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1.
贺利平 《实用中西医结合临床》2022,22(14)
目的 探讨胆囊结石合并胆总管结石(CBDS)术后患者复发情况及危险因素。方法 纳入114例2019年1月~2020年12月在本院行ECRP联合LC治疗的胆囊结石合并CBDS患者,回顾性分析其临床资料,根据所选患者ECRP联合LC术后随访1年内是否复发(REC)将其分为REC组(32例)和未REC组(82例)。回顾性统计胆囊结石合并CBDS术后患者REC情况,比较REC组和未REC组的临床资料,并分析胆囊结石合并CBDS术后患者REC的危险因素。结果 114例胆囊结石合并CBDS术后患者REC32例,发生率28.07%。胆囊结石合并CBDS术后患者REC的危险因素为胆道感染、胆道口括约肌切开、术者经验≤3年、胆道括约肌功能障碍(OR=4.170、4.047、3.568、3.367,P<0.05)。结论 胆囊结石合并CBDS术后患者REC的危险因素与胆道感染、胆道口括约肌切开、术者经验≤3年、胆道括约肌功能障碍密切相关,可据此针对性制定临床治疗及护理干预措施方案,以降低胆囊结石合并CBDS术后患者REC率。 相似文献
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《American journal of surgery》2023,225(1):198-205
BackgroundLiver resection is commonly performed for hepatic tumors, however preoperative risk stratification remains challenging. We evaluated the performance of contemporary prediction models for short-term mortality after liver resection in patients with and without cirrhosis.MethodsThis retrospective cohort study examined National Surgical Quality Improvement Program data. We included patients who underwent liver resections from 2014 to 2019. VOCAL-Penn, MELD, MELD-Na, ALBI, and Mayo risk scores were evaluated in terms of model discrimination and calibration for 30-day post-operative mortality.ResultsA total 15,198 patients underwent liver resection, of whom 249 (1.6%) experienced 30-day post-operative mortality. The VOCAL-Penn score had the highest discrimination (area under the ROC curve [AUC] 0.74) compared to all other models. The VOCAL-Penn score similarly outperformed other models in patients with (AUC 0.70) and without (AUC 0.74) cirrhosis.ConclusionThe VOCAL-Penn score demonstrated superior predictive performance for 30-day post-operative mortality after liver resection as compared to existing clinical standards. 相似文献
3.
《Sleep medicine》2020
ObjectivesTo determine the prevalence of restless legs syndrome (RLS) and RLS-mimic conditions, the risk factors for RLS, and whether RLS contributes to functional impairment in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).MethodsADHD children and adolescents were prospectively studied at the outpatient psychiatric clinic. A trained registered nurse used the 2012 Revised International Restless Legs Syndrome Study Group diagnostic criteria to diagnose RLS. Sociodemographic data and medical records were reviewed. Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) Thai version was used to identify association between RLS and 6 domains of function [family, school (learning), school (behavior), life skills, child self-concept, social activities, and risky activities].ResultsA total of 217 patients were included. Of those, 23 (11%) patients met the criteria for RLS, and 49 (23%) had RLS-mimic conditions. Those conditions included myalgia (30/49), habitual foot tapping (23/49), positional discomfort (20/49), leg ulcer/bruise (1/49), and arthralgia/arthritis (1/49). Binary logistic regression revealed first-degree relative having RLS symptom to be significantly associated with RLS in study patients (OR: 5.06, p < 0.01). Multivariate linear regression showed RLS to be independently associated with school (behavior) (Β = 1.18, p = 0.05) and life skills (Β = 2.36, p = 0.05) impairment.ConclusionsRLS was found to be common in ADHD children and adolescents. RLS-mimic conditions were found in two-thirds of patients who previously met 4 essential RLS criteria. First-degree relative with RLS symptom was associated with RLS, and RLS was associated with functional impairment in the life skills and school (behavior) domains. 相似文献
4.
