| BackgroundOur country has already entered the aging society officially according to the world health organization standards,and National Bureau of Statistics 2010 population census showed our population over 60 years old reached 160 million.Compared with the national level statistics,the sixth National Population Census in Liaoning province in 2010 showed the population over 60 years old accounted for 15.43%in the provincial population,in which the population aged 65 and above accounted for 10.31%.Compared with the national census results,the national proportion 8.87%of population aging was less 6.56%than the corresponding proportion 15.43%in Liaoning province;Compared with the last census in Liaoning province,the proportion of population aging over 60 years old rose by 3.8%.Based on data,it was not hard to see that the aging population was a problem that not only Liaoning province,but also China and even the whole world had to face,aging population became an important part of the social population,and the proportion rose year by year.Social population aging is a sign of its progress,which shows the extension of human life,and the drop in death rates.Compared with its positive side,it also derives a series of problems for the elderly themselves,their families and the whole society.For elderly people,"aged diseases" come with the degenerative aging of their bodies,multiple organ degradation and restoration function decline;Common aged diseases include:high blood pressure,coronary heart disease,cerebral infarction,diabetes and other chronic systemic diseases.With the growth of the age,decline in immune ffunction,and the increase of tissue cells susceptibility,the danger of tumor formation is greater,especially the danger of malignant tumors formation is the greatest.The comprehensive treatment in tumor diseases is advocated at this stage,and is still dominated by surgical treatment.For huge crowds of elderly patients in the surgical department,its diagnosis and treatment have particularity and complexity,most surgical elderly inpatients have one or more concomitant diseases,and most concomitant diseases have the characteristics of sickliness coexistence,complex causes of diseases,delayed course of diseases,and lack of standardized treatment.For the surgical elderly inpatients needing the operative treatment,perioperative risk assessment,control of smooth life indicators during the perioperative period and prevention of postoperative complications and reasonable disposal of postoperative complications are particularly important.For surgical department,the perioperative management of the elderly inpatients is a priority for all.As a branch of the surgery system,the oral and maxillofacial surgery should treat this clinical problem cautiously.Objectives1.To investigate the constituent ratio of diseases of elderly inpatients with oral and maxillofacial disease and to conduct the epidemiological analysis;2.To make the statistical analysis for concomitant diseases of elderly inpatients with oral and maxillofacial disease;3.To analyze and discuss perioperative preparation for concomitant diseases of elderly inpatients with oral and maxillofacial disease;4.To analyze the perioperative safety of elderly patients with oral and maxillofacial disease through the retrospective analysis of data and specialist adviceMaterials and methods2123 elderly patients with oral and maxillofacial disease,who were hospitalized in The First Affiliated Hospital of Danlian Medical University from January,2007 to December 2016 and were aged 60 or above were collected.The clinical data investigated and analyzed includes disease composition and characteristics,age,gender,anesthesia and operation method,concomitant disease composition and its cnaractenstics,etc.Tne cases witn concomitant disease and postoperative complications were retrospectively analyzed.Statistics X2 test and regression analysis were used to evaluate perioperative factors and prognosis correlation.According to the postoperative complications Logistic multifactor regression analysis results,the risk of related factors was evaluated,and perioperative safety was assessed on the elderly patients with oral and maxillofacial disease combined with document literature and specialist opinions.Results1.2123 elderly patients with oral and maxillofacial disease included 1159 men,and 964 women,with the male-female ratio of 1.20:1,and male cases were more than female cases,with the overall flat sex ratio.There were 1332 elderly patients with oral and maxillofacial disease aged 67-70 in nearly 10 years,accounting for 62.74%,the highest proportion.But with the extension of life expectancy,the proportion of elderly patients over 80 years old increased in recent years.In the specified age of elderly patients,the relatively "younger" groups were dominant;2.The length of stay of most cases was 1-10 days,and the length of stay of 11-20 days accounted for two-thirds.The average length of stay of elderly patients with concomitant disease before and after perioperative period was extended;3.2123 elderly patients with oral and maxillofacial disease were classified by tumor,infection and trauma,including 1152 cases of tumor disease(52.26%),749 cases of benign tumor,and 403 cases of malignant tumor,with the benign-malignancy ratio of 1.86:1;Including 517 cases of infectious disease,accounting for 24.35%;365 cases of traumatic disease,accounting for 17.19%;4.1855 cases underwent surgery in 2123 elderly patients with oral and maxillofacial disease,accounting for 87.37%of the total patients.The proportion of the general anesthesia to local anesthesia was 2.29:1 in 1855 elderly patients who underwent surgery;At the exclusion of perioperative taboo,most of the patients with maxillofacial disease still chose to undergo surgery under general anesthesia by tracheal cannula;5.1456 patients had concomitant systemic diseases in 2123 elderly patients with oral and maxillofacial disease,accounting for 68.60%.1456 patients only had one concomitant systemic disease,accounting for 66.14%;493 patients had two or above concomitant diseases,accounting for 33.86%.1526 patients had concomitant cyclic system disease,including 798 patients with hypertension(54.80%),328 patients with arrhythmia(22.53%),and 246 patients with coronary heart disease(16.89%).Conclusion1.Most of elderly patients with maxillofacial disease are men aged 60-70,and with the extension of the average population lifetime,the proportion of the elderly patients over the age of 80 increased;2.The length of stay of elderly patients with maxillofacial disease focused on 10-20 days,and the average length of stay of elderly patients with concomitant diseases before and after perioperative period was extended;3.The percentage of neoplastic diseases was the highest in the elderly patients with maxillofacial diseases,and the gland lymphoma and tongue cancer had the highest incidence of benign and malignant tumor respectively;4.Most of the patients with oral and maxillofacial disease chose the operative treatment,and after comprehensive consideration,patients still chose general anesthesia by tracheal intubation first;5.Nearly 70%of elderly patients with oral and maxillofacial disease had concomitant diseases,which mainly include cardiovascular disease and endocrine disease,in which high blood pressure and diabetes had the highest concomitant percentage respectively.The effective assessment on their concomitant diseases,perfect,positive,proper anesthesia and preoperative preparation,strengthening intraoperative monitoring and postoperative nursing can effectively reduce the perioperative risk and the incidence of complications of elderly patients with oral and maxillofacial disease,so as to safeguard life safety. |
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