Table of Content

20 November 2021, Volume 35 Issue 11 Previous Issue    Next Issue

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Relationship between acute insular infarction and stress hyperglycemia in the elderly CAI Ying-yuan, LU Xiao-wei 2021, 35 (11):  1126-1130.  doi: 10.3969/j.issn.1003-9198.2021.11.006 Abstract ( 191 )   PDF (1448KB) ( 1067 )   Save Objective To investigate the relationship between acute insular infarction and stress hyperglycemia (SH) in the elderly. Methods A total of 75 patients (≥60 years) with acute anterior circulation ischemic stroke (ACI) in the Emergency Department of Jiangsu Province Hospital from January 2017 to December 2018 were enrolled. According to MRI, the patients were divided into insular cortex involved group and non-involved group. The clinical features were collected, as well as National Institute of Health Stroke Scale (NIHSS), blood pressure, serum glucose, hemoglobin, creatinine and glycosylated hemoglobin (HbA1c). Stress hyperglycemia ratio (SHR) was used to assess the intensity of SH. SHR was classified by quartile category. Ordinal regression analysis was used to explore the relationships between the risk factors and the increase of SHR category.SHR≥1.14 was defined as SH, and then binary Logistic regression analysis was performed to predict the risk of post-stroke SH. Results There were significant differences in diabetes mellitus history (P=0.027) and SH (P =0.041) between the insular cortex involved group and non-involved group. With the increase of NIHSS score, SHR showed an upward trend(r2=0.121). The risk of the increase of SHR category increased to 1.214-fold (P=0.017) with the increase of 1 point of NIHSS score, and to 2.641-fold (P=0.036) with insular involvement. The risk of SH increased to 2.917-fold (P=0.041) with insular involvement. Conclusions Insular involvement is an independent risk factor for SH in the elderly patients with ACI. References | Related Articles | Metrics

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Application value of heparin-binding protein in evaluating the condition and prognosis of elderly patients with infectious diseases SHEN Hua, FENG Qian-ru, ZHANG Zheng, SUN Cai-zhi, GUO Lei, QIN Hai-dong 2021, 35 (11):  1131-1135.  doi: 10.3969/j.issn.1003-9198.2021.11.007 Abstract ( 158 )   PDF (1046KB) ( 954 )   Save Objective To investigate the value of heparin binding protein(HBP) in assessing the condition and prognosis of elderly patients with infectious diseases. Methods From August 2018 to December 2020, 168 elderly patients in the Emergency Department of our hospital were selected. According to the presence of infection and organ failure, they were divided into in the sepsis group (group A, n=81), the mild infection group (group B, n=48) and the non-infection group (group C, n=39). The levels of HBP, procalcitonin(PCT), C-reaction protein(CRP), white blood cell count (WBC) and the highest body temperature were collected within 24 h after admission, and sequential organ failure score was assessed. Receiver operating characteristic (ROC) curve was established to evaluate the prognostic significance of each index, and Youden index was calculated to determine the best cut-off value. Results The levels of HBP, PCT and CRP in group A were significantly higher than those in group B and group C (P<0.05). The levels of HBP, CRP and WBC in group B were higher than those in group C (P<0.05). There was no significant difference in the level of PCT between group B and group C (P>0.05). The highest 24 h body temperature in group A was significantly higher than that in group B and group C (P<0.001). In predicting the risk of death of all selected patients, the areas under the ROC curve (AUC) of HBP, PCT and CRP were 0.802, 0.777 and 0.711, respectively. In predicting the risk of death in sepsis patients, the AUC of HBP and PCT were 0.724 and 0.648, respectively. Conclusions HBP can be used as an effective biomarker to evaluate the condition and prognosis of infectious diseases in the elderly. References | Related Articles | Metrics

