论著

恶性梗阻性黄疸患者行经皮肝穿刺胆道引流术后出院准备度现状及其影响因素

Current status and influencing factors of discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage surgery

:1020-1026
 
目的 分析恶性梗阻性黄疸患者实施经皮肝穿刺胆道引流术后出院准备度情况,探究此类患者出院准备度的影响因素。方法 选择2020年9月—2023年4月于天津市人民医院消化内科接受经皮肝穿刺胆道引流术的80例恶性梗阻性黄疸患者,选择院内系统对入组患者的性别、年龄等资料进行统计,并使用出院准备度量表评估患者出院准备度,应用出院指导质量量表评估患者出院指导质量,选择Pearson相关性分析的措施对影响患者出院准备度和出院指导质量的关联进行分析,并分析患者出院准备度影响因素。结果 合并慢性疾病以及居住方式方面,不同亚组患者间出院准备度得分比较差异具有统计学意义(P<0.05);Pearson相关性分析显示出院准备度量表各维度得分与出院指导质量得分呈正相关(均P<0.05);Logistic回归分析显示,居住方式得分为出院准备度量表得分的独立影响因素(P<0.05)。结论 经皮肝穿刺胆道引流术恶性梗阻性黄疸患者出院准备度得分较低,通过改变患者居住方式、提高患者出院指导质量,将有助于提高患者出院准备度。
Objective To analyze the discharge readiness of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage,and explore the influencing factors of discharge readiness of such patients.Methods A total of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage in Tianjin People's Hospital from September 2020 to April 2023 were selected as the research objects.The data such as sex and age of the patients were statistically analyzed in the hospital system,and the discharge readiness scale was used to evaluate the discharge readiness of the patients.The discharge guidance quality scale was used to evaluate the discharge guidance quality of patients.Pearson correlation analysis was selected to analyze the relationship between the discharge readiness and the discharge guidance quality,analyze factors influencing patient discharge readiness.Results There was a statistically significant difference(P<0.05)in the comparison of discharge readiness scores between different subgroups of patients with combined chronic diseases and living habits.Pearson correlation analysis showed that the scores of each dimension of the discharge readiness measurement table were positively correlated with the scores of discharge guidance quality(all P<0.05).Logistic regression analysis showed that the residential style score was an independent influencing factor(P<0.05)for the discharge readiness scale score.Conclusions The discharge readiness score of patients with malignant obstructive jaundice undergoing percutaneous liver puncture biliary drainage was low.By changing the patient's living style and improving the quality of discharge guidance,will help to improve the patient's discharge readiness.
论著

乳腺癌术后疼痛综合征发生情况及影响因素分析

The incidence and influencing factors of PMPS after breast cancer surgery

:1015-1019
 
目的 探讨乳腺癌术后疼痛综合征(PMPS)的发生率及影响因素。方法 选择2021年1月—2023年2月医院收治的82例乳腺癌患者为研究对象,采取手术治疗,统计PMPS发生率,分析PMPS的特征,比较PMPS患者和非PMPS患者的临床资料,采用 Logistic 逐步回归分析。结果 82例中有20例患者术后发生PMPS,发生率为24.39%,其中患侧腋窝45.00%、麻木样疼痛35.00%、中度疼痛60.00%、术后即刻疼痛50.00%、每日发作疼痛50.00%占比较高。PMPS患者和非PMPS患者的体质指数、教育程度、病理分期、肿瘤占位、手术方式、术前使用非甾体抗炎药、术前化学治疗、术后化学治疗比较差异均无统计学意义(P>0.05)。PMPS患者年龄低于非PMPS患者,负性情绪率30.00%高于非PMPS患者8.06%,清扫腋窝淋巴结率95.00%高于非PMPS患者72.58%,术后放射治疗率30.00%高于非PMPS患者6.45%(P<0.05)。年龄、负性情绪、清扫腋窝淋巴结、术后放射疗为PMPS发生的危险因素(P<0.05)。结论 乳腺癌术后较容易发生PMPS,主要表现为术后即刻腋窝疼痛、麻木,发作频率较高,疼痛较重,其中年龄小、术前焦虑、清扫腋窝淋巴结、术后放疗为引发PMPS的危险因素,需加强监测和针对性处理,研究价值较高。
Objective To investigate the incidence and influencing factors of post-mastectomy pain syndrome(PMPS)in breast cancer patients.Methods A total of 82 patients with breast cancer admitted to our hospital from January 2021 to February 2023 were selected as the research objects,and underwent surgical treatment.The incidence of PMPS was counted,the characteristics of PMPS were analyzed,and the clinical data of PMPS patients and non-PMPS patients were compared.Results Among the 82 patients,20 patients had PMPS after surgery,with an incidence of 24.39%.Among them,the affected axilla accounted for 45.00%,numbness pain 35.00%,moderate pain 60.00%,immediate postoperative pain 50.00%,and daily pain 50.00%.There were no significant differences in body mass index,education level,pathological stage of disease,tumor location,surgical method,preoperative use of non-steroid anti-inflammatory drugs,preoperative chemotherapy and postoperative chemotherapy between PMPS patients and non-PMPS patients(P>0.05).The age of PMPS patients was significantly higher than that of non-PMPS patients,the rate of negative emotion was 30.00%,the rate of axillary lymph node dissection was 95.00%,and the rate of postoperative radiotherapy was 30.00%,which was significantly higher than that of non-PMPS patients(P<0.05).Age,negative emotion,axillary lymph node dissection and postoperative radiotherapy were independent risk factors for PMPS(P<0.05).Conclusions PMPS is prone to occur after breast cancer surgery,mainly characterized by immediate postoperative axillary pain and numbness,with a high frequency and severe pain.Young age,preoperative anxiety,axillary lymph node dissection,and postoperative radiotherapy are independent risk factors for PMPS,which need to be strengthened monitoring and targeted treatment.
论著

