抗生素对老年前期及老年患者所致肠菌群紊乱的探讨

本文对23例联合用广谱抗生素的老年前期及老年患者发生腹泻后,进行了肠菌群分析,部分做了难辨梭菌的培养。结果表明,全部被检患者应用广谱抗生素后都发生腹泻,应用抗生素种类繁多,其中以氨苄加庆大或先锋加庆大最多。取患者新鲜便作肠菌群分析,6例曾进行纤维结肠镜检查,其中2例肠粘膜有小片状伪膜附着。在使用大量、多种抗生素后,最短在半天内,大多在2周内即发生腹泻,菌群中肠杆菌、拟杆菌、双歧杆菌、乳杆菌,肠球菌、葡萄球菌、酵母菌、小梭菌及真杆菌有显著的差异,均明显低于正常,6/15例难辨梭菌为阳性,检出率40％。治疗先停用抗生素加强支持疗法或用健康人粪便滤液灌肠,15例停止腹泻,2例使用万古霉素才停止。     

牙周病患者和普通正畸患者拔牙模式的分析

本文通过采用回顾性分析方法,选取480例患者统计临床资料,筛选牙周致拔牙治疗者为牙周组其余为正畸组,比对两组性别、病情、拔牙方式。从中探讨牙周病患者与普通正畸治疗特点、拔牙模式,总结诊疗经验。     

老年肿瘤患者医院感染控制的护理探讨

目的探讨老年肿瘤患者并发感染的危险因素、护理与感染控制措施。方法采取前瞻性和回顾性相结合的调查方法,对我院2003年至2007年收治的350例老年肿瘤患者的临床资料进行分析。结果老年肿瘤患者发生医院感染的危险因素为住院时间长、长期卧床、严重的基础疾病、抗菌药物的不合理使用和侵入性操作等。结论加强医院感染管理,针对各种相关的危险因素采取相应的预防措施,有效控制医院感染的发生。     

高龄老年患者抗凝安全性及其影响因素分析

摘要 目的：探讨高龄老年患者抗凝治疗的安全性及其影响因素,为临床合理用药提供参考。方法：选入2019年3月~2021年3月在我院老年科一病区接受抗凝治疗的128例高龄（≥80岁）老年患者作为研究对象,收集患者一般资料、病史、合并用药等,并对其进行3~12个月的随访,记录国际标准化比率（INR）以及出血、缺血性脑卒中等不良事件的发生情况,并分析其影响因素。结果：128例患者共有不良事件39例（30.47 %）,其中出血26例（20.31 %）,新发缺血性脑卒中3例（2.34 %）,PT高值2例（1.56 %）,死亡11例（8.59 %）（其中2例大出血死亡,1例缺血性脑卒中死亡）;Logistic多因素回归分析结果显示：患者性别、合用激素、合用抗血小板药以及新发恶性肿瘤是高龄老年患者抗凝治疗后发生不良事件的独立影响因素（P＜0.05）。结论：高龄老年患者根据综合评估后,采用小剂量、常规剂量等不同抗凝方案进行治疗均是合理的选择,其疗效及安全性无明显差异;但对于女性、合用激素和血小板药以及新发恶性肿瘤的患者要警惕不良事件的发生。     

与老年患者沟通的技巧

随着人口老龄化的进展,老年患者约占住院患者总数的89.67%.可见关心老年人的健康,改善老年人的生活质量非常重要.从护理学角度来说,关心老年患者首先是关心他们的疾苦,促进身心健康.而良好的护患关系则是与患者良好的接触沟通为基础的,护士与患者之间的接触沟通主要是通过语言、举止、表情、态度等方式来进行的,如果沟通障碍,将影响到护患关系及患者康复,甚至导致不良后果.因此,护士必须掌握与老年患者沟通的技巧.     

