瑞芬太尼在老年人腹腔镜手术麻醉中的应用

目的观察瑞芬太尼复合静脉麻醉的效果，为老年患者临床应用提供依据。方法气管插管全身麻醉下腹腔镜老年患者胆囊切除手术60例，随机分为瑞芬太尼组（RF）、芬太尼组（F）；诱导用咪唑安定0．08mg·Kg^-1，丙泊酚1mg·Kg^-1，瑞芬太尼1ug·Kg^-1（RF组）或芬太尼4ug·Kg^-1（F组），阿曲库铵0．8mg·Kg^-1气管插管后接麻醉机行间隙正压通气，术中持续泵注瑞芬太尼0．3ug·Kg^-1·min^-1（RF组）或芬太尼0．04ug·Kg^-1·min^-1（F组）加丙泊酚（0．06-0．08）mg·Kg^-1·min^-1，阿曲库胺8ug·Kg^-1·min^-1，手术结束前10min停药。观察平均动脉压（MAP）、HR、自主呼吸恢复时间、呼之睁眼时间及拔管时间。结果插管后即刻和插管后5min两组间MAP、HR差异极为显著，RF组明显低于F组，术后恢复情况RF组患者呼吸恢复时间、呼之睁眼时间及拔管时间明显短于F组。结论瑞芬太尼复合静脉麻醉，用于老年患者腹腔镜手术效果优良，苏醒快，恢复好，但停药后很快感到疼痛，需提前予以镇痛。     

老年糖尿病低血糖昏迷原因及治疗分析

目的探讨老年糖尿病低血糖昏迷的原因。方法采用回顾性分析46例老年糖尿病低血糖昏迷并行相应对症处理的方法。结果自行加大治疗前药物剂量，进食减少或未及时进食及急性感染是产生低血糖昏迷的主要原因，经抢救处理45例血糖逐渐回升至正常，神志较清，1例死于乳酸酸中毒。结论老年人对血糖调节功能低下，药物过量和进食不当均已导致低血糖，甚至昏迷，治疗过程中应定期监测血糖，指导饮食与治疗。     

东菱克栓酶治疗老年急性脑梗塞疗效观察

目的研究东菱克栓酶治疗老年人急性脑梗塞的疗效.方法将72例老年脑梗塞病人分为观察组和对照组,采用随机、单盲对照试验.观察组用东菱克栓酶治疗,对照组进行常规治疗,观察治疗前后临床疗效、PT、血小板、红细胞压积及副作用.结果治疗组临床症状改善明显,治愈率为92.1%,与对照组比较有显著性差异(P＜0.01).治疗组治疗后PT延长,红细胞压积下降,与治疗前比较存在差异(P＜0.05).治疗前后血小板无明显变化.结论东菱克栓酶治疗老年脑梗塞效果显著、安全、无明显副作用.     

无张力疝修补术治疗老年腹股沟疝15例护理体会

目的:总结无张力疝修补术治疗老年腹股沟疝护理方法。方法:术前充分准备,术后密切观察,加强体位、疼痛、饮食及预防并发症的护理。结果:患者术后恢复快,未发生与护理相关的并发症。结论:充分的术前准备和完善的术后护理是提高老年无张力疝修补术成功的关键。     

老年患者医院感染537例分析

目的分析老年患者医院感染的发生规律及特点，对临床采取积极有效的防治措施提供帮助。方法对我院537名发生医院感染的老年患者分别进行易感人群的基础疾病、感染部位、病原体种类及药敏结果、危险因素进行分类、统计、分析。结果老年患者医院感染率74．1％，多系统疾病、侵袭性操作、药物尤其抗生素使用时间、住院时间、不良习惯与医院感染密切相关。真菌导致医院感染占所有病原体的17.9％。结论老年患者改变不良习惯，改善病房环境，对症治疗基础疾病，抗生素使用及侵袭性操作要坚持原则，加强支持治疗。     

