临床诊疗

上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙发生及牙根吸收的影响因素

:91-94
 
目的 分析上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙牙根吸收影响因素。方法 选取2017年8月—2021年5月我院正畸科上颌唇侧倒置埋伏中切牙患者1 542例,统计上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙及牙根吸收发生情况,并进行单因素多因素分析。结果 1 542例上颌唇侧倒置埋伏中切牙患者正畸矫治后共出现埋伏牙186例,其中男102例、女84例,出现埋伏牙1颗最多,占比65.05%,年龄以12~18岁居多,单侧埋伏牙157例(84.41%),双侧埋伏牙29例(15.59%),埋伏牙位置为斜位81例(43.55%),倒置47例25.27%,平行42例(22.58%),水平16例(8.60%);186例正畸矫治后出现埋伏牙的患者中,发生牙根吸收患者75例,发生率为40.32%;出现牙根吸收的患者埋伏牙位置为颌骨中间占比高于未发生牙根吸收患者,近远中分区0~1区占比、年龄均小于未发生牙根吸收患者(P<0.05);埋伏牙位置(颌骨中间)、近远中分区(0~1区)、年龄(低)是上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙牙根吸收的独立危险因素(P<0.05)。结论 上颌唇侧倒置埋伏中切牙患者正畸矫治后埋伏牙发生情况不容乐观,主要为12~18岁的患者为主,且多为单发,牙根吸收发生率较高,主要影响因素包括埋伏牙位置、近远中分区、年龄,临床应根据患者实际情况合理选择治疗方案。
论著

非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素

Occurrence of bone marrow suppression and its influencing factors in patients with non-small cell lung cancer undergoing chemotherapy

:61-63
 
目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR>1,P<0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。
Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.
临床诊疗

蒽环类药物序贯曲妥珠单抗治疗导致乳腺癌患者心脏毒性的相关危险因素研究

:105-108
 
目的 本文主要分析乳腺癌患者应用蒽环类药物序贯曲妥珠单抗治疗对其心脏毒性的相关危险因素,并按照危险因素选择合适患者的治疗方案。方法 研究纳入了2019年6月—2022年6月在本院接受治疗的300例乳腺癌患者,患者接受蒽环类药物序贯曲妥珠单抗治疗,按照患者治疗期间是否发生心脏毒性进行分组,即为11例发生心脏毒性(观察组),289例患者未发生心脏毒性(对照组)。记录2组患者个人基础资料、肿瘤分期、病史、蒽环类药物以及联合化疗等因素,通过Logistic回归逐一对各项因素展开分析,了解相关危险因素。结果 在本次研究分析中,心脏毒性发生例数为11例,发生率为3.67%。其中289例患者未出现心脏毒性,患者用药后未出现相关反应。2组患者在联合放疗、高脂血症、蒽环类药物种类均有差异,差异有统计学意义(P<0.05)。结论 乳腺癌患者应用蒽环类药物序贯曲妥珠单抗后,发生心脏毒性的几率升高,其危险因素主要包括高脂血症史、应用表柔比星治疗以及左胸放疗史。
论著

广州市白云区男性年龄因素与精液质量现况研究

Study on male age and semen quality in Baiyun District of Guangzhou

:83-86
 
目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例(占比57.52%),随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低(P<0.05)。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好(P<0.05),是男性生育的黄金年龄。
Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects.Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases(57.52%)of male semen data of childbearing age in Baiyun District were within the normal range.With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually(P < 0.05). Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups(P < 0.05),which is the golden age of male fertility.
论著

回顾性分析非手术输血患儿红细胞恢复的影响因素

Retrospective analysis of influencing factors of RBCs recovery in children with non-surgical blood transfusion