糖尿病患者拔牙创区微生物分布的临床研究

探讨糖尿病患者拔牙术后创区微生物分布情况 ,为临床防治术后感染提供理论依据。随机选取 3 9例已确诊为糖尿病的拔牙患者 ,在术后即刻采取拔牙创的渗出物 ,按 1 0倍系列稀释 ,培养微生物 ,然后进行分离、纯化和鉴定菌。结果从标本中培养出 1 87株微生物 ,鉴定到属或种 ,共获得 1 1种不同的细菌 ,常见的 7种。研究结果表明 ,糖尿病患者拔牙创区常见微生物依次为链球菌、萘瑟氏菌、梭杆菌、产黑色素拟杆菌、拟杆菌 ,韦荣菌属、二氧化碳嗜纤维菌属等。其中 ,链球菌、萘瑟氏菌为优势菌。     

老年卧床患者褥疮的护理体会

老年长期卧床患者,发生褥疮是常见的并发症。对褥疮进行科学、合理、有效的护理,不仅可以减轻老年卧床患者的痛苦,提高生活质量,而且还可以减轻患者家庭的经济负担。本文通过对80位老年卧床患者并发褥疮的病因、易发部位和护理误区的回顾性研究,结合褥疮新发展理论,总结出老年卧床患者并发褥疮的具体护理措施。     

青年与老年非小细胞肺癌患者的术后结果比较

目的:比较青年和老年非小细胞肺癌手术患者,临床特点和术后生存率.方法:我院1997-2002年胸外科肺癌手术患者,根据初诊时的年龄随机选择非小细胞肺癌患者40例作为青年组(≤40岁)和50例作为老年组(≥70岁).对比两组患者的年龄、性别、吸烟史、伴随疾病、病理类型、临床分期、手术方式、术后并发症、5年生存率.结果:青年组的伴随疾病发生率(22.5%)明显低于老年组(50.0%)(P=0.034);青年组的腺癌发生率(52.5%)明显高于老年组(12.0%)(P=0.008),而青年组的鳞癌发生率(32.5%)明显低于老年组(78.0%)(P=0.016);青年组术后并发症发发生率(12.5%)明显低于老年组(32.0%)(P=0.026);青年组5年总生存率(32.2%)明显高于老年组(20.5%)(P=0.041).结论:青年非小细胞肺癌患者以腺癌多见,5年总生存率高于老年组,这可能与老年人伴随疾病和术后并发症较多有关.     

老年住院患者失眠原因及护理

失眠是指各种原因导致患者夜间难以入睡、睡不安稳、经常醒来或清晨早醒。失眠使人的生理节律紊乱,活动能力降低,机体的免疫功能下降。失眠已成为影响疾病的主要因素。对于住院患者而言,疾病本身及外界环境都会影响到他们的睡眠。而睡眠是重要的生理现象,良好的睡眠对维持生命活动、保持身体健康都有重要作用。     

老年患者压疮的护理进展

<正>我国已逐渐进入人口老龄化社会,而且由于老年患者常患有多种疾病,生理功能减退,使老年患者成为压疮高发人群[1]。据统计,老年患者压疮的发生率为10%~25%,而老年人入住院护理时的压疮发生率为17.4%,发生压疮的老年患者病死率较未发生压疮的增加4~6倍[2]。有研究显示,通过全面的评估、科学的管理、有效的护理,可明显降低压疮发生率。现本文就老年患者的压疮护理进展综述如下。1基本概念及分期     

Orthodontic treatment in an elderly patient with extraction of upper premolar

In the past few years, life expectancy of the world's population has gradually increased and as a result the number of elderly patients seeking orthodontic treatment is becoming higher. The objective of this work is to report a clinical case of orthodontic treatment of an elderly patient in which a dental extraction was performed to correct the relationship between upper and lower arches. The results favoured an improved dental arch relationship and promoted adequate aesthetics and function.     