早期鼻饲对老年脑卒中患者康复的影响

目的探讨早期鼻饲营养支持对脑卒中患者营养状况改善、感染性并发症的发生及神经功能康复的影响。方法收集伴有进食障碍脑卒中住院病例44例,随机分为2组：早期鼻饲组及对照组。均给予鼻肠内营养支持治疗,其余治疗措施相同,时间为1个月。监测2组患者营养状况（指标包括血白蛋白,血红蛋白及血淋巴细胞总数）和神经功能缺损程度（NFS）以及进食障碍的持续时间,并观察感染性并发症的发生（消化道出血、肺部感染及死亡）情况。结果早期鼻饲营养支持组患者的营养状况良好,血白蛋白,血红蛋白及血淋巴细胞总数均显著高于对照组（P〈0.05）;2组间进食障碍的持续时间无显著性差异（P〉0.05）,但NFS指标有显著性差异（P〈0.05）;此外,早期鼻饲组感染性并发症的发生率较对照组低（P〈0.05）。结论早期鼻饲营养支持有利于改善脑卒中后的营养状况,减少感染性并发症的发生,有利于神经功能的恢复。     

Senile dementia of the Alzheimer type treated with aniracetam: a new nootropic agent

Forty-four patients with senile dementia of the Alzheimer type were randomly allocated into double-blind treatment with either aniracetam (RO 13-5057) 1 g or placebo daily for 3 months. Neurological examinations were made before and after treatment and psychometric tests were performed before and after 1 month's and after 3 month's treatment. Treatment was interrupted due to occurrence of confusion in four cases in the aniracetam group and in one case in the placebo group. During treatment, an improvement was seen in several cognitive tests, especially those associated with memory, but this improvement occurred in the placebo as well as in the aniracetam-treated group. In clinical evaluation no difference was seen in efficacy between the two treatment groups.     

经尿道电气化治疗高龄前列腺增生症

目的 :探讨高龄 (>70岁 )前列腺增生 (BPH)病人经尿道前列腺电气化术 (TVP)的手术要求与效果。方法 :应用气化电极经尿道气化前列腺以治疗高龄BPH病人 45例。结果 :手术时间平均 95min ,术中平均失血 187ml,切除前列腺组织平均重量 73g。无电切综合征发生。手术后血清钠无显著下降。随访 1～ 18个月 ,国际前列腺症状评分 (I -PSS)由术前2 4± 4分降至术后 5± 3分。残余尿由术前平均 85ml降至术后 18 7ml。结论 :TVP是一种适用于高龄BPH病人的治疗方法 ,具有安全性高 ,并发症少 ,疗效显著的特点     

Quantitative Study of Neurofibrillary Tangles in Subdivisions of the Hippocampus

The frequency of neurofibrillary tangles (NFTs) in relation to aging was examined in five regions of the hippocampus of 139 normal controls (60 to 106 years) and 14 patients with senile dementia of the Alzheimer type (SDAT). The regions were CA4, CA3, CA2 and CA1, the latter being subdivided into CA1a (the region near CA2) and CAlb (the region near the subiculum). Only CA2 showed no correlation of NFTs with normal aging. CA2 in SDAT was the site most vulnerable to NFT formation. Therefore, it is considered that CA2 is a special region in both normal aging and SDAT. CA1 was characterized by the early appearance of large amounts of NFT, and was the most reliable marker of senile change related to aging. Like CA1, both CA3 and CA4 showed an increase of NFTs with normal aging, but their aging process was far less marked. In addition, statistical analysis based on a "normal" distribution was considered to be unsuitable for quantitative study of senile change, because no histogram of NFTs in any subdivisions for any age showed such a distribution. Acta Pathol Jpn 41: 597-603, 1991.     

不同年龄组老年人毛发老化度调查研究

本文对不同年龄组(50、60、70、80周岁)老年人(200人)毛发老化度进行了调查研究,并对新生儿50人及18岁男女青年50人的毛发进行了对照检查。主要检查了头发的密度、白发、软发的数目,眉毛的异常等。对其结果应用两种计算方法判定了老化度标准,做为不同年龄组老年人老化度指标之一。