Objective To summarize the characteristic manifestations in the middle and old aged people with meniscus injury and the outcome of the treatment under the arthroscope. Methods Fifty-two patients, aged 52-58 years, with meniscus injury to a total of 57 knee joints, were diagnosed and treated under the arthroscope. The history of their knee diseases was 1-21 years. Horizontal tearsoccurred in 19 knee joints, degenerative tears in 13 knee joints, complex tears in 9 knee joints, longitudinal tears in 5 knee joints, oblique tears in 4 knee joints, radial tears in 4 knee joints, and flap tears in 3 knee joints. Three meniscus tears were sutured and 54 meniscus tears were cut fully or partly under thearthroscope. Results All the postoperative patients were followed up for 6-15 months, and the average follow-up period after operation was 9 months. According to the DONG Tianxiang’s standards for the therapy under the arthroscope, the excellent result was achieved in 39 knee joints, good in 12 knee joints, and fair in 6 knee joints, with no failure. The excellent and good rate was 89.5%. Conclusion The clinical manifestations of meniscus injury are not typical in the middle and old aged people. The therapeutic effect with the help of the arthroscope is satisfactory with an advantage of minimal traumatic invasiveness to the knee joint.
目的:評價70歲以上老年非小細胞肺癌患者大分割放療的長期療效和并發癥。方法:對1997年8月至2003年2月收治的38例70歲以上非小細胞肺癌實施大分割三維適形放療(3D-CRT),年齡70～85歲,中位年齡74歲。全組卡氏評分均≥70。其中Ⅰ期8例, Ⅱ期20例, Ⅲ期8例,Ⅳ期2例。結果:全組有效率(CR+PR)92.1%;1,2,3,5年生存率分別為94.7%、65.7%、38.9% 和 28.0%。1,2 級急性放射性食管炎發生率 47.4%(18/38);未出現急性癥狀性放射性肺炎,未發現嚴重心臟、食管、脊髓放射性反應。晚期局部肺放射性纖維化表現(CT和/或胸片)為34.2%(13/38).結論:不能手術的老年非小細胞肺癌患者大分割適形放射治療,安全有效,副作用可以耐受。
摘要:目的:探討老年人梗阻性大腸癌的圍手術期處理。方法:回顧性分析2003年至2008年間71例60歲以上老年人梗阻性大腸癌的圍手術期處理情況。 結果:術前發現并存病者43例,術中出現并發癥19例,術后發生并發癥37例得,除5例死亡外,均得到有效控制,死亡原因與并存疾病有關。結論:加強圍手術期處理,積極治療并存疾病,老年人梗阻性大腸癌的治療同樣能取得滿意的效果。Abstract: Objective:To study the perioperative measures for the aged patients with Obstructive Colorectal Cancer. Methods: Seventyone cases above 60 years with Obstructive Colorectal Cancer were analysed retrospectively on their individual accompanied diseases and perioperative treatments, from 2003 to 2008.Results: Fortythree cases of them had suffered from other diseases. Midoperative complications occurred in 19 cases. Postoperative complications occurred in 37 cases. Except 5 cases of death, complications occurring in others cases were well controlled. The death causes mainly were correlated with accompanied chronic diseases. Conclusion: Strengthen care, active management of other chronic diseases are important significantly for senile patients with colorectal carcinoma to get satisfied outcome.
目的 總結超聲引導下經皮經肝穿刺膽管引流術(PTCD)的優、缺點,為臨床治療重癥急性膽管炎（SAC）提供參考。方法 回顧性分析我院1994年8月至2008年7月期間對156例老年SAC患者行在超聲引導下的PTCD治療的臨床資料。結果 156例行PTCD均獲成功,1次穿刺成功140例，其成功率達89.7%（140/156）; 16例首次穿刺失敗后再次穿刺均成功。無一例發生腹腔出血、膽汁性腹膜炎等并發癥。本組引流效果較好,中毒危象緩解，黃疸減退，肝功能改善。結論 PTCD較外科手術創傷小、操作簡單、快速,具有微創的特點,對老年、有嚴重合并癥及復雜疾病不能耐受手術及麻醉的SAC患者，其作為緊急搶救措施切實可行,并為后期施行根治性手術爭取了時間。
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
目的:探討老年結直腸癌并急性腸梗阻的處理原則和方法。方法:回顧性分析10年間收治的78例(70～80歲)結直腸癌并急性腸梗阻的臨床資料。78例中Dukes B期20例,C期18例,D期40例。全部患者經手術治療,包括急診手術46例,擇期性手術32例。采用右半結腸一期切除腸吻合治療30例,左半結腸一期切除吻合40例。Hartmann 5例, Di×on手術2例,腫瘤近端腸管造瘺1例。結果:術后出現并發癥16例(20.5%)21例次,包括切口感染14例次,腹腔感染5例次和吻合口瘺2例次,死亡3例(3.85%),75例(96.2%)痊愈出院。結論:對于急性結直腸癌性梗阻除非有急診手術指征,應首先采用非手術治1～2 d,盡可能轉為擇期手術;一期切除吻合治療結直腸癌并發急性梗阻,是方便可行而安全有效的方法,加強圍手術期處理是手術成功的關鍵。
Aiming at the shortcomings in the theory and practice of integrated elderly care and medical services in China, using the methods of literature analysis and comparative analysis, we summarize four typical models of integrated elderly care and medical services, namely, the American commercial pension model, the British national tax financing system pension model, the Japanese national security transformation, and the German long-term care insurance system, and compare the four models systematically from the aspects of system overview, service principle, operation mode, financing supervision, etc. The enlightenment for the policy and practice development of integrated elderly care and medical services in China is obtained: firstly, the service concept should be innovated; secondly, it is important to improve the relevant legal protection and supporting measures; thirdly, the refinement of the integrated elderly care and medical service projects are supposed to be promoted; fourthly, a multi-party linkage mechanism ought to be establishd; and fifthly, community endowment model should be advocated.