论著

干预因素对孤独症谱系障碍患儿社交行为影响的观察性研究

An observational study on the impact of intervention factors on social behavior in children with autism spectrum disorders

:1159-1165
 
目的 探索干预因素对4~12岁孤独症谱系障碍(ASD)患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法 选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表(SRS)对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况(性别、共患病情况、干预时长、上学情况等)。结果 202例ASD患儿中,男性患儿162例(80.2%),女性40例(19.8%),性别对社交反应的影响比较差异无统计学意义(t=2.969,P>0.05)。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义(F=6.920,P<0.05)。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义(F=3.823,P<0.05),但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义(P>0.05)。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义(F=4.477,P<0.05),但干预<1年与未干预患儿相比,两者差异无统计学意义(P>0.05)。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。
Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder(ASD)aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected.The social behavior of the children was evaluated using the Social Response Scale(SRS),and the parents were surveyed using a self-made general situation questionnaire.The survey content included the basic information of the children(gender,comorbidity,intervention duration,and school attendance,etc.). Results Among the 202 cases of ASD,162 were male(80.2%)and 40 were female(19.8%).There was no statistically significant difference in the impact of gender on social response(t=2.969,P>0.05).In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder(F=6.920,P<0.05).In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school(F=3.823,P<0.05),but there was no statistically significant difference between children enrolled in special schools and those who did not attend school(P>0.05).In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant(F=4.477,P<0.05).However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant(P>0.05). Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response.Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment.
论著

纤维支气管镜肺泡灌洗吸痰术联合药物治疗ICU重症肺部感染患者疗效以及炎症因子的影响

Effect of bronchofiberoptic alveolar lavage and sputum aspiration combined with medication on ICU patients with severe pulmonary infection and the influence of inflammatory factors

:1146-1151
 
目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%(χ2=3.887,P<0.05),观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为(3.09±1.25)(4.17±2.24)(3.95±1.53)(4.05±1.77)d,均低于对照组(5.14±2.43)(7.03±3.23)(6.40±2.62)(6.32±1.81)d(t=5.143、4.988、5.536、6.147,P<0.05),观察组的 C 反应性蛋白(C-reactive protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)以及Toll样受体4(Toll-like receptor 4,TLR-4)水平分别为(3.64±0.87)mg/L、(54.59±10.65)ng/mL、(7.94±1.57)%,均低于对照组(7.51±1.43)mg/L、(87.66±11.17)ng/mL、(12.11±2.48)%(t=15.850、14.690、9.740,P<0.05),观察组的气道压力、动脉血二氧化碳分压(partial pressure of carbon dioxide in artery,PaCO2)水平分别为(6.92±3.60)cmH2O、(43.19±6.29)mmHg,低于对照组(8.68±2.98)cmH2O、(55.43±5.95)mmHg,观察组动脉氧分压(Partial arterial oxygen pressure,PaO2)(86.06±5.31)mmHg、血氧饱和度(oxyhemoglobin saturation,SpO2)(98.03±6.63)%高于对照组(68.04±5.19)mmHg、(90.22±5.51)%要高(t=2.582、9.692、16.638、6.221,P<0.05),观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义(χ2=2.849,P>0.05)。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。
Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group.The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration.The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group(χ2=3.887,P<0.05).The relief time of fever,pulmonary rale,cough and sputum in observation group was(3.09±1.25)d,(4.17±2.24)d,(3.95±1.53)d,and(4.05±1.77)d,respectively,which were significantly lower than the control group[(5.14±2.43)d,(7.03±3.23)d,(6.40±2.62)d and(6.32±1.81)d](t=5.143,4.988,5.536,6.147,P<0.05).The levels of CRP,IL-6 and TLR-4 in the observation group were(3.64±0.87)mg/L,(54.59±10.65)ng/mL and(7.94±1.57)%,respectively.They were significantly lower than(7.51±1.43)mg/L,(87.66±11.17)ng/mL and(12.11±2.48)% in the control group(t=15.850,14.690,9.740,P<0.05).The airway pressure and PaCO2 levels of the observation group were(6.92±3.60)cmH2O and(43.19±6.29)mmHg,respectively,which were significantly lower than those of the control group[(8.68±2.98)cmH2O and(55.43±5.95)mmHg].The levels of PaO2[(86.06±5.31)mmHg] and SpO2[(98.03±6.63)%] in the observation group were higher than those in the control group[(68.04±5.19)mmHg and(90.22±5.51)%],and there were statistically significant differences(t=2.582,9.692,16.638,6.221,P<0.05).The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference(χ2=2.849,P>0.05). Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients.
论著