131I治疗儿童及青年格雷夫斯病疗效及影响因素分析

Efficacy and affecting factors in 131I therapy for children and young people with Graves' disease

:991-996
 
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目的 探讨131I治疗儿童及青年格雷夫斯病(GD)的疗效及其影响因素。方法 回顾性分析2013年—2022年在简阳市人民医院核医学科院接受131I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140 μCi,依据甲状腺吸碘率及甲状腺质量,确定131I的用量。依据131I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果 纳入患者71例:男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。131I的用量在6~24 mCi,均值11.3 mCi。49例(69%)患者获得治愈,22例(31%)未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及131I用量等,治愈组与非治愈组间比较差异均无统计学意义(均P>0.05)。结论 以每克甲状腺组织80~140 μCi的计划用量,确定131I用量治疗儿童青年GD的疗效可达69%。
Objective To investigate the effect of 131I on Graves' disease(GD)in children and young adults and its influencing factors.Methods The clinical data of GD patients aged ≤22 who received 131I treatment in Nuclear Medicine Department of Jianyang People's Hospital from 2013 to 2022 were retrospectively analyzed.The planned dosage of 131I was 80~140 μCi per gram of thyroid tissue,and the dosage of 131I was determined according to the iodine uptake rate and thyroid mass.According to the thyroid function indicators of 3 to 6 months after 131I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured.The clinical characteristic parameters of the cured group and the non-cured group were analyzed to evaluate the factors that might affect the curative effect.Results Seventy-one patients were included:23 males and 48 females,aged 11-22.The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g.The dosage of 131I ranges from 6 to 24 mCi,with an average of 11.3 mCi.Forty-nine patients(69%)were cured and 22(31%)were not cured.Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and 131I dosage between the cured group and the non-cured group(all P>0.05).Conclusions With the planned dosage of 80~140 μCi per gram of thyroid tissue,the efficacy of 131I in the treatment of GD in children and young adults can reach 69%.
论著

80例局部宫颈癌根治性同步放化疗的临床疗效及预后影响因素

Clinical efficacy and prognostic factors of curative synchronous radiotherapy and chemotherapy for 80 cases of local cervical cancer