:34-39
 
目的 调查儿科急诊非急诊手术患儿输血后红细胞恢复的影响因素。方法 回顾2020年1月—2020年12月期间广州市妇女儿童医疗中心珠江新城院区儿科急诊1月~18岁患儿的输血情况,其中分为Hb提升达预期组(n=93),Hb提升未达预期组(n=156),根据年龄、性别、体质量、是否恶性肿瘤、是否发热、有无延迟输血、输血前血红蛋白水平、输注红细胞类型情况,分析输血疗效及影响因素。结果 2组患儿的性别、年龄、体质量、有无恶性肿瘤、是否发热、输血等待时间、输血前后血红蛋白值、输注红细胞悬液量以及有无及时输血均无统计学差异;输注红细胞类型组间存在显著差异,Hb提升未达预期组更多输注了洗涤红细胞悬液(13.5% vs 5.4%,P=0.044),输血后 Hb 值较低(中位数,73 g/L vs 84 g/L,P<0.001),变化 Hb 值较小(中位数,18 g/L vs 30 g/L,P<0.001),归因分析未发现影响因素。结论 输注洗涤红细胞可能是降低输血后红细胞提升的影响因素,输注洗涤红细胞时需严格输血指征同时注意红细胞提高预值的设定。
Objective To investigate the influencing factors of blood transfusion efficacy in patients without emergency operations in pediatric emergency.Methods A retrospective analysis of the blood transfusion of pediatric emergency children(1 month~ 18 year of age)in Zhujiang New Town Branch of Guangzhou Women and Children's Medical Center from January 2020 to December 2020 was carried out,patients were divided into Hb elevation up to expectation group(n=93)and Hb elevation not up to expectation group(n=156).The efficacy of blood transfusion and the factors affecting it were analyzed according to age,gender,body mass,with or without malignant tumor,whether fever was present,whether there was delayed transfusion,pre-transfusion hemoglobin level,and the type of red blood cells transfused.Results There were no significant differences in gender,age,weight,malignant tumor,fever,waiting time for blood transfusion,hemoglobin level before and after blood transfusion,infusion volume of red blood cell suspension and whether had timely blood transfusion between the two groups.Significant differences were found between groups of transfused red blood cell types,with more washed red blood cell suspensions transfused in the Hb elevation not meeting expectations group(13.5% vs 5.4%,P=0.044),which had lower post-transfusion Hb values(median,73 g/L vs 84 g/L,P<0.001),and smaller change Hb values(median,18 g/L vs 30 g/L,P<0.001),and attribution analysis did not reveal influencing factors.Conclusions Transfusion of washed red blood cell may be an influencing factor that reduces the RBCs elevation after transfusion.Attention should be paid to strict indications for washed red blood cell transfusion and setting the expected Hb level.
临床诊疗

柳州市老年骨质疏松性骨折现状及危险因素分析

:94-99
 
目的 探讨柳州市老年骨质疏松性骨折(OPF)现状及其发生的危险因素。方法 回顾性分析2018年1月—2020年12月柳州市工人医院创伤中心收治的5 235例60周岁及以上老年OPF患者的临床资料,并从中随机抽取300例老年OPF患者临床资料作为研究组;选取同时期接诊的老年骨质疏松未骨折的300例患者临床资料作为对照组,通过医院病案管理系统,详细收集2组患者各项临床资料,分析柳州市老年OPF现状及危险因素。结果 5 235例老年OPF患者中,以胸腰椎压缩性骨折占比最高58.19%、其次为股骨颈骨折15.42%;60~74岁年龄段患者以胸腰椎压缩性骨折占比最高77.03%,75~89年龄段患者股骨颈骨折、粗隆间骨折占比均较高分别为43.36%、41.34%,≥90岁患者粗隆间骨折占比最高49.25%;男性、女性均以胸腰椎压缩性骨折占比较高,分别为46.34%、62.47%。经单因素/多因素分析显示,年龄、性别、体质量指数(BMI)、跌倒史、骨折史、骨密度(BMD)、糖尿病、不良生活习惯为老年OPF发生的独立危险因素(P<0.05)。结论 胸腰椎压缩性骨折是柳州市老年OP患者骨折的主要类型;老年OPF的发生与年龄、性别、BMI、跌倒史、骨折史、BMD 、糖尿病、不良生活习惯等因素有关,应采取积极预防措施,降低OPF的发生风险。
论著

