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目的探讨老年髋部骨折合并糖尿病治疗的经验。方法从2000年8月~2004年8月,对24例老年髋部骨折合并糖尿病患者进行围手术期处理,其中男13例,女11例,平均年龄72岁(63—85岁)。结果本组病例切口均顺利愈合,术后3—15天出院;全部获得随访,平均随访时间6个月;无一例死亡。骨愈合时间3~10个月。所有病例术后骨折均愈合,髋关节优良满意率为98.4%。结论对于髋部骨折合并糖尿病患者,良好的围手术期康复治疗能够保证老年患者顺利进行手术、切口和骨折快速愈合、恢复良好关节功能、降低并发症及致残率,提高生存质量,延长寿命。 相似文献
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老年糖尿病患者髋部骨折围手术期胰岛素的应用 总被引:5,自引:1,他引:4
[目的]探讨老年糖尿病患者髋部骨折围手术期胰岛素的应用。[方法]对37例老年髋部骨折合并糖尿病患者围手术期监测、控制血糖,在手术前后使用胰岛素,进行总结。[结果]本组37例患者,25例术前或术后使用胰岛素,使用胰岛素患者术前、术后血糖控制满意,无心脑血管并发症发生;伤口无感染,愈合良好。[结论]老年糖尿病患者合并髋部骨折在手术前后应采用胰岛素治疗,将血糖控制基本正常水平以利于手术,减少并发症,降低死亡率。 相似文献
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目的探讨老年髋部骨折合并糖尿病患者的围手术期护理体会。方法对48例合并糖尿病的老年髋部骨折患者实施心理、饮食、运动、糖尿病教育等围术期护理措施。结果本组48例患者均顺利完成手术,术后2例泌尿系感染,1例小腿深静脉血栓形成,均经对症处理后痊愈,无压疮、切口感染等并发症发生,无死亡病例。结论老年糖尿病患者的手术风险大,实施围手术期综合护理可有效提高手术成功率,减少并发症发生,改善患者生活质量。 相似文献
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老年人髋部骨折合并糖尿病的围手术期治疗 总被引:5,自引:0,他引:5
自1996~2003年对46例老年人髋部骨折合并糖尿病的患者进行了手术治疗,其中38例获得了随访,取得了满意的疗效,报告如下。 相似文献
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目的 总结老年患者髋部骨折合并糖尿病围手术期的护理经验. 方法 分析60例老年髋部骨折合并糖尿病患者的临床护理资料,根据老年糖尿病的特点,加强糖尿病的教育,以有效地预防和控制并发症. 结果 60例患者均平稳的度过围手术期. 结论 老年糖尿病患者手术风险大,切口愈合差,加强围手术期的护理,是提高手术成功率,减少并发症和降低病死率的重要保证. 相似文献
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髋部骨折合并糖尿病患者的围手术期处理 总被引:2,自引:1,他引:1
目的:总结中老年髋部骨折合并糖尿病患者围手术期的特点及治疗经验。方法:回顾性分析21例髋部骨折合并糖尿病中老年患者手术治疗的临床资料。结果:无1例死亡,无1例术后感染,病人切口良好愈合,病人安全度过围手术期。结论:髋部骨折合并糖尿病患者在无手术禁忌症的情况下,应积极采取手术治疗,术前准备和术后治疗要予以重视。 相似文献
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并存糖尿病老年人髋部骨折的围手术期治疗 总被引:3,自引:1,他引:2
[目的]探讨并存糖尿病老年人髋部骨折的围手术期治疗方法。[方法]对26例并存糖尿病老年人髋部骨折的围手术期的血糖控制、胰岛素使用、手术及麻醉方式选择进行分析。[结果]26例患者安全度过围手术期,无1例死亡。[结论]并存糖尿病老年人髋部骨折患者在无手术禁忌证的情况下,应积极手术治疗,提高老年人的生活质量。 相似文献
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骨质疏松所致老年骨折中髋部骨折常见。国内医生非常重视老年髋部骨折手术技术,但缺乏对围手术期处理的重视。合理的围手术期处理能够保证手术安全、提高手术效果、最大程度恢复患者功能,科学的多学科协作康复计划和出院后指导亦能有效提高患者术后功能。该文就近年老年髋部骨折围手术期处理作一系统阐述。 相似文献
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目的总结老年髋部骨折患者的围手术期护理措施。方法对78例老年髋部骨折患者的围手术期护理资料进行回顾性分析。结果本组78例老年髋部骨折患者均获治愈,随访3个月1年,未出现并发症。结论对老年髋部骨折患者在术前、术后进行全程严密护理,能有效减少并发症,提高治愈率。 相似文献
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目的 了解肠内营养支持对围手术期糖尿病患者血糖水平及营养状况的影响。方法 将38例围手术期糖尿病病人分成对照组和实验组,两组病人术前均按糖尿病的营养治疗原则予饮食。术后开禁后对照组根据胃肠耐受性逐步选用流质、半流或普食。实验组口服补充含4%膳食纤维的糖尿病人专用型营养膳。两组病人能量摄入维持在84~105kj/kg?d。结果 对照组与实验组患者术前空腹血糖分别为7.2±1.3mmol/L和7.2±1.6mmol/L,组间无显著性差异。术后第8天实验组空腹血糖水平为7.6±1.1mmol/L,显著性低于对照组(8.8±1.8mmol/L)。术后第8天实验组血清前白蛋白、血淋巴细胞总数均较营养治疗前显著增高,且显著性高于对照组。实验组患者术后感染的发生率显著低于对照组。所有病例术后均无出现低血糖、酮症酸中毒等并发症。结论 糖尿病围手术期患者给予合理的营养支持可有效控制血糖,改善营养状况,促进病人术后伤口的愈合,防止感染并发症的发生。 相似文献