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Investigation on cognitive function, depression and drug compliance in elderly patients with HIV FENG Cai-yun, YE Yong-xiu, XIONG Hai-yan, ZENG Hui 2021, 35 (11):  1136-1139.  doi: 10.3969/j.issn.1003-9198.2021.11.008 Abstract ( 174 )   PDF (1026KB) ( 1168 )   Save Objective To investigate the epidemiological status of cognitive function, depression and medication compliance of the elderly patients with human immunodeficiency virus (HIV) in Hunan Province and to conduct correlation analysis. Methods A total of 252 people infected with HIV aged ≥60 years old were selected by the random sampling method. The general social information questionnaire, the Montreal Cognitive Assessment Scale (MoCA), the Five Geriatric Depression Scale (GDS-5), and the Morisky Medication compliance (MMAS-8) were used to investigate the patients' cognitive function, depression and medication adherence status, respectively. Results The scores of MoCA, GDS-5 and MMAS-8 were 18.16±5.57,0.51±1.15 and 7.56±0.82,respectively. The proportion of cognitive abnormalities was 89.2%; The proportion of depressive symptoms was 12.7%; The high compliance rate of taking medicine was 81.97%, the middle compliance rate was 16.26%, and the low compliance rate was 2.77%. The dimensions with greatest decline in cognitive function were memory, visual space and executive ability. Depression was negatively correlated with medication compliance score (r=-0.243, P<0.01), and MoCA score was positively correlated with depression score (r=0.155, P<0.05), but the correlation between cognitive function and medication compliance was not statistically significant (r=0.055, P>0.05). Conclusions The cognitive function is relatively low in the patients infected with HIV, but the depressive symptoms are mild, and medication compliance does not meet 95% as the target. The depression is positively related to cognitive function and negatively related to medication compliance. References | Related Articles | Metrics

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Application of high-flow nasal cannula oxygen therapy for anesthesia induction in elderly patients undergoing gastrointestinal surgery XIONG Jing-wei, ZHANG Li-dong, JI Qing, LIU Yang 2021, 35 (11):  1140-1143.  doi: 10.3969/j.issn.1003-9198.2021.11.009 Abstract ( 159 )   PDF (1030KB) ( 1070 )   Save Objective To investigate the application of high-flow nasal cannula oxygen therapy (HFNC) for anesthesia induction in the elderly patients undergoing gastrointestinal surgery. Methods Eighty elderly patients undergoing elective gastrointestinal surgery were randomly equally allocated into the HFNC group and the face mask group. In the HFNC group, high-flow oxygen inhalation through the nasal catheter was performed until endotracheal intubation was completed. While in the face mask group, endotracheal intubation was achieved after pre-oxygenation and mechanical ventilation through non-invasive mask. The heart rate (HR),mean arterial pressure (MAP), pulse oxygen saturation (SpO2), partial pressure of oxygen in artery (PaO2) and partial pressure of carbon dioxide in artery (PaCO2) were recorded at the time of arterial puncture completed (T0), 5 minutes after pre-oxygenation (T1), 3 minutes after cis-atracurium injection (T2), and immediately after the endotracheal intubation (T3). The apneic tracheal intubation period was defined from apnea to the completion of endotracheal intubation (T2 to T3). Results There was no significant difference in vital signs between the two groups. The level of PaO2 was significantly higher in the HFNC group than that in the face mask group at T1 (P<0.05). During apneic tracheal intubation period, the decrease of PaO2 and the increase of PaCO2 in the HFNC group were significantly lower than those in the face mask group (P<0.05). The comfort level in the HFNC group was significantly higher than that in the face mask group (P<0.05). Conclusions HFNC provides effective pre-oxygenation, slight decrease of PaO2 during apneic tracheal intubation period without CO2 accumulation and is more comfortable for the elderly patients undergoing gastrointestinal surgery. References | Related Articles | Metrics

