生減少，患者對護理工作的滿意度提高。 結論 加強風險管理有助于保障患者安全，提高患者滿意度，構建和諧護患關系。【Abstract】 Objective To investigate the role and the effect of risk management in good care service on the safety of elder in-patients. Methods From February 2010 to March 2011, the risk management was carried out during applying good care service. The prevention and control of the poor nursing events for the elder in-patients were retrospectively analyzed. Results The poor nursing events for the elder in-patients decreased obviously after the application of risk management, and the patients were pleased with the service of nurses. Conclusion Risk management is conducive to prove the safety of the in-patients, improve the degree of satisfaction of the patients, and make the harmonious relations between the nurses and the patients.
本文通過總結護士與老年患者進行一般性溝通和治療性溝通的臨床護理經驗,提出改善臨床護患溝通的重要性和意義,旨在增進老年病房護士的臨床溝通技巧,適應不斷增長的老年患者服務需求,提高老年病房護理質量。
ObjectiveTo discuss the clinical characteristics of liver cirrhosis in elderly patients. MethodsWe retrospectively analyzed the clinical data of 67 patients (elderly group) with liver cirrhosis aged ≥60 treated between January 1998 and December 2010. Then, we compared these cases with another 72 liver cirrhosis patients (non-elderly group) aged<60. ResultsThe incidence of jaundice, ascites and albumin deficiency in the elderly patients was significantly higher than that in the non-elderly patients (P<0.05). Complications in the elderly group were relatively more, including electrolyte imbalance, infections, gastrointestinal bleeding, hepatic encephalopathy, liver cancer, liver and kidney syndrome and liver and lung syndrome, and the incidence of these complications was all significantly higher than the non-elderly group (P<0.05) except the liver and kidney syndrome (P>0.05). The causes of liver cirrhosis in both groups were similar. The most common cause was hepatitis B virus infection, followed by chronic alcoholism, but in the elderly group, chronic alcoholism, cholestasis, poisoning from medicines and poisons and liver blood circulation disorders were more common than the non-elderly group (P<0.05); hepatitis B and non-alcoholic fatty hepatitis were more common in the non-elderly group than in the elderly group (P<0.05). The elderly group had more Child-Pugh class C cases (P<0.05), while there were more class A cases in the non-elderly group (P<0.05). Twenty-six patients died in the elderly group with a mortality rate of 38.8%; while only 13 died in the non-elderly group with a mortality rate of 18.1%. The difference of mortality rate was significant between the two groups (P<0.05). Common causes of death in the elderly group were infection, hepatic encephalopathy, and electrolyte disorders and gastrointestinal bleeding, while the common causes of death in the non-elderly group were gastrointestinal bleeding and electrolyte disorders. ConclusionThe etiology, clinical manifestations and prognosis of liver cirrhosis in elderly patients differ from those in younger patients. We must pay more attention on treating complications of liver cirrhosis in elderly patients.
目的 調查醫療文書填寫現狀并探討其對患者滿意度之間的影響。 方法 2012年10月－12月以呼吸內科住院的患者為調查對象，調查其醫療文書完成情況，統計醫療文書缺項數目。同時參考國內外患者滿意度研究，自制滿意度調查表，調查患者對醫務人員滿意度；分析醫療文書缺項數目對患者滿意度的影響。 結果 研究共納入151例患者，共有126份醫療文書存在不同程度填寫缺陷，占83.44%，平均缺項（11.58 ± 11.63）條。總體患者就醫滿意度為6.85分，與醫療文書缺項數目呈現負相關性（R=?0.602，P=0.001）。患者性別、年齡、文化程度、付費方式和住院天數與患者滿意度無相關性。 結論 醫療文書缺項數目較多、完成質量不高。需要加強醫務人員對于醫療文書完成質量的重視程度。
Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
【摘要】 目的 探討多功能外固定支架治療老年股骨粗隆間骨折的療效和優點。 方法 2007年7月-2009年10月，采用外固定架治療28例老年股骨粗隆間骨折患者，其中男11例，女17例；年齡74~91歲，平均81歲。致傷原因:摔傷25例，交通事故傷3例。骨折按Evans分型:Ⅰ型1例，Ⅲ型15例，Ⅳ型12例。受傷至手術時間2~7 d。 結果 術后患者切口均Ⅰ期愈合，無延遲愈合及其他早期并發癥發生。28例均獲隨訪，隨訪時間5~14個月，平均9個月。X線片示骨折全部愈合，愈合時間11～24周，平均17周。無髖內翻和下肢短縮等并發癥發生。術后3個月，采用Harris評分進行功能評價，優18例，良7例，差3例，優良率89.3%。出現輕度針道感染7例，中度5例，重度2例，針道感染率50%；合并糖尿病者2例出現中度針道感染，2例出現重度針道感染。重度者經局部換藥、應用抗生素后愈合，后又反復出現，2~3個月取釘后愈合。無骨感染發生，患者均未出現褥瘡，合并癥無明顯加重。 結論 外固定架治療粗隆間骨折，手術創傷小，操作簡便，符合生物力學原理，可以早期離床活動及早期骨折愈合。【Abstract】 Objective To explore the effectiveness and advantages of multifunctional external fixator for the treatment of femoral intertrochanteric fractures in the elderly patients. Methods Twenty-eight patients with femoral intertrochanteric fractures including 11 males and 17 females receiving external fixator treatment between July 2007 and October 2009 were enrolled in this study. Their age ranged from 74 to 91 years old with the average to be 81 years. Twenty-five patients had the disease because of ground falls, and the other 3 were due to traffic accidents. Based on the Evans Type classification, there were 1 Type-Ⅰ case, 15 Type-Ⅲ cases, and 12 Type-Ⅳ cases. The time between injury and surgery was ranged from 2 to 7 days. Results All incisions of the patients healed during phase Ⅰ without delayed healing or other early complications. Follow-up was done to all the patients for 5 to 14 months, averaging 9 months. X-ray showed all fractures healed, and the healing time ranged from 11 to 24 weeks with an average of 17 weeks. No varus or leg shortening or other complications occurred. Three months after surgery, based on the Harris hip score for functional evaluation, there were 18 excellent cases, 7 good cases and 3 poor cases with a excellent and good rate of 89.3%. Mild pin tract infection was detected in 7 patients, moderate in 5, and severe in 2 with a total pin tract infection rate of 50%. Two patients with diabetes suffering from severe pin tract infection recovered by local medication and antibiotics, but the infection reoccurred repeatedly till the healing nails were taken. No bone infection of ulcers occurred, and the existing complications were not aggravated. Conclusion Treatment of intertrochanteric fractures with multifunctional external fixator is minimally invasive, simple, and consistent with biomechanical principles, which can promote early activities out of bed and early fracture healing for the patients.