IPSS-V/S在TUVP术后下尿路症状评估的临床价值

目的：探讨国际前列腺症状评分的排尿期/储尿期评分比值（international prostatic symptom score-voiding/storage sub－score ratio,IPSS-V/S）在经尿道前列腺汽化电切术（transurethral electrovaporization prostatectomy,TUVP）术后下尿路症状（lower urinary tract symptoms,LUTS）再评估的临床价值。方法：回顾性分析了2015年1月至2016年12月期间234例接受TUVP的良性前列腺增生（benign prostatic hyperplasia,BPH）患者的国际前列腺症状评分（international prostatic symptom score,IPSS）等临床资料。按照IPSS-V/S比值将患者分为A组（IPSS-V/S≤1,80例）和B组（IPSS-V/S>1,154例）。术后6个月再次评估IPSS,储尿期症状评分（international prostatic symptom score-storage,IPSS-S）,排尿期症状评分（international prostatic symptom score-voiding,IPSS-V）和生活质量评分（quality of life,QOL）。结果：234例患者术后6个月IPSS和QOL较术前明显降低,差异有统计学意义（t=33.0,P=0.000;t=34.3,P=0.000）。术后6个月B组患者IPSS改善程度明显优于A组[（12.36±3.67）分 vs. （8.20±3.21）分]（t=8.96,P=0.000）。其中A组术后6个月IPSS-S明显高于B组[（9.61±2.88）分 vs. （5.55±2.63）分]（t=10.8,P=0.000）;而2组患者术后6个月时IPSS-V对比无统计学差异（t=1.56,P=0.120）。虽然A组术后6个月的QOL明显改善[（3.59±0.91）分 vs.（5.19±0.55）分]（t=14.8,P=0.000）,但是基本满意及以上者仅占13.75%,明显低于B组的70.78%。A组术后6个月IPSS-S各症状评分均有一定改善,改善程度从高到低依次为尿急评分、尿频评分和夜尿评分,其中夜尿评分改善率最低,仅为36.3%（29/80）,是A组患者IPSS及QOL改善较小的重要原因。结论：相比IPSS,IPSS-V/S更能准确反映TUVP术后疗效,LUTS排尿期症状改善明显优于储尿期症状。对于以夜尿症为主的BPH/LUTS患者,TUVP对患者QOL改善有限,需要引起临床医师重视。     

多功能充气式介入术后上肢垫的设计与应用

经桡动脉行冠状动脉造影(CAG)术后使用弹力绷带进行加压止血,患者手腕经常出现肿胀、疼痛、麻木等症状,而使用上肢垫抬高肢体有利于促进静脉回流,减轻症状,但是,临床以往使用的上肢垫存在种种弊端,无法满足使用需求。该研究设计了一种多功能充气式介入术后上肢垫,用于经桡动脉行CAG术后抬高、制动、冷敷术肢,可以缓解术肢肿胀、疼痛,减少皮下出血,提高患者的舒适度。     

韩树人教授谈“哮喘专主于风”

哮喘为临床的常见病、多发病,历来为医家所重视。韩树人教授在研究继承传统理论的基础上形成了自己的学术观点,提出了“哮喘专主于风”的理论。详细分析了临证时的分型特点,阐明哮喘发作程度有轻重之分,证型有寒热之别,缓解时肺脾肾各有所虚,但辨证总须与“风”紧密联系,抓住这一中心环节进行遣方用药,为临床工作提供了新的思路。      

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

父母对PNS的认知度及对患儿的护理程度与PNS患儿复发的相关性研究

[目的]探讨患儿父母对原发性肾病综合征(PNS)的认知度及对患儿的护理程度与PNS患儿复发的关系。[方法]选择2009年1月1日—2011年12月31日在我科住院的PNS患儿76例,进行跟踪随访,随访时间为1年。随访内容为父母对PNS的认知度、对患儿的护理程度、患儿复发原因。对资料进行单因素分析。[结果]患儿父母对PNS的认知度差、对患儿的护理程度差与PNS患儿复发存在正相关。感染、不规范应用激素为PNS患儿复发的危险因素。[结论]在临床工作中应充分重视父母对PNS的认知度评估,进行有针对性的健康教育及以家庭为中心的护理,提高父母对患儿的护理程度,以减少PNS复发。