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糖尿病患者标准化饮食健康教育的实施 总被引:4,自引:0,他引:4
目的探讨标准化饮食健康教育对糖尿病患者饮食知识、行为、血糖控制效果的影响。方法将100例诊断为糖尿病且无糖尿病并发症的患者按照住院时间顺序分成对照组与观察组各50例。对照组由管床护士按照自行设计的健康教育路径进行饮食教育,观察组采用标准化饮食健康教育对糖尿病患者进行饮食教育。观察3个月后糖尿病患者饮食知识掌握的程度,患者饮食行为改变的情况以及血糖的变化。结果干预后3个月,观察组饮食知识、行为评分显著高于对照组,空腹血糖、餐后2h血糖显著低于对照组(均P<0.01)。结论标准化饮食健康教育对患者饮食教育有针对性地进行指导,并将饮食知识转化为技能,落实在日常行动中,在促使患者行为改变及血糖控制方面优于传统健康教育方式。 相似文献
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【摘要】 目的 探讨胰岛素瘤切除术的围术期管理。方法 回顾性分析本院5年来通过手术治疗胰岛素瘤患者的临床资料。结果 18例患者中男6例,女12例,均有典型的Whipple三联征。15例行开放性肿瘤切除术,3例行腹腔镜下肿瘤切除术。开腹手术采用硬膜外麻醉复合气管内全麻,腹腔镜手术采用单纯气管内全麻。根据术中不同的血糖管理方式将患者分为两组:持续泵注组(C组,n=10)术中静脉泵注50%葡萄糖溶液,根据血糖调节输注速度,维持血糖在3.0~6.0 mmol·L-1;非持续泵注组(NC组,n=8)未予持续泵注葡萄糖,仅在血糖低于2.8 mmol·L-1时才静脉推注50%葡萄糖50 mL。术中每隔15分钟监测一次血糖,肿瘤切除前30 min停止给糖。所有患者术中患者生命体征平稳。持续泵注葡萄糖组肿瘤切除前后血糖控制较非持续泵注稳定(P<0.05)。结论 胰岛素瘤手术时采用持续泵注葡萄糖能够稳定手术过程中血糖水平,肿瘤切除前静脉泵注50%葡萄糖可以避免肿瘤切除前后血糖急剧波动。 相似文献
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Hamed Abedini Najafabadi Mohammad Shahrokhi 《Optimal control applications & methods.》2016,37(4):559-573
In this article, two adaptive model predictive controllers (AMPC) are applied to regulate the blood glucose in type 1 diabetic patients. The first controller is constructed based on a linear model, while the second one is designed by using a nonlinear Hammerstein model. The adaptive version of these control schemes is considered to make them more robust against model mismatches and external disturbances. The least squares method with forgetting factor is used to update the model parameters. For simulation study, two well‐known mathematical models namely, Puckett and Hovorka which describe the dynamical behavior of patient's body have been selected. The performances and robustness of the proposed controllers are tested for regulating the blood glucose of diabetic patients in presences of model mismatches and measurement noises. Simulation results indicate that the non‐linear model predictive controller (NMPC) outperforms the linear one. To improve the performance of the NMPC in rejecting the meal disturbances, two different feedforward control strategies have been considered. Simulation results indicate that the combined adaptive NMPC with feedforward controller has a better performance over the other considered control schemes. Copyright © 2015 John Wiley & Sons, Ltd. 相似文献
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目的提高老年胆囊结石患者的治疗水平。方法对84例病人临床资料进行回顾性总结。结果76例完全治愈,8例症状缓解。结论根据老年人特点,选择手术方式并加强围手术期处理。 相似文献
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Objective: To assess the curative effect and investigate the indications of total hip arthroplasty for treatment of comminuted intertrochanteric fractures.