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Genetic variation of DAF rs150046210 affects the risk of colorectal cancer in the elderly JIN Min, WU Hong-jiao, FU Ning, ZHANG Hong-mei, SONG Qin-qin, XU Shan-shan, JI Shan-shan, ZHANG Xue-mei, ZHANG Zhi 2021, 35 (11):  1144-1148.  doi: 10.3969/j.issn.1003-9198.2021.11.010 Abstract ( 133 )   PDF (1041KB) ( 1059 )   Save Objective To explore the association of genetic variants of decay-accelerating factor (DAF)rs150046210 with the risk of colorectal cancer. Methods DAF rs150046210 was genotyped by Polymerase Chain Reaction in 380 patients with colon cancer and 380 normal controls, 450 patients with rectal cancer and 450 normal controls, respectively. Logistic regression was used to investigate the association between rs150046210 and colorectal. Results Compared with DAF rs150046210 DD genotype carriers,Ⅱ genotype carriers had 0.764 times (95%CI: 1.763-2.675, P=0.008) and 0.789 times (95%CI: 1.227-2.608, P=0.003) higher risk of colon cancer and rectal cancer, respectively. When stratified by sex, women with genotype Ⅱ had a 1.015-fold increased risk of colon cancer (95%CI: 1.085-3.742, P=0.026), and men with genotype Ⅱ had a 1.041-fold increased risk of rectal cancer (95%CI: 1.290-3.228, P=0.002),comparing with DAF rs150046210 DD carriers. In the age stratification, this genetic variation affected the risk of colon cancer (OR=2.355, 95%CI: 1.273-4.356,P=0.006) in the low age group (≤60 years old) who carried Ⅱ gene, also affected the risk of rectal cancer (OR=1.757,95%CI:1.106-2.789,P=0.017),(OR=2.313, 95%CI:1.334-4.012,P=0.003) in the high age group (>60 years old) with DI or Ⅱ genotype. Compared with DAF rs150046210 DD genotype carriers, Ⅱ genotype of not smoking, not drinkers had a 0.791(95% CI: 1.106-2.900, P=0.018) and 0.714 (95% CI: 1.086-2.704, P= 0.021)-fold increased risk of colon cancer incidence, type Ⅱ gene carriers who didn′t smoke or drink wine showed increased risk of rectal cancer(OR=2.395, 95%CI:1.514-3.788,OR=1.923, 95%CI: 1.221-3.030, respectively). Conclusions DAF rs150046210 polymorphism can increase the risk of colorectal cancer in the elderly patients. References | Related Articles | Metrics

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Efficacy and safety of three anticoagulants in elderly patients with atrial fibrillation WANG Wei, ZHANG Dong-mei, GUO He-jie, WANG Jing, ZONG Jing, LIN Gang 2021, 35 (11):  1149-1153.  doi: 10.3969/j.issn.1003-9198.2021.11.011 Abstract ( 158 )   PDF (1046KB) ( 973 )   Save Objective To compare the safety and effectiveness of warfarin, dabigatran and rivaroxaban in the elderly patients with atrial fibrillation aged 65 years old and above, and to provide a reference for clinical decision-making. Methods The elderly patients with non-valvular atrial fibrillation who were hospitalized in our hospital from 2015 to 2019 were enrolled in the study. The patients were divided into three groups as 65-74 years old group, 75-84 years old group, and ≥85 years old group according to their ages, and divided into warfarin group, dabigatran group, and rivaroxaban group according to the anticoagulant treatment plan. They were followed up until the first occurrence of any embolism, bleeding event or death and the end of the study(12/31/2020). The incidence rate of end-point events among the three groups was compared. Results A total of 581 patients were finally enrolled in this study. Among them 292 were female (50.26%); 293 cases (50.43%) were 65-74 years old, 253 cases (43.55%) were 75-84 years old, 35 cases were ≥85 years old (6.02%); 301 cases received warfarin, 119 cases received dabigatran, and 161 cases received rivaroxaban. There was statistically significant difference in stroke and hemorrhoea events among different anticoagulant groups. Warfarin group had a higher risk of bleeding and embolism than dabigatran group (all P<0.05); Stratified by age, the patients receiving Warfarin in 75-84 years old group had the highest incidence rate of embolization and bleeding, followed by the patients receiving rivaroxaban and dabigatran (P<0.05). The incidence rate of embolism and bleeding had no statistical difference between different anticoagulant groups in 65-74 years old group and ≥85 years old group. Conclusions Three anticoagulant drugs show value in the elderly patients with atrial fibrillation. In elderly patients aged 75-84 years old, the safety and effect of warfarin are lower than dabigatran and rivaroxaban. References | Related Articles | Metrics