目的 探讨食管癌高、低发区食管鳞癌患者的生存状况及其影响因素。方法 收集38 741例经病理学证实为食管鳞癌患者的资料,其中,高发区患者23 273例(60.1%),低发区15 468例(39.9%)。所有患者均行食管癌根治术。运用卡方检验分析不同临床病理特征患者的组间差异,Kaplan-Meier法绘制不同临床病理特征患者的生存曲线并用Log rank进行检验。多因素Cox比例风险回归模型法分析影响生存的主要因素。结果 低发区男性患者所占比例高于高发区(P<0.001),低发区诊断年龄≥50岁食管癌患者所占比例高于高发区(P<0.001)。高发区食管鳞癌患者的整体生存优于低发区患者(P<0.001)。Cox比例风险回归模型综合分析结果表明:高低发区、性别、确诊年龄、肿瘤部位、分化程度、TNM分期和肿瘤家族史均是影响食管鳞癌患者生存的独立因素。结论 高发区食管鳞癌患者整体生存优于低发区;低发区是食管鳞癌患者预后差的独立危险因素。 相似文献
5.
背景 慢性阻塞性肺疾病(COPD)患者肺栓塞(PE)发生率显著高于常人,但目前不伴红细胞增多的COPD患者并发PE的机制尚不明确。目的 探讨不伴红细胞增多的COPD患者并发PE的影响因素。方法 本研究为回顾性病例对照研究。收集2017年1-12月在新疆医科大学第一附属医院呼吸与呼吸危重症中心住院治疗的血红蛋白(Hb)≤140 g/L的COPD患者。依据肺多层螺旋CT肺血管成像(CTPA)检查结果将患者分为并发PE组和单纯COPD组。记录患者的年龄、性别、合并症、服用抗血小板或抗凝药物史。采用倾向性评分匹配(PSM)方法,通过二元Logistic回归分析估计倾向性评分值,采用1∶1最邻近原则匹配,卡钳值为0.05,筛选出基线相同的两组病例。记录患者的D-二聚体、血常规检查结果,比较两组间差异;分析不伴红细胞增多的COPD患者并发PE的影响因素,红细胞分布宽度(RDW)与中性粒细胞/淋巴细胞比值(NLR)的相关性。结果 共纳入病例339例,其中单纯COPD组289例,并发PE组50例。采用PSM方法筛选两组患者,最终得到单纯COPD组、并发PE组各50例进行后续研究。并发PE组患者D-二聚体、中性粒细胞计数(N)、RDW、NLR高于单纯COPD组,淋巴细胞计数(L)低于单纯COPD组(P<0.05)。二元Logistic回归分析结果显示,RDW是不伴红细胞增多的COPD患者并发PE的影响因素〔OR=1.561,95%CI(1.096,2.225),P<0.05〕。Spearman秩相关分析结果显示,不伴红细胞增多的COPD患者RDW与NLR呈正相关(rs=0.225,P<0.05)。结论 RDW升高是Hb≤140 g/L的COPD患者并发PE的危险因素,且RDW与NLR呈正相关。 相似文献
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《Australian critical care》2019,32(6):540-559
ObjectivesThe objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases.Review methods and data sourcesA literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized.ResultsAfter eliminating duplicates, 55 325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations.ConclusionsIt is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool. 相似文献
10.
目的探讨新生儿医用粘胶相关性皮肤损伤(MARSI)危险因素和护理对策。方法选取2016年4月至2018年5月在本院接受治疗的新生儿483例为研究对象,统计其发生MARSI例数和损伤类型,依据是否发生MARSI将患儿分成MARSI组61例和未发生MARSI组422例,记录患儿温箱、胎龄、抢救台、出生体质量、潮湿多汗、蓝光治疗、感染、留置胃管、禁食、经外周静脉置入中心静脉导管(PICC)、水肿及皮肤干燥情况,对影响患儿发生MARSI的因素进行多因素logistic回归分析。结果患儿皮肤受损类型依次为表皮剥脱伤(6.21%)、皮肤撕裂伤(3.73%)、接触性皮炎1.45%。蓝光治疗、留置胃管、出生体质量<2200 g、胎龄<30周及皮肤干燥为患儿发生MARSI的独立危险因素(P<0.05)。结论临床新生儿MARSI发生率较高,且影响因素多,医护人员应采用有针对性护理措施,加强防范,以降低新生儿MARSI的发生率。 相似文献