scholarly journals Application Effect of Case Management Mode Combined with ERAS in Elderly Patients with Hip Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Na Peng ◽  
Jing Li

Objective. To explore the effect of the case management mode combined with enhanced recovery after surgery (ERAS) in elderly patients with hip fracture. Methods. A total of 102 elderly hip fracture patients admitted to our hospital from June 2018 to December 2019 were selected. The patients with hip fracture were divided into the control group (n = 51) and the observation group (n = 51) by the random number table method. The control group adopts the conventional nursing mode, and the observation group adopts the case management mode combined with ERAS. The bed activity time, hospitalization time, total hospitalization expenses, and the satisfaction of patients were observed. The numeric rating scale (NRS) was used to assess the patient’s pain before treatment and at 1, 3, and 5 days after treatment. The Harris score was used to assess the patient’s joint motor function before treatment and at the 8th week after treatment. The perioperative complications of the two groups were compared. Result. After treatment, the observation group was better than the control group in terms of out of bed activity time, hospitalization time, total hospitalization expenses, and the satisfaction of patients ( P < 0.05 ). Before treatment, there was no significant difference in NRS scores between the two groups ( P > 0.05 ). After treatment, the NRS scores of the two groups were lower than before treatment, and on days 1, 3, and 5 after treatment, the NRS scores of the observation group were lower than those of the control group ( P < 0.05 ). Before treatment, there was no difference in the Harris score between the two groups ( P > 0.05 ). At the 8th week after treatment, the Harris scores of the two groups were higher than those before treatment, and the Harris scores of the observation group were higher than those of the control group ( P < 0.05 ). The total incidence of perioperative complications in the observation group (4/51) was lower than that in the control group (13/51) ( P < 0.05 ). Conclusion. The application of the case management mode combined with ERAS nursing in elderly patients with hip fracture can improve the clinical symptoms of patients, improve the therapeutic effect, and reduce the occurrence of complications, which is worthy of clinical application.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hong Lv ◽  
Ning Yang

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Jing Li ◽  
Jinzhi Ji ◽  
Fuyan Liu ◽  
Lingling Wang

Objective: To investigate the clinical efficacy of insulin glargine combined with acarbose in the treatment of elderly patients with diabetes. Methods: One hundred and forty-four elderly patients with diabetes who received treatment between December 2016 and December 2017 in Binzhou People’s Hospital, China, were selected and divided into a control group and an observation group, 72 each, using random number table. The control group was treated with insulin glargine, while the observation group was treated with insulin glargine combined with acarbose. The therapeutic effect, improvement of quality of life and adverse reactions were compared between the two groups. Results: After treatment, fasting blood glucose (FBG), 2h postprandial blood glucose (PBG) and glycosylated hemoglobin (Hb Alc) of the two groups were lower than those before treatment, and the decrease degree of the observation group was significantly larger than that of the control group (P<0.05). The time needed for blood glucose reaching the standard level and daily insulin dosage of the observation group were significantly lower than that of the control group, and the differences were statistically significant (P<0.05). SF-36 scale score of the observation group was significantly better than the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The combination of insulin Glargine and Acarbose can significantly control the blood glucose level of elderly patients with diabetes, improve the biochemical indicators, and enhance the quality of life. It is worth promotion in clinical practice. doi: https://doi.org/10.12669/pjms.35.3.86 How to cite this:Li J, Ji J, Liu F, Wang L. Insulin Glargine and Acarbose in the treatment of elderly patients with diabetes. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.86 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Author(s):  
Yazhen Lang

Abstract Objective: This study aims to explore the effect of multi-disciplinary cooperative complete management mode in the treatment of multi-drug resistant tuberculosis (MDR-TB).Methods: 280 patients were randomly classified into the observation group (n = 140) and the control group (n = 140). The control group was applied with the routine management mode, while the observation group was applied with the multi-disciplinary cooperative complete management one. The treatment compliance, life quality, treatment completion rate as well as the patient satisfaction in the two groups were observed.Results: The treatment compliance of the observation group was better than that of the control group (P༜0.05). The life quality of the observation group was higher than those of the control group (P༜0.05). The treatment completion rate of the observation group was higher than that of the control group (P༜0.05). The patient satisfaction of the observation group was better than that of the control group (P༜0.05).Conclusion: The application of multi-disciplinary cooperative management mode to MDR-TB patients can enhance their treatment compliance, life quality, treatment completion rate and satisfaction degree.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhao-Nan Ban ◽  
Zheng-Jiang Li ◽  
Qi-Shan Gu ◽  
Jun Cheng ◽  
Qiang Huang ◽  
...  