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Effects of postoperative enteral nutrition time on gastrointestinal function recovery in the elderly patients with esophageal cancer XING Yi-hui, LIU Man, ZHANG Zhi 2021, 35 (11):  1154-1156.  doi: 10.3969/j.issn.1003-9198.2021.11.012 Abstract ( 130 )   PDF (1055KB) ( 1502 )   Save Objective To explore the effects of enteral nutrition time on gastrointestinal function recovery in the elderly patients with esophageal cancer. Methods A total of 84 elderly patients with esophageal cancer receiving surgery were selected from August 2017 to August 2018 in our hospital, and they were randomly divided into experimental group and control group. Patients in the control group was given enteral nutrition within 24-48 h after surgery, and the patients in the experimental group were given enteral nutrition within 12 h after surgery. The postoperative gastrointestinal function recovery and complications were compared between the two groups. Results The levels of serum albumin, prealbumin and transferrin one week after nutritional support in the experimental group were higher than those in the control group (P<0.05). The time of the first defecation, the first anal exhaust and the time of recovery of bowel sound after surgery in the experimental group were shorter than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the incidence rate of postoperative complications between the two groups (P>0.05). Conclusions Enteral nutrition intervention within 12 h after surgery can improve the nutritional state of the elderly patients with esophageal cancer, and promote the recovery of gastrointestinal function. References | Related Articles | Metrics

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Relationship between serum ferritin, CRP and CIMT in elderly patients with subclinical hypothyroidism complicated with T2DM LIN Hong-xia, LIU Xiao-ping, WENG Xiu-zhen 2021, 35 (11):  1157-1161.  doi: 10.3969/j.issn.1003-9198.2021.11.013 Abstract ( 148 )   PDF (1056KB) ( 1007 )   Save Objective To study the relationship between serum ferritin(SF), C-reactive protein (CRP) and carotid intima-media thickness (CIMT) in the elderly patients with subclinical hypothyroidism (SCH) combined with type 2 diabetes mellitus (T2DM), and to analyze the influencing factors of CIMT thickening. Methods From January 2018 to January 2020, seventy-eight elderly patients with SCH complicated with T2DM were selected as the disease group, and the patients with only SCH (SCH group) or T2DM (T2DM group) matched by age and gender were selected as controls. The levels of SF and CRP of all the subjects were detected, and CIMT was detected by carotid ultrasound. The levels of SF, CRP and CIMT were compared between the three groups. Pearson correlation analysis was used to analyze the correlation between SF, CRP and CIMT. Univariate and multivariate Logistic regression analysis was used to evaluate the risk factors of CIMT thickening in the elderly patients with SCH combined with T2DM. Results The levels of SF, CRP and CIMT of the disease group were higher than those of SCH group and T2DM group(P<0.001).There were no statistically significant differences between SCH group and T2DM group in the levels of SF, CRP and CIMT(P＞0.05). Pearson correlation analysis showed that the levels of SF and CRP in the disease group were positively correlated with CIMT (P<0.05). Univariate analysis showed that the levels of SF, CRP, low density lipoprotein (LDL-C), total cholesterol (TC), thyroid stimulating hormone (TSH) and hypertension history in the CIMT thickening group were higher than those in the normal group, while the level of HDL-C in the thickening group was lower than that in the normal group (P<0.05). Logistic regression analysis showed that SF, CRP, LDL-C and TC were risk factors for CIMT thickening in the elderly patients with SCH combined with T2DM, and HDL-C was a protective factor (P<0.05). Conclusions The levels of SF, CRP and CIMT are increased in the elderly patients with SCH combined with T2DM, and SF and CRP are the influencing factors of CIMT thickening in the elderly patients with SCH and T2DM. References | Related Articles | Metrics

