重症肺炎并呼吸衰竭患儿接受早期持续气道正压通气治疗对血气指标及预后的影响

目的分析重症肺炎并呼吸衰竭患儿接受早期持续气道正压通气(CPAP)治疗对血气指标及预后的影响。方法选取2019年2月至2020年6月本院收治的110例重症肺炎并呼吸衰竭患儿,按照组间基本资料具有可比性的原则分为对照组与实验组,各55例。对照组接受常规方案治疗,实验组接受早期持续CPAP治疗,比较两组血气指标改善情况以及患儿预后。结果治疗后,两组PaO₂、PaCO₂、SaO₂均显著改善,且实验组改善程度明显优于对照组(P<0.05)。实验组临床病死率明显低于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义。结论采用早期持续CPAP治疗重症肺炎并呼吸衰竭患儿效果显著,能明显改善血气指标和预后,具有临床推广价值。     

Neuroprotection in paediatric traumatic brain injury

Traumatic brain injury (TBI) is the leading cause of trauma-related death and disability in children worldwide. The outcome from TBI can be improved by early aggressive management of oxygenation and blood pressure. There is evidence to suggest that adhering to guidelines when managing these patients can have a positive effect on the outcomes. In this article we review the general supportive and targeted neuroprotective measures that are outlined in international paediatric guidelines and are most widely used in the critical care management of patients with TBI; we further review how these measures can influence the underlying evolving pathophysiology in these patients. The aim of critical care management of patients with TBI is to prevent or limit secondary brain injury by optimizing cerebral perfusion and oxygenation to improve survival and clinical outcomes. We also discuss how to monitor patients with traumatic brain injury on the paediatric intensive care unit and we give a practical approach on how to respond to deteriorating patients and to the complications arising during the course of their management.     

Lateral ventricular liponeurocytoma: Review of literature and case illustration

BackgroundLiponeurocytoma is an uncommon tumor of the central nervous system. It is very rare for this tumor to originate within the lateral ventricle. In the context of the rarity of this tumor entity, this review article aims to summarize the clinical, radiological, and pathological features of lateral ventricular liponeurocytoma to facilitate its diagnosis and management.MethodsHere, we conduct a systematic literature review using the Pubmed, Scopus, and Cochrane Library database for all cases of lateral ventricular liponeurocytoma. A case illustration complements this review.ResultsThe described cases from 1997 onward include 14 cases that have been published in full papers in the English literature. Six additional cases are reported in short English abstracts in full non-English papers, and one case was described in a central neurocytoma report. There is a definite male predominance of 70% (14 male) and a mean age of 37 years (range 24–62). Heterogenous enhancement and signals in magnetic resonant images (MRI) are the radiological characteristics. In all reported cases, the presence of lipocytes and fat vacuoles is considered the paramount histopathological feature. Total surgical resection was achieved in 80% (12 out of 15) of the cases. Only two cases (including ours) received radiation therapy. Recurrence was seen in two patients during follow-up that was treated by radiation therapy in one and surgery in the other. The proliferation index is mostly below 5% in all cases, with the Ki-67 range between < 1% to 10%.ConclusionsLateral ventricular liponeurocytoma has been treated effectively by surgical resection in a limited number of cases. The decision for radiation therapy is based on a high proliferation index and tumor recurrence.     

无创中心动脉压测量的现状与展望

心血管系统疾病是威胁居民健康的重要因素之一，居各种死因首位。因此，对人体心血管健康状况的监测和诊断尤为重要。相较于传统的外周动脉压，中心动脉压（central arterial pressure, CAP）与许多心血管事件发生有更高的相关性，通过测量CAP可以更加准确地反映人体血压的真实情况，并为诊断和疾病的预防提供重要依据。因此，实现高精度、高泛化能力、低成本的CAP无创测量方法一直是该领域的研究重点。结合国内外的相关文献，总结CAP测量现状，从参数测量与波形测量两个方面介绍相关的研究进展，并探讨现有方法的特点以及未来的发展方向。