Abstract Purpose To access serum parathyroid hormone (PTH) level in elderly patients with hip fracture in relation to fracture healing outcomes. Methods This study included 90 elderly male patients with hip fracture and they were defined as the hip fracture group, and they were divided into healing effective group and delayed healing group by final fracture healing outcomes, 45 cases in each group; another 45 male patients older than 70 years without established osteoporosis and hip fracture were included as the control group. The levels of serum PTH level were examined in each group. Results Serum PTH level was significantly higher in healing effective group patients at the 7 days and 14 days after fracture than the delayed healing patients. Conclusions Our results show that serum PTH level may be an effective indicator of hip fracture delayed healing risk in the elderly.


2022 ◽  
pp. 1-8
Author(s):  
Jun Li ◽  
Hui Li ◽  
Wenjiao Deng ◽  
Lixin Meng ◽  
Wenya Gong ◽  
...  

<b><i>Background:</i></b> Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD. <b><i>Methods:</i></b> One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment. <b><i>Results:</i></b> There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (<i>p</i><sub>1</sub> &#x3e; 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Tao Zhang ◽  
Hai Jiang ◽  
Chen Yu Ming ◽  
Yan Wang ◽  
Deng Mao ◽  
...  

Objective: To investigate the effects of two kinds of surgical resection schemes, a conventional open surgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer. Methods: A total of 100 elderly patients with esophageal cancer seen in the Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 were enrolled and randomly divided into two groups, including a control group (50 patients) with a conventional open surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomy surgical scheme. The operation time, the amount of bleeding during the operation, the incision length, the number of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before and after the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, the recurrence and metastasis rates and the mortality at follow-up and the incidence of related complications of both groups were compared. Results: The operation time, the amount of bleeding during the operation, the incision length and the hospitalization time in the observation group were significantly less than those in the control group (p<0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group (p<0.05). The HAMA scores and HAMD scores after the operation in the observation group were significantly lower than those in the control group and those before the operation (p<0.05). The PSQI scores and SF-36 scores after the operation in the observation group were significantly better than those in the control group and those before the operation (p<0.05). The levels of PCT, CRP and IL-6 after the operation in the observation group were significantly lower than those in the control group (p<0.05). The recurrence and metastasis rates at follow-up in the observation group were significantly lower than those in the control group (p<0.05). There was no significant difference in mortality at follow-up between the two groups (p>0.05). The complication incidence after the operation in the observation group was significantly lower than that in the control group (p<0.05). Conclusion: Compared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomy surgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, including being a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negative emotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing the risk of related complications. doi: https://doi.org/10.12669/pjms.36.3.1465 How to cite this:Mahjoubi F, Hashemipour M, Moshiri F, Iranpour R, Amini M, . Genetic analysis of TTF2 gene in congenital hypothyroid infants with thyroid dysgenesis. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1465 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 1 (01) ◽  
Author(s):  
Xiongxin Wang ◽  
Man Xu

Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Jun Xue ◽  
Yanan Zhang ◽  
Zhaohe Song ◽  
Lei Wang ◽  
Baoyin Bo

Aims:Objective to explore the influence of family enteral nutrition support on nutritional status, lung function, activity tolerance and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) in stable stage and malnutrition. Methods: a total of 165 elderly patients with COPD and malnutrition discharged from the geriatric department of our hospital were randomly divided into two groups: control group (82 cases) and observation group (83 cases). The control group was treated with conventional diet, and the observation group was treated with conventional diet + enteral nutrition suspension (nengjin, 500kcal / bottle, newdisia Pharmaceutical Co., Ltd.) for support. One month later, they were observed The body mass index (BMI), serum albumin (ALB), total protein (TP), hemoglobin (HB), pulmonary function of the two groups were observed: forced vital capacity (FVC), forced expiratory volume (FEV1) in the first second, FEV1 / FVC, FEV1% of the predicted value (FEV1%), exercise tolerance and quality of life.Results (1) compared with the control group, BMI and ALB in the observation group increased significantly (t = 10.465, 6.189, P < 0.05), TP and Hb had no significant change, and the difference was not statistically significant (t = 1.310, 1.302, P > 0.05). (2) compared with the control group, FVC, FEV1, FEV1 / FVC, FEV1% in the observation group increased, with statistical differences (t = 11.999, 19.654, 13.418, 16.924, P < 0.05). (3) compared with the control group, the quality of life symptom score, activity score, influence score and total score of the observation group decreased significantly (t = 15.303, 6.773, 23.600, 14.766, P < 0.05), and 6MWT increased significantly (t = 111.962, P < 0.05).Conclusion enteral nutrition support can improve the nutritional status, lung function, activity tolerance and quality of life of elderly patients with COPD in stable stage and malnutrition.