Pattern of tooth loss in an elderly population from Ibadan, Nigeria

Objectives: To determine tooth loss, edentulousness, causes of tooth loss and pattern of tooth loss in the elderly in South East Local Government area (SELGA) in Ibadan. Background data: SELGA is one of the largest in Oyo State, Nigeria and has a population of 225 800. Design: A cross‐sectional survey. Methodology: A total of 690 elderly individuals who were 65 years and above living in various wards in SELGA were interviewed by two interviewers and examined by two trained and calibrated examiners whilst two record clerks recorded all the findings of the examination. Result: Forty‐eight per cent of the subjects in the study had not lost any teeth. The mean tooth loss was 4.5 ± 7.6. Percentage edentulousness was 1.3% and this was higher in males than in females. This difference was not statistically significant (χ² = 0.07 p = 0.7). The total number of teeth lost was 3102, 14% of the total number of teeth examined. The study showed that caries was not a major cause of tooth loss. Only 22 (0.7%) teeth were lost as a result of caries, 19 (0.6%) were lost because of trauma and periodontal disease contributed to loss of 3061 (98.7%) teeth. Mandibular teeth exhibited a higher rate of retention than maxillary teeth. The percentage of elderly individuals with tooth loss increased with age. Conclusion: The study highlights the high life expectancy of a tooth among the elderly in SELGA. Despite the different cause of tooth loss in this area, in comparison with developed countries, the pattern of tooth retention appeared similar.     

Affective state and acceptance of dentures in elderly patients

Objective : To examine the relationship between the affective state and acceptance of dentures by elderly patients. Setting : Dental Outpatient clinics and a residential home for the elderly. Bialystok, Poland. Design : Cross sectional survey of denture wearers. Subjects : One hundred and forty one patients between the ages of 60–94. Intervention : A semi-structured interview, which focused on the patient's self-evaluation of their affective state, and a clinical examination. Results : There was a trend for the negative affects (irritability, boredom, anger, loneliness, helplessness) to relate to denture intolerance and for the positive affects (joy, peace, usefulness) to relate to denture acceptance. Conclusions : Anger related significantly t o intolerance of upper and lower dentures. The relationship of age and gender to the acceptance of dentures in the present sample was not significant.     

Tooth movement in the elderly: a case report

Orthodontic appliances can take advantage of favourable growth in adolescents to achieve treatment goals. However in the elderly where growth potential is modest, tooth movement is still highly feasible and is a useful adjunct to multidisciplinary treatment. Orthodontic treatment of the elderly normally involves limited objectives with goals customised to the patients concerns and functional needs. This case report demonstrates that orthodontic treatment of the elderly is possible and can improve the function and aesthetics of the dentition and thus increase their quality of life.     

Oral health status of elderly hospitalised psychiatric patients

doi: 10.1111/j.1741‐2358.2012.00633.x Oral health status of elderly hospitalised psychiatric patients Objectives: This study investigated the oral health status of an elderly mentally ill population hospitalised in a psychogeriatric ward in Athens. Materials and methods: A structured interview recorded sociodemographic and dental data, and an oral examination recorded the status of oral tissues and the existing dentures. The patients’ medical records were examined by a hospital’s physician. Results: One hundred and eleven patients with a mean age of 73 years participated in the study. Almost half of them suffered from schizophrenia. Forty percent were completely edentulous but only 38.6% of them used a pair of dentures. The dentate had an average of 12.9 teeth, 50.7% of them had at least one decayed tooth, 44.8% needed at least one extraction, and only 26.7% had filled teeth. The dental hygiene was poor in 83.6% of the patients. More than 60% of the dentures had a defect. Multiple regression analyses showed that increasing age and dementia were significantly related to fewer remaining teeth, and the use of atypical antipsychotics was related to fewer caried teeth. Conclusion: The oral health of the elderly psychiatric patients was very poor. Access to dental care should improve, and the health care staff should be trained to identify oral problems.     

An eye for a tooth

Objective: To propose a possible link between dental extraction and intra‐ocular complications. Background: Several publications in medical literature describe intra‐ocular complications after different dental procedures. Results: Retinal detachment and vitreous hemorrhage following dental extraction with an appropriate anesthesia. Conclusion: Systemic complications following dental treatments should not be neglected and proper medical treatment must be provided as soon as possible.