胆固醇息肉形成的影响因素分析

Analysis of the factors influencing the formation of cholesterol polyps

:39-45
 
目的 探讨胆固醇胆囊息肉形成的高危因素。方法 将广州市第一人民医院住院的219例接受腹腔镜胆囊切除的患者按照术后胆囊病理结果分为胆固醇息肉组(162例)和非胆固醇息肉组(57例)。对所有研究对象的年龄、性别、血脂水平、肝功、超敏C反应蛋白、CA199、癌胚抗原(CEA)、胆囊结石病史、糖尿病病史、肝硬化病史进行数据收集及统计学处理。结果 经非参数检验方法Mann-Whitney U分析结果显示:1. 脂代谢相关指标在胆固醇息肉组和非胆固醇息肉组间比较差异有统计学意义;2. 总胆固醇指标在胆固醇息肉组高于非胆固醇息肉组,且高于参考值范围;3. 胆固醇息肉组和非胆固醇息肉组比较部分脂代谢指标有统计学意义,但均在参考值范围内。胆固醇息肉形成的Logistic回归分析:得到的Logistic模型差异有统计学意义,χ2=179.14,P<0.001。模型纳入的8个自变量中,总胆固醇每增加一个单位,发生胆固醇息肉的风险相比于非胆固醇息肉组将增加38.2倍(P<0.05)。结论 总胆固醇是胆囊胆固醇息肉形成的高危因素。
Objective To investigate the risk factors of cholesterol polyps formation.Methods The 219 patients who underwent laparoscopic cholecystectomy in Guangzhou First People's Hospital were divided into cholesterol polyps group(162 cases)and non-cholesterol polyp group(57 cases)according to postoperative gallbladder pathological results.The age,gender,blood lipids levels,liver function,high-sensitivity C-reactive protein,CA199,carcinoembryonic antigen(CEA),history of gallstones,diabetes,and liver cirrhosis of all patients were collected and statistically processed.Results Mann-Whitney U analysis by nonparametric test method showed that the lipid metabolism-related indexes were significantly different between the cholesterol polyps group and the non-cholesterol polyp group.The total cholesterol indexes in the cholesterol polyps group were higher than those in the non-cholesterol polyp group,and higher than the reference range.The cholesterol polyps group and the non-cholesterol polyp group had statistical significance in some lipid metabolism indexes,but they were all in the normal range.Logistic regression analysis of cholesterol polyps formation showed the obtained Logistic model was statistically significant,χ2=179.14,P<0.001.Among the 8 independent variables included in the model,total cholesterol was statistically significant.For each unit increased in total cholesterol,the risk of developing cholesterol polyps increased by 38.2 times compared with the non-cholesterol polyp group.Conclusions Total cholesterol is a high risk factor for the formation of cholesterol gallbladder polyps.
论著

影响不全流产期待治疗效果的相关因素分析

Analysis of factors associated with the effect of expectant treatment of incomplete abortion

:34-38
 
目的 探讨影响宫腔修复的因素,为不全流产妇女选择期待治疗提供理论依据。方法 2021年1月—12月在香港大学深圳医院招募早孕药流不全的患者534例,记录其人口学特征以及从排胎到流产后3周到月经复潮后的相关情况,通过多因素Logistic回归分析影响不全流产者宫腔修复的因素。结果 534例药流不全患者中,月经复潮后宫腔残留240例,残留率为44.9%;多因素Logistic回归分析显示,BMI(OR=0.888,95%CI:0.808~0.975)、子宫位置(OR=1.836,95%CI:1.139~2.958)、人工流产次数(OR=2.258,95%CI:1.078~4.728)、阴道流血时长(OR=0.344,95%CI:0.141~0.837)、残留物最大径线(OR=1.061,95%CI:1.031~1.092)、残留物血流信号2级/3级(OR=3.636,95%CI:1.790~7.394;OR=4.001,95%CI:1.561~10.256)是宫腔残留的影响因素。结论 宫腔残留的高危因素有子宫后位、残留物最大径线、1次以上的人工流产、2级及以上的残留物血流信号,且血流信号等级影响最大。BMI和阴道流血时长>3周是宫腔残留的保护因素。
Objective To investigate the factors affecting uterine cavity repair and to provide a theoretical basis for the choice of expectant treatment for women with incomplete abortion.Methods From January to December 2021,534 patients with incomplete abortions were recruited at University of Hong Kong-Shenzhen Hospital,and their demographic characteristics and correlations from expulsion of the gestational sac to 3 weeks after medication abortion and after menstrual resumption were recorded,and the factors affecting uterine cavity repair in incomplete abortions were analyzed by multifactorial logistic regression.Results In 534 women,there were 240 cases of uterine cavity remnants after menstrual return,with a remnant rate of 44.9%;the results of multifactorial logistic regression analysis showed that BMI(OR=0.888,95% CI:0.808-0.975),uterine position(OR=1.836,95% CI:1.139-2.958),number of abortions(OR=2.258,95% CI:1.078-4.728),length of vaginal bleeding(OR=0.344,95% CI:0.141-0.837),maximum diameter of residuals(OR=1.061,95% CI:1.031-1.092),and residual blood flow signal grade 2/3(OR=3.636,95% CI:1.790-7.394;OR=4.001,95%CI:1.561-10.256)were influential factors for uterine residuals.Conclusions High-risk factors for uterine residuals are posterior uterus,the maximum diameter of residuals,more than one abortion,grade 2 or higher residual blood flow signal,and the grade of blood flow signal had the greatest effect.BMI and duration of vaginal bleeding >3 weeks are protective factors for uterine residuals.
临床诊疗