2020 ◽  
Vol 185 ◽  
pp. 04006
Author(s):  
Zongjin Yue ◽  
Ruyin Liu ◽  
Lu Yu ◽  
Liuqiao Zhang ◽  
Zhongkai Feng ◽  
...  

To investigate the clinical effects of Bushen Jiangu Decoction combined with percutaneous vertebroplasty (PVP) in the treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fracture (OVCF). Seventy-four elderly patients with OVCF were enrolled in our hospital and randomized by digital table method, 37 cases each. The control group received PVP treatment, and the observation group was treated with Bushen Jiangu Decoction on the basis of PVP treatment. Cobb angle, bone mineral density, Oswestry dysfunction index questionnaire (ODI) score, and visual analogue scale (VAS) were compared before and after treatment. After treatment, the Cobb angle of the observation group was smaller than that of the control group, and the bone density was higher than that of the control group (P<0.05). The ODI score of the observation group was lower than that of the control group after treatment (P<0.05); 1 month and 3 months after treatment, the VAS score of the 6-month observation group was lower than that of the control group (P<0.05). Bushen Jiangu Decoction combined with Western medicine in the treatment of elderly patients with OVCF can restore Cobb angle, increase bone density, reduce postoperative pain and improve thoracic and lumbar spine function.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jinyou Chen ◽  
Yue Gao

Objective. The role of deep learning-based echocardiography in the diagnosis and evaluation of the effects of routine anti-heart-failure Western medicines was investigated in elderly patients with acute left heart failure (ALHF). Methods. A total of 80 elderly patients with ALHF admitted to Affiliated Hangzhou First People’s Hospital from August 2017 to February 2019 were selected as the research objects, and they were divided randomly into a control group and an observation group, with 40 cases in each group. Then, a deep convolutional neural network (DCNN) algorithm model was established, and image preprocessing was carried out. The binarized threshold segmentation was used for denoising, and the image was for illumination processing to balance the overall brightness of the image and increase the usable data of the model, so as to reduce the interference of subsequent feature extraction. Finally, the detailed module of deep convolutional layer network algorithm was realized. Besides, the patients from the control group were given routine echocardiography, and the observation group underwent echocardiography based on deep learning algorithm. Moreover, the hospitalization status of patients from the two groups was observed and recorded, including mortality rate, rehospitalization rate, average length of hospitalization, and hospitalization expenses. The diagnostic accuracy of the two examination methods was compared, and the electrocardiogram (ECG) and echocardiographic parameters as well as patients’ quality of life were recorded in both groups at the basic state and 5 months after drug treatment. Results. After comparison, the rehospitalization rate and mortality rate of the observation group were lower than the rates of the control group, but the diagnostic accuracy was higher than that of the control group. However, the difference between the two groups of patients was not statistically marked ( P > 0.05 ). The length and expenses of hospitalization of the observation group were both less than those of the control group. The specificity, sensitivity, and accuracy of the examination methods in the observation group were higher than those of the control group, and the differences were statistically marked ( P < 0.05 ). There was a statistically great difference between the interventricular delay (IVD) of the echocardiographic parameters of patients from the two groups at the basic state and the left ventricular electromechanical delay (LVEMD) parameter values after 5 months of treatment ( P < 0.05 ), but there was no significant difference in the other parameters. After treatment, the quality of life of patients from the two groups was improved, while the observation group was more marked than the control group ( P < 0.05 ). Conclusion. Echocardiography based on deep learning algorithm had high diagnostic accuracy and could reduce the possibility of cardiovascular events in patients with heart failure, so as to decrease the mortality rate and diagnosis and treatment costs. Moreover, it had an obvious diagnostic effect, which was conducive to the timely detection and treatment of clinical diseases.


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