Methods: Total hip arthroplasty was carried out in 9 cases of severe intertrochanteric fracture. The patients included two men and seven women. The average age of the patients was 68 years (48-75 years). The period from fracture to operation was 5 days (2-10 days). The mean follow- up period lasted for 11 months (3 months-2 years). There was one patient with comminuted intertrochanteric fracture accompanied by femoral head necrosis and 2 patients with intertrochanteric fracture and stroke. Other 6 patients had severe osteoporosis. The Harris score before operation was 63 points (45-71 points).
Results: At the last follow-up, the patients gained 86points (70-100 points) according to the Harris score. The effects of the 8 cases were good. The Harris score of all patients improved after treatment. Only two hemiplegia patients needed sticks to walk. The others could walk without hip pain. No radiographic evidence of acetabular wear and prosthesis dislocation or other major complications happened during the follow-up.
Conclusions: Prosthetic replacements can well treat unstable intertrochanteric fracture if operative indication is correctly selected. It is suitable for elderly patients and the operation should be performed by experienced surgeons. 相似文献
Methods: Total hip arthroplasty was carried out in 9 cases of severe intertrochanteric fracture. The patients included two men and seven women. The average age of the patients was 68 years (48-75 years). The period from fracture to operation was 5 days (2-10 days). The mean follow- up period lasted for 11 months (3 months-2 years). There was one patient with comminuted intertrochanteric fracture accompanied by femoral head necrosis and 2 patients with intertrochanteric fracture and stroke. Other 6 patients had severe osteoporosis. The Harris score before operation was 63 points (45-71 points).
Results: At the last follow-up, the patients gained 86points (70-100 points) according to the Harris score. The effects of the 8 cases were good. The Harris score of all patients improved after treatment. Only two hemiplegia patients needed sticks to walk. The others could walk without hip pain. No radiographic evidence of acetabular wear and prosthesis dislocation or other major complications happened during the follow-up.
Conclusions: Prosthetic replacements can well treat unstable intertrochanteric fracture if operative indication is correctly selected. It is suitable for elderly patients and the operation should be performed by experienced surgeons. 相似文献
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Malmstedt J Wahlberg E Jörneskog G Swedenborg J 《The British journal of surgery》2006,93(11):1360-1367
BACKGROUND: High glucose levels are associated with increased morbidity and mortality after coronary surgery and in intensive care. The influence of perioperative hyperglycaemia on the outcome after infrainguinal bypass surgery among diabetic patients is largely unknown. The aim was to determine whether high perioperative glucose levels were associated with increased morbidity after infrainguinal bypass surgery. METHODS: Ninety-one consecutive diabetic patients undergoing primary infrainguinal bypass surgery were identified from a prospective vascular registry. Risk factors, indication for surgery, operative details and outcome data were extracted from the medical records. Exposure to perioperative hyperglycaemia was measured using the area under the curve (AUC) method; the AUC was calculated using all blood glucose readings during the first 48 h after surgery. RESULTS: Multivariable analysis showed that the AUC for glucose (odds ratio (OR) 13.35, first versus fourth quartile), renal insufficiency (OR 4.77) and infected foot ulcer (OR 3.38) was significantly associated with poor outcome (death, major amputation or graft occlusion at 90 days). Similarly, the AUC for glucose (OR 14.45, first versus fourth quartile), female sex (OR 3.49) and tissue loss as indication (OR 3.30) was associated with surgical wound complications at 30 days. CONCLUSION: Poor perioperative glycaemic control was associated with an unfavourable outcome after infrainguinal bypass surgery in diabetic patients. 相似文献