:1350-1356
 
目的 探讨80例局部宫颈癌根治性同步放化疗的临床疗效及预后影响因素。方法 选取鹤壁市妇幼保健院2018年1月—2021年1月收治的80例宫颈癌患者进行回顾性分析,患者依照其病变程度均采取积极的手术与同步放化疗,其中40例患者采取单纯化疗,将其分为化疗组,40例患者采取同步放化疗,将其分为同步放化疗组,分析其近远期临床疗效与不良反应发生率。对所有患者进行3年随访,将患者分为两个亚组,即预后不良组(n=20)和预后良好组(n=60),对比两组患者一般临床特征,应用Logistic回归模型分析局部宫颈癌根治性同步放化疗的预后影响因素。结果 同步放化疗组ORR、DCR高与化疗组(P<0.05),对照组中位无进展生存期为5.4(2.38~14.52)个月。观察组中位无进展生存期为6.66(2~20.1)个月,观察组高于对照组(χ2=4.536,P=0.041);同步放化疗组盆腔积液、阴道炎症、泌尿生殖道反应、直肠反应、骨髓抑制、胃肠道反应发生率略高于化疗组,但两组对比差异无统计学意义(P>0.05);预后良好组与预后不良组患者年龄、是否绝经、病理类型、肿瘤大小对比差异无统计学意义(P>0.05),预后良好组与预后不良组患者临床分期、组织分化程度、淋巴结转移、是否同步放化疗、治疗前血红蛋白水平对比差异有统计学意义(P<0.05);组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为局部宫颈癌的预后不良影响因素(P<0.05)。结论 对局部宫颈癌患者采取根治性同步放化疗与单一化疗相比可提升其临床疗效与远期生存率,同时安全性较高。组织分化程度低、未同步放化疗、治疗前血红蛋白水平低为宫颈癌预后不良影响因素。
Objective To explore the clinical efficacy and prognostic factors of 80 cases of local cervical cancer treated with radical synchronous radiotherapy and chemotherapy.Methods A retrospective analysis was conducted on 80 cervical cancer patients admitted to Hebi Maternal and Child Health Hospital from January 2018 to January 2021.Patients underwent surgery and synchronous radiotherapy and chemotherapy according to their degree of lesion.Among them,40 patients received simple chemotherapy and were divided into a chemotherapy group,while 40 patients received synchronous radiotherapy and chemotherapy and were divided into a synchronous radiotherapy and chemotherapy group.The short-term and long-term clinical efficacy and incidence of adverse reactions were analyzed.A 3-year follow-up was conducted on all patients,and patients were divided into two subgroups,namely the poor prognosis group(n=20)and the good prognosis group(n=60).The general clinical characteristics of the two groups of patients were compared,and a Logistic regression model was used to analyze the prognostic factors of local cervical cancer radical synchronous radiotherapy and chemotherapy.Results The objective relief rate and disease control rate of the synchronous radiotherapy and chemotherapy group were significantly higher than those of the chemotherapy group(P<0.05),and the median progression free survival of the control group was 5.4(2.38-14.52)months.The median progression free survival of the observation group was 6.66(2-20.1)months,which was higher than that of the control group(χ2=4.536,P=0.041).The incidence of pelvic fluid accumulation,vaginitis,urogenital reactions,rectal reactions,bone marrow suppression,and gastrointestinal reactions in the synchronous radiotherapy and chemotherapy group was slightly higher than that in the chemotherapy group,but there was no statistically significant difference between the two groups(P>0.05).There was no statistically significant difference in age,menopause,pathological type,and tumor size between the patients with good prognosis and those with poor prognosis(P>0.05).However,there was a statistically significant difference in clinical stage,tissue differentiation,lymph node metastasis,synchronous radiotherapy and chemotherapy,and pre-treatment hemoglobin levels between the patients with good prognosis and those with poor prognosis(P<0.05).Low degree of tissue differentiation,lack of synchronous radiotherapy and chemotherapy,and low hemoglobin levels before treatment were adverse prognostic factors for local cervical cancer(P<0.05).Conclusion sCompared with single radiotherapy,radical synchronous radiotherapy and chemotherapy can improve the clinical efficacy and long-term survival rate of patients with local cervical cancer,with higher safety.The severe tissue differentiation,unsynchronized chemoradiotherapy and hemoglobin before treatment were the adverse prognostic factors of cervical cancer.
论著

良性前列腺增生患者手术接受意愿调查及影响因素研究

Survey on willingness to accept surgery and study of influencing factors in patients with benign prostatic hyperplasia