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Predictive value of metalloproteinase-inhibiting factors for in-hospital death in elderly patients with chronic heart failure LI Jun, LYU Zhen, LI Bei-bei 2021, 35 (11):  1162-1165.  doi: 10.3969/j.issn.1003-9198.2021.11.014 Abstract ( 134 )   PDF (1031KB) ( 1005 )   Save Objective To evaluate the predictive value of metalloproteinase-inhibiting factors (TIMPs) for in-hospital death in the elderly patients with chronic heart failure. Methods A total of 394 patients with CHF in our hospital during January 2018 to January 2020 were divided into in-hospital death group(n=40) and non-in-hospital death group(n=354). The levels of TIMPs were compared between the two groups. The risk factors of in-hospital death were analyzed by Logistics regression model. ROC curve was used to analyze the predict value for in-hospital death. Results Early serum levels of TIMP-1, TIMP-2 and TIMP-4 in in-hospital death group were lower than those in non-in-hospital death group(P<0.05). ROC curve showed that optimal cut-off value of serum TIMP-1 at the early stage after admission was 149.40 pg/mL, with an AUC of 0.751(95%CI: 0.657-0.846), with a sensitivity and specificity of 74.07% and 62.50% respectively. Optimal cut off value of serum TIMP-2 was 180.30 pg/mL, with an AUC of 0.819(95%CI: 0.734-0.905), with a sensitivity and specificity of 78.75% and 75.00% respectively. Optimal cut off value of TIMP-4 was 193.30 pg/mL, with an AUC of 0.746(95%CI: 0.649-0.843), with a sensitivity and specificity of 63.75% and 70.00% respectively. According to Logistics regression analysis, age over 70 years old, low hemoglobin level, TIMP-1<149.40 pg/mL, TIMP-2<180.30 pg/mL, TIMP-4<193.30 pg/mL, high NT-proBNP level were independent risk factors for in-hospital death in the elderly CHF patients(P<0.05). Conclusions Low serum levels of TIMP-1, TIMP-2 and TIMP-4 are independent risk factors for in-hospital death in the elderly patients with CHF after admission, which has early predictive value for in-hospital death. References | Related Articles | Metrics

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Correlation between nutritional status screened by MNA-SF and acute stroke-associated infections in the elderly GU Shuang-shuang, GAO Feng-juan, ZHOU Yi, WANG Jun 2021, 35 (11):  1166-1169.  doi: 10.3969/j.issn.1003-9198.2021.11.015 Abstract ( 166 )   PDF (1029KB) ( 1106 )   Save Objective To investigate the correlation between nutritional status and stroke-associated infections (SAI) in the elderly patients with acute stroke. Methods The patients with acute stroke aged over 70 years who were admitted to the hospital within 24 h of disease attack from January 2018 to June 2020 were retrospectively enrolled in this study. The baseline nutritional status of all patients was assessed by using the mini nutritional assessment short-form (MNA-SF). Then, all patients were divided into normal nutritional status group, malnutrition risk group and malnutrition group. At the same time, the baseline clinical data of the patients in the three groups, including stroke type, demography, laboratory examination and the incidence of SAI were collected and analyzed. Moreover, the risk factors of SAI were identified by multivariate Logistic regression, so as to determine the correlation between nutritional status and SAI. Results This study included 233 patients with a mean age of 77.02±6.60 years, ranging 70-90 years, and 142(60.9%) patients were male. There were 51(21.9%) patients with concomitant SAI. According to MNA-SF assessment, 34.0% of the patients with malnutrition presented with SAI, while 26.2% of the patients with malnutrition risk presented with SAI. Compared with the patients with normal nutrition(12.7%), the incidence rate of SAI in the three groups was statistically different (P=0.007). Multivariate analysis showed that malnutrition risk (OR=3.401,95%CI=1.414-8.181) and malnutrition (OR=4.088,95%CI=1.612-10.363) were the risk factors of SAI. Conclusions The elderly patients with acute stroke who have malnutrition and malnutrition risk are identified as the high-risk group of SAI. Nutritional support should be implemented as early as possible for such patients. References | Related Articles | Metrics