基于COX回归分析MHD尿毒症患者AVF使用寿命的独立危险因素

:93-98
 
目的 分析接受自体动静脉内瘘(AVF)维持性血液透析(MHD)尿毒症患者AVF使用寿命的影响因素,以期为临床延长AVF使用寿命提供可参考依据。方法 选取我院2019年1月—2021年2月期间收治的接受AVF的367例MHD尿毒症患者为研究对象,随访1年,统计AVF功能丧失状况,将AVF功能丧失患者纳入丧失组,AVF通畅患者纳入通畅组,分析AVF使用寿命的影响因素。结果 随访1年,AVF通畅率为80.65%(296/367),功能丧失率为19.35%(71/367);不同糖尿病、血液透析中低血压(IDH)、血磷、低密度脂蛋白、钙磷乘积、高凝倾向、前壁动静脉内径、血肿状况为AVF MHD尿毒症患者的AVF寿命存在差异(P<0.05);经COX回归模型分析显示,糖尿病、IDH、血磷≥2.04 mmol/L、低密度脂蛋白>2.38 mmol/L、高凝倾向、血肿、前壁动静脉内径<2 mm为AVF MHD尿毒症患者AVF功能丧失的独立危险因素(P<0.05)。结论 AVF MHD尿毒症患者AVF使用寿命受糖尿病、IDH、血磷≥2.04 mmol/L、低密度脂蛋白>2.38 mmol/L、高凝倾向、血肿、前壁动静脉内径<2 mm等因素影响,临床可针对性制定干预措施以延长AVF使用寿命。
临床诊疗

儿童肺炎支原体肺炎合并EB病毒感染的临床表现及危险因素分析

:73-77
 
目的 分析儿童肺炎支原体肺炎(MPP)合并EB病毒(EBV)感染的临床表现及危险因素,以期进一步提升疾病预防及治疗有效率。方法 分析2020年4月—2022年4月间于我院进行入院治疗的MPP合并EBV感染患儿基本资料,选择84例进行研究,另选择单一EBV感染患儿作为对照组,对比两组患儿临床表现差异及各项指标,分析合并感染的危险因素。结果 一般资料上,研究组患儿低体质量、免疫力低下、流行病接触史占比均高于对照组,数据差异存在统计学意义(P<0.05);临床表现上,研究组患儿高热、发热时间≥10 d、呼吸困难、胸腔积液、侵犯多肺叶占比及白细胞、淋巴细胞指标均高于对照组,血小板、Hb低于对照组,数据差异存在统计学意义(P<0.05);经多因素分析发现,低体质量、免疫力低下、流行病接触史、高热、发热时间≥10 d、呼吸困难、胸腔积液、侵犯多肺叶、白细胞、血小板、Hb、淋巴细胞是MPP合并EBV感染的重要危险因素(P<0.05)。结论 儿童MPP合并EBV感染临床病症表现明显,且相较于单一EBV感染症状更为严重,医务人员需要根据患儿表现及相关危险因素及时予以准确诊断,对患儿实施针对性有效治疗,提升疾病治疗有效率。
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