:1282-1289
 
目的 调查良性前列腺增生(BPH)患者对前列腺手术的接受意愿,并分析其影响因素。方法 采用问卷调查法,于2021年3月—2022年10月选取中山大学附属第一院惠亚医院收治的133例BPH患者为研究对象。由调查者床边发放问卷,并当场收回。结果 调查共发放问卷133份,回收有效问卷130份,有效率为97.74%。单因素分析结果显示,经济负担、医保报销、BPH程度、住院陪护、了解BPH对自身的危害等因素与患者接受手术意愿相关(P<0.05)。Logistic多因素回归分析显示,患者的经济负担、医保报销及已存在BPH并发症是影响患者接受手术意愿的因素(P<0.05)。结论 本区域BPH患者由于经济、医保及已存在BPH并发症的问题,直接影响了接受前列腺手术的意愿,不仅影响患者的生理健康,也影响生活质量及家庭和睦关系,应加大疾病认知宣传力度,组建患者互助团体,促进居民对BPH疾病及手术的了解,提高该类患者的生活质量。
Objective To investigate the willingness of patients with benign prostatic hyperplasia(BPH)to accept prostate surgery and analyze its influencing factors.Methods A questionnaire survey method was used to select 133 patients with BPH admitted to a hospital from March 2021 to October 2022.The questionnaires were distributed and collects by the investigator at the bedside.Results A total of 133 questionnaires were distributed during the survey and 130 valid questionnaires were collected,with an effective rate of 97.74%.The results of single factor analysis showed that factors such as financial burden,medical insurance reimbursement,degree of BPH,hospitalization accompaniment,and understanding of the harm of prostate hyperplasia were significantly related to patients’ willingness to receive surgery,with statistical significance(P<0.05).Logistic multifactor regression analysis showed that the patient’s financial burden,medical insurance reimbursement,and existing BPH complications were factors that affected the patient’s willingness to receive surgery.Conclusion sBPH patients in local region have financial burden,medical insurance and existing complications of BPH,which directly affect their willingness to undergo prostate surgery.Those factors not only affect the patients’ physical health but also affect the quality of theirlife and harmonious thier family relationships. Awareness of the disease should be increased to promote publicity,and patient mutual aid groups should be started to improve residents’ understanding of BPH disease and surgery and improve the quality of patients’life.
论著

某净水公司职工脂肪肝检出情况及影响因素分析

Prevalence of fatty liver disease and influencing factors among employees in a water purification company

:1456-1463
 
目的 了解广州市某净水公司职工脂肪肝检出情况,并分析影响因素。方法 选取2023年广州市某净水公司参加职业健康检查的职工为研究对象,收集研究对象的一般情况、个人史、职业史、身体质量指数(BMI)、血压、血生化指标、肝脏彩超等资料。对该人群脂肪肝的患病情况进行描述性分析,对脂肪肝的影响因素进行单因素及多因素Logistic回归分析。结果 共收集研究对象1 217人,检出脂肪肝543例,检出率为44.62%。单因素分析结果表明,脂肪肝的发生与性别、年龄、体质量指数、高血压相关(P<0.05)。接触硫化氢、氨的职工脂肪肝检出率高于非接触者(P<0.05),且职工工龄越长,脂肪肝检出率越高(P<0.05)。患脂肪肝职工的肝功能、脂代谢、血糖及尿酸水平高于非脂肪肝者(P<0.05)。多因素Logistic回归分析提示,年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸是脂肪肝的影响因素(P<0.05)。结论 广州市某净水公司职工的脂肪肝检出率较高,脂肪肝的发生主要与年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸等因素相关。
Objective To investigate the prevalence of fatty liver disease and influencing factors among employees of a water purification company in Guangzhou.Methods Employees of a water purification company in Guangzhou who participated in occupational health examinations in 2023 were selected as the study subjects.The subjects' general conditions,personal history,occupational history,BMI,blood pressure,blood biochemical indicators,and liver ultrasound images were collected.Descriptive analysis was used to analyze the prevalence of fatty liver disease in this population.The influencing factors of fatty liver were analyzed by single factor and multiple factor Logistic regression.Results A total of 1 217 subjects were included in this study,and 543 were diagnosed as fatty liver disease,with a detection rate of 44.62%.The results of single factor analysis showed that the occurrence of fatty liver was closely related to gender,age,BMI and hypertension(P<0.05).The analysis of occupational hazard factors showed that,the detection rate of fatty liver disease was higher in people exposed to hydrogen sulfide and ammonia compared to non-exposed individuals(P<0.05).The longer the working years,the higher the detection rate of fatty liver(P<0.05).The levels of liver function,lipid metabolism,blood glucose and uric acid in workers with fatty liver were higher than those in workers without fatty liver(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,abnormal liver function,abnormal lipid metabolism,high blood glucose levels and hyperuricemia were independent influencing factors for fatty liver disease(P<0.05).Conclusions The detection rate of fatty liver disease among employees of a water purification company in Guangzhou is high,and the occurrence of fatty liver disease is mainly related to factors such as age,BMI,abnormal liver function,abnormal lipid metabolism,high sugar levels and hyperuricemia.
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.
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.
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.
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