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61.
Marilyn Hravnak Leslie A Hoffman Melissa I Saul Thomas G Zullo Julie F Cuneo Ronald V Pellegrini 《American journal of critical care》2004,13(6):499-507; discussion 508
BACKGROUND: Studies suggest that patients who undergo off-pump coronary artery bypass grafting (OPCABG) have fewer short-term complications and use fewer inpatient resources than do patients who undergo standard coronary artery bypass grafting (CABG) with extracorporeal circulation. However, dissimilarity between groups in risk factors for complications has hindered interpretation of results. OBJECTIVES: To compare the prevalence of selected complications (atrial fibrillation, stroke, reoperation, and bleeding) and inpatient resource utilization (length of stay, discharge disposition, total charges) between subjects undergoing primary isolated CABG or OPCABG who were matched with respect to key risk factors. METHODS: Retrospective, causal-comparative survey conducted in 1 center for 18 months. Patients who underwent primary isolated CABG or OPCABG were matched for sex, age (within 2 years), left ventricular ejection fraction (within 0.05), and graft-patient ratio (exact match) and compared for prevalence of new-onset atrial fibrillation, stroke, reoperation within 24 hours, and bleeding. Statistical analysis included Wilcoxon and t tests for paired comparisons. RESULTS: The sample (107 matched pairs) was 63% male, with a mean age of 66 (SD 9.5) years, a mean left ventricular ejection fraction of 0.51 (SD 0.13), and a mean graft-patient ratio of 3.41 (SD 0.74). The 2 groups did not differ significantly in New York Heart Association class (P = .43), Acute Physiology and Chronic Health Evaluation III score (P = .22), postoperative beta-blocker use (P = .73), or comorbid conditions. None of the complications examined differed significantly between pairs. CONCLUSION: Patients with comparable risk profiles have similar prevalences of selected complications after CABG and OPCABG. 相似文献
62.
Hyo-Chang Kim Seok-Gu Kang Pil-Woo Huh Do Sung Yoo Kyoung Suok Cho Dal Soo Kim 《Journal of clinical neuroscience》2007,14(11):1135-1139
Pituitary abscess is a rare and potentially lethal condition. Pituitary abscess in a pregnant woman has not been previously described. A 38-year-old pregnant woman (34 weeks gestation) with a pituitary mass complained of a progressive headache and sudden visual impairment. She was afebrile and had no inflammatory symptoms on admission. On MRI, the preoperative diagnosis was pituitary adenoma with sphenoid sinusitis. She underwent an uncomplicated transsphenoidal procedure for removal of the pituitary mass. The next day, labor commenced and a healthy preterm baby was delivered. Pathologic examination of the intrasellar mass showed polymorphonuclear cells, debris and no tumor cells. The sellar contents were cultured and Streptococcus viridans was grown. To our knowledge this is the first case of pituitary abscess reported during pregnancy. Although the patient was pregnant, the transsphenoidal approach was safe for the mother and the fetus. Surgical drainage and antibiotic therapy are required for the definitive treatment of this condition. 相似文献
63.
64.
作者用免疫组化ABC法对41例胆囊癌标本核苷二磷酸激酶(NDPK,下同)/nm23表达进行了测定,结果发现:nm23在恶性肿瘤中的表达率明显高于良性病变(P<0.05)。NDPK/nm23表达与胆囊癌组织的分化、局部浸润及淋巴转移密切相关(P<0.01)。NDPK/nm23阳性患者生存中位数12.25个月,阴性患者6.5个月,两者存在显著差异(P<0.01),提示nm23检测对预后有重要价值。 相似文献
65.
In a period of 2 years 7 months, we performed heat probe (HP) thermocoagulation in 153 cases of massive peptic ulcer hemorrhage. The male/female sex ratio was 125/28. The average age was 57.6 +/- 1.3 years (mean +/- SEM; range, 17 to 88). There were 69 cases (45.1%) of spurting hemorrhage, 50 cases (32.7%) of oozing hemorrhage, and 34 cases (22.2%) of nonbleeding visible vessels. Seventy-seven patients (50.3%) were in shock before therapy. After therapy we obtained initial success in 147 cases (96.1%). Rebleeding episodes occurred in 23 patients (15.6%) within 1 month after therapy. Nineteen patients received a second therapy, and treatment in 15 of these cases (78.9%) was ultimately successful. Finally, treatment in 142 cases (92.8%) was ultimately successful. The duration of hospitalization was 6.3 +/- 0.4 days (mean +/- SEM). After discharge all patients were followed at the outpatient department for at least 1 month. Sixty-seven patients were followed endoscopically for at least 2 to 3 months after therapy. Fifty-six patients (83.6%) had a healed scar at the previous bleeding site 2 months after therapy, and 62 patients (92.5%) had a healed scar 3 months after therapy. We conclude that HP thermocoagulation is an ideal and reliable modality of therapeutic endoscopy in arrest of massive peptic ulcer hemorrhage. HP thermocoagulation may become the first choice of therapy for massive peptic ulcer bleeding in the near future. 相似文献
66.
目的总结分析1%联苯苄唑凝胶治疗婴儿花斑癣的临床疗效及不良反应。方法对22例婴儿花斑癣患者采用外用1%联苯苄唑凝胶治疗2周,总结分析其临床资料。结果外用1%联苯苄唑凝胶2周后,总有效率达到90.91%,真菌清除率达到86.36%。结论联苯苄唑凝胶治疗婴儿花斑癣安全、有效,不良反应少。 相似文献
67.
68.
石刻雕塑作业劳动卫生学调查及实验研究 总被引:1,自引:0,他引:1
测定了石雕作业粉尘浓度,几何平均浓度为82.35~3.67mg/m3。工人职业性健康检查结果,接尘工人的咽部充血、咳嗽、咯痰检出率高于对照组;肺功能低下的检出率也高于对照组。该厂自1972年以来发生尘肺患者17例,其病情发展和晋期缓慢,发病工龄长。动物实验研究表明,石雕粉尘有轻微的致纤维化作用。 相似文献
69.
70.
J. K. Kang Sang Won Lee Min Woo Baik Byung Chul Son Yong Kil Hong Chul Ku Jung Keon Hee Ryu 《Child's nervous system》1998,14(7):297-301
Accurate assessment and replacement of blood loss and fluid–electrolyte deficit during craniosynostosis repair is difficult
owing to patient size and the diversity of surgical technique. Forty-three patients undergoing primary craniosynostosis repair
over a 10-year period were studied retrospectively to determine blood loss and fluid deficit and to assess blood transfusion
practices during both intraoperative and postoperative periods. Blood loss was calculated on the basis of estimated red cell
mass (ERCM) and fluid-electrolyte imbalance was investigated with blood samplings. Blood transfusion was considered appropriate
if the postoperative or posttransfusion ERCM was within 12% of the preoperative value. Estimated fluid requirement (EFR) was
used in 4 ml kg–1 h–1 except for neonates. Intraoperatively, 80% of all patients were appropriately managed with respect to blood transfusion and
EFR. Postoperatively only 20% of the patients receiving transfusions were transfused appropriately. In 23.3% of these patients
(10/43) unexpected respiratory distress developed immediately after their recovery from the anesthesia. With the measurement
of estimated blood volume and allowable blood loss, appropriate transfusion could be achieved for the successful treatment
of the primary craniosynostosis.
Received: 16 February 1998 相似文献