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Analysis of comorbidities in elderly inpatients with type 2 diabetes mellitus JI Qian-yun, LI Man, CUI Wen-xia, GAO Lei, PAN Feng-hui, ZHANG Ming-rui, HU Yun 2021, 35 (11):  1170-1173.  doi: 10.3969/j.issn.1003-9198.2021.11.016 Abstract ( 159 )   PDF (1083KB) ( 1118 )   Save Objective To investigate the comorbidities in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A retrospective study was conducted to collect clinical data of 427 hospitalized elderly patients with T2DM. The Charlson comorbidity index (CCI) was calculated. CCI≤2 was defined as low comorbidity group, and CCI > 2 was defined as high comorbidity group. The general condition, comorbidites, blood glucose control and multiple drug use were analyzed in different comorbidity group. Results Among 427 elderly patients with T2DM, the high comorbidities prevalence was 65.34%. The age and course of diabetes of the high comorbidity group were significantly higher than those of the low comorbidity group (P<0.05).In the high comorbidity group, 88.53% were complicated with hypertension, 81.00% with hyperlipidemia, 63.44% with peripheral artery disease, 60.93% with cerebrovascular disease, and 40.50% with ischemic heart disease. In the low comorbidity group, 77.70% were complicated with hyperlipidemia, 62.84% with peripheral artery disease, and 53.38% with hypertension. The proportion of polypharmacy in high comorbidity group (62.37%) was significantly higher than that of low comorbidity group (47.30%) (P<0.01). There were no significant differences in blood glucose control and islet function between low comorbidity group and high comorbidity group (P>0.05). Conclusions Compared with the low comorbidity group, the patients in the high comorbidity group show older age, longer course of disease, higher proportion of taking multiple drugs, and are more likely to be complicated with diseases such as hypertension, cardiovascular and cerebrovascular diseases. References | Related Articles | Metrics

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Efficacy and safety of minimally invasive percutaneous nephrolithotomy in the treatment of elderly patients with kidney stones LI Mao-lin, ZHOU Hong-yi 2021, 35 (11):  1174-1177.  doi: 10.3969/j.issn.1003-9198.2021.11.017 Abstract ( 191 )   PDF (1027KB) ( 1303 )   Save Objective To evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy(mPCNL) in the treatment of the elderly patients with kidney stones. Methods The clinical data of the patients with kidney stones treated with mPCNL from 2017 to 2019 were collected, and the patients were divided into the young group (<60 years) and the elderly group (≥60 years).The differences in stone diameter, operation time, retention time of nephrostomy, stone clearance rate, length of hospital stay, postoperative complications between the two groups were analyzed. Results A total of 310 patients were enrolled, including 168 cases in the young group and 142 cases in the elderly group. There were no significant differences in urinary culture, stone size, operation time, retention time of nephrostomy and length of hospital stay between the two groups (P>0.05).There were statistically significant differences in the prevalance rate of hypertension, American Soctety of Anesthesiologists (ASA) degree and the incidence rate of fever after operaion (P<0.05). Conclusions mPCNL for the treatment of kidney stones in the elderly shows good efficacy and safety, with good clinical application value. References | Related Articles | Metrics

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Application and the effect of knowledge-belief-practice model on self-management ability in patients with severe bronchiectasis complicated with pulmonary infection GONG Yu-lei, WEI Jun, YU Chun-ni, NIU Xiao-na 2021, 35 (11):  1194-1197.  doi: 10.3969/j.issn.1003-9198.2021.11.022 Abstract ( 147 )   PDF (1020KB) ( 1181 )   Save Objective To explore the application of the knowledge-belief-practice model on atomization inhalation therapy in the patients with severe bronchiectasis complicated with pulmonary infection and the effect on self-managment ability. Methods From 2017 to 2019, ninety-four patients with severe bronchiectasis and pulmonary infection were selected and divided into control group and observation group, with 47 cases in each group. Both groups were treated with aerosol inhalation of acetylcysteine solution. The control group was given routine nursing intervention, and the observation group was given the knowledge-belief-practice mode intervention on the basis of the control group. Lung function, arterial blood gas index, and self-management ability were compared between the two groups before and after intervention. Results After the intervention, the vital capacity, expiratory flow rate, and expiratory volume in the observation group were higher than those in the control group (P<0.05). The pH, arterial oxygen pressure (PaO2), and arterial oxygen saturation (SaO2) in the observation group were higher than those in the control group(P<0.05), and the arterial blood carbon dioxide partial pressure (PaCO2) was lower than that in the control group(P<0.05). The self-dietary management, drug management, emotional management, health knowledge level and self-care ability score in the observation group were higher than those in the control group(P<0.05). Conclusions The use of the knowledge-belief-practice model is beneficial in the treatment of the patients with severe bronchiectasis and pulmonary infection. It can effectively improve the patients' pulmonary function index, the arterial blood gas index, and the patient's self-management ability, which is worth popularizing and applying. References | Related Articles | Metrics

