Preoperative Risk Factors Associated With PACU Pediatric Respiratory Complications: An Integrative Review

PurposeThis article reviews state of the science of preoperative risk factors associated with postanesthesia care unit (PACU) pediatric respiratory complications.DesignAn integrative review.MethodsA search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Scopus, Cochrane, and Joanna Briggs Institute databases was performed. Thirty-one articles, published between 2006 and 2018, were appraised for quality and the level of evidence using the Johns Hopkins Nursing Evidence-Based Practice Model.FindingsThese articles were grouped into the following categories: age, American Society of Anesthesiologists status, gender, airway comorbidities, syndromes, anomalies, pulmonary comorbidities, ethnicity, obesity, neurologic comorbidities, and cardiac comorbidities.ConclusionsEvidence identified significant preoperative and anesthesia risk factors that are associated with PACU pediatric respiratory complications. This article reveals the importance for the perioperative team to identify, assess for, communicate, and develop a management plan for pediatric respiratory complications.     

Efficacy and Feasibility of Allogeneic Hematopoietic Stem-Cell Transplantation in the Treatment of Refractory Acute Myeloid Leukemia

Background

Refractory acute myeloid leukemia (AML) includes AML includes failure of disease to respond to standard induction chemotherapy, relapse within 6 months after first CR, and 2 or more relapses. The outcome of these patients is usually very poor; only a small proportion can be rescued by allogenic hematopoietic stem-cell transplantation (allo-HSCT). The aim of this study was to evaluate the efficacy and feasibility of allo-HSCT in patients with refractory AML.

脑后部可逆性脑病综合征(PRES)的临床MR诊断

目的：探讨MR对PRES的临床诊断价值。方法应用3.0 T MR对30例PRES患者进行常规扫描，其中19例同时行MRA检查，13例行MRV检查。结果 PRES病变主要累及顶枕叶，双侧基本对称；病变主要位于脑白质内，也可累及其它部位。PRES病变的特点是呈长T 1长T 2信号，边缘不清，无明显占位效应。MRA及MRV均无异常发现。结论 MR对PRES可以作出准确诊断，对临床有重要的指导意义。     

经鼻导管高流量吸氧与经鼻气道正压通气在重症毛细支气管炎呼吸支持中的应用价值比较

目的：比较经鼻导管高流量吸氧（HFNC）与经鼻气道正压通气（nCPAP）在重症毛细支气管炎呼吸支持中的应用价值，为临床治疗方案的选择提供参考。方法：选取2016年12月至2018年12月我院儿科收治的重症毛细支气管炎患儿90例，采用随机数字表法分为观察组和对照组各45例。两组患儿入院后均给予常规综合治疗以保证呼吸道通畅，在此基础上观察组采用HFNC治疗，对照组采用nCPAP治疗，比较两组患儿治疗前和治疗24 h后呼吸频率、经皮血氧饱和度（TcSO2）、呼吸窘迫评分体系（CSS）评分、动脉血氧分压（PaO2）等呼吸相关指标及治疗前后临床症状体征改善情况。结果：两组患儿治疗24 h后呼吸频率、CSS评分均降低，且观察组降低程度更大，TcSO2、PaO2于治疗24 h后升高，观察组升高幅度较对照组明显；治疗后两组患儿咳嗽及肺部湿啰音、肺部炎症情况均改善，观察组症状体征消失时间早于对照组，差异均有统计学意义（P<0.05）。结论：重症毛细支气管炎患儿采用HFNC治疗可明显改善通气功能和临床症状，治疗效果优于nCPAP治疗，可扩大样本量进一步观察。     

从中医角度探讨多囊卵巢综合征的发生与肺胃的相关性

对于“多囊卵巢综合征”中医病位的认识,学者们众说纷纭,主要涉及肺、肝、脾、肾、胃、冲任等。本文对其病位在“肺”“胃”这一观点提出质疑,并以多囊卵巢综合征现代文献资料为主要研究对象,确定多囊卵巢综合征的病变脏腑,提取多囊卵巢综合征的主要症状,总结多囊卵巢综合征的核心病机,从而探究多囊卵巢综合征的病位,讨论本病的发生与肺胃的相关性,加深对多囊卵巢综合征的中医认识。