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Effects of ICF-based family empowerment program on home care of patients with heart failure ZHANG Qiong, XUE Jie, LI Mei-ling 2021, 35 (11):  1198-1202.  doi: 10.3969/j.issn.1003-9198.2021.11.023 Abstract ( 195 )   PDF (1043KB) ( 1110 )   Save Objective To explore the effects of ICF-based family empowerment program on the patients’ function status and prognosis and the care burden of primary caregivers in home care of patients with heart failure. Methods From November 2018 to July 2019, we selected 104 patients with heart failure and their main caregivers as subjects by convenience sampling. All of the subjects were divided into control group and experimental group with the method of random number table. Patients in the control group carried out routine nursing. On the basis of control group, experimental group applied family empowerment program based on ICF. Dutch Objective Burden Inventory was used to assess caregivers' burden. The readmission rate and all-cause mortality were compared between the two groups one and three months after discharge. Results Finally, a total of 48 cases were included in experimental group and 45 included in control group. There was no statistically significant difference between the two groups in the ICF assessment function grades before and one month after discharge (P>0.05). After three months, mineral, water and electrolyte balance function, emotional function, sleep function, readmission rate and all-cause mortality were statistically significant between the two groups. The main caregivers burden score of each dimension in the two groups at discharge were of no statistical difference (P>0.05). One month later, the difference in dimension of personal care was statistically significant (P＜0.01), and three months later, except for the incentive support dimension, the differences in the other dimensions were all statistically significant between the two groups. Conclusions Appling the family empowerment scheme based on ICF in the home care for heart failure can not only improve patients' functional status and disease prognosis, but also reducing the burden of disease care for primary caregivers, which is beneficial to both patients and their families. References | Related Articles | Metrics

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Application of comprehensive nursing intervention in elderly patients with atrial fibrillation undergoing second-generation cryoballoon ablation SHE Li-ping, WU Ya-feng, LI Shao-man, LIN Song 2021, 35 (11):  1203-1206.  doi: 10.3969/j.issn.1003-9198.2021.11.024 Abstract ( 137 )   PDF (1024KB) ( 1125 )   Save Objective To explore the effect of comprehensive nursing intervention in the elderly patients with atrial fibrillation undergoing the second-generation cryoballoon ablation(CBA). Methods A total of 106 elderly patients with atrial fibrillation undergoing second-generation CBA from August 2019 to December 2020 in Nanjing First Hospital were randomly assigned to the experimental group and the control group with 53 cases in each group. Patients enrolled in the experimental group received comprehensive nursing intervention, and those in the control group received conventional nursing care. Anxiety scores at preoperation and postoperation, pain scores during intraoperation, the incidence of adverse effect, the dosage of analgesic drugs and the patients' postoperative satisfaction with nursing work were compared between the two groups. Results The anxiety scores, the pain scores and the dosage of Fentanyl in the experimental group were significantly lower than those in the control group (all P<0.05 or P<0.01). There were no significant differences in the incidence rate of intraoperative vagus nerve reflex, nausea and vomiting between the two groups (P>0.05). The patients in the experimental group were more satisfied with nursing work than those in the control group (P<0.05). Conclusions Comprehensive nursing intervention for elderly patients with atrial fibrillation undergoing second-generation CBA might reduce periprocedural anxiety,alleviate CBA procedure-related chest pain, reduce the dosage of intraoperative analgesic and improve the patient's satisfaction with our nursing work. References | Related Articles | Metrics