早产儿坏死性小肠结肠炎的临床特征及危险因素分析

Clinical characteristics and risk factors of necrotizing enterocolitis in premature infants

:1141-1145
 
目的 分析早产儿发生新生儿坏死性小肠结肠炎(NEC)的临床特点及危险因素。方法 选取2021年3月—2023年3月在濮阳市人民医院出生的早产儿160例,根据有无NEC分为NEC组(40例)和非NEC组(120例),总结和比较两组患儿的临床资料,分析早产儿NEC的危险因素。结果 NEC组早产儿的发病时间主要集中在出生后的3~21 d,平均发病时间为(12.84±3.5)d。主要临床症状包括肉眼便血23例(57.5%)、腹胀31例(77.5%)、呕吐18例(45.0%)、呼吸暂停7例(17.5%)、肠穿孔9例(22.5%)。Logistic回归分析发现,败血症、输血、呼吸窘迫综合征及新生儿窒息是早产儿发生NEC的危险因素(P<0.05),而预防应用益生菌以及母乳喂养是NEC的保护因素(P<0.05)。结论 NEC的主要临床表现包括肉眼便血、腹胀、呕吐、呼吸暂停、肠穿孔等;患儿出现NEC与败血症、输血、呼吸窘迫综合征及新生儿窒息等因素相关;母乳喂养和益生菌的应用是其保护因素。
Objective To analyze the clinical characteristics and risk factors of necrotizing enterocolitis(NEC)in premature infants. Methods A total of 160 premature infants born in Puyang People's Hospital from March 2021 to March 2023 were selected and divided into NEC group(40 cases)and non-NEC group(120 cases)according to the presence or absence of NEC.The clinical data were obtained and compared between the two groups.The clinical data of two groups were compared,and the related risk factors of NEC in premature infants were analyzed and summarized. Results The onset time of NEC premature infants is mainly between 3-21 days after birth,with an average onset time of(12.84±3.5)days.The main clinical symptoms included 23 cases(57.5%)of bloody stool,31 cases(77.5%)of abdominal distension,18 cases(45.0%)of vomiting,7 cases(17.5%)of apnea,and 9 cases(22.5%)of intestinal perforation.Logistic regression analysis found that sepsis,blood transfusion,respiratory distress syndrome,and neonatal asphyxia were risk factors for NEC in premature infants(P<0.05),while prophylactic use of probiotics and breastfeeding were protective factors for NEC(P<0.05). Conclusions The main clinical manifestations of NEC include bloody stool,abdominal distension,vomiting,apnea,intestinal perforation,etc.NEC in infants is related to sepsis,blood transfusion,respiratory distress syndrome and neonatal asphyxia.Breastfeeding and the application of probiotics are its protective factors.
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.
论著

血清中炎症因子与炎性衰老的相关性研究

Correlation between inflammatory factors and inflamm-aging in human serum

:1407-1413
 
目的 探讨人外周血中炎症因子的表达与炎性衰老的相关性。方法 通过招募年轻和老年志愿者,检测外周血中炎症因子IL-6、IL-8、TNF-α和IL-1β的mRNA表达水平和蛋白水平。结果 显示老年个体组中IL-6,IL-8和TNF-α的mRNA表达水平高于年轻组,且蛋白水平呈现相同的趋势,比较差异均有统计学意义(P<0.05)。此外,通过热图分析了炎症因子mRNA和蛋白水平的相对表达谱,也发现相同的结果。结论 当年龄超过65岁以后,随着年龄的增长,体内的炎症因子表达水平会升高,这一结果具有成为炎性衰老生物标志物的潜力,对评估老年人的健康状况和疾病风险具有重要意义。
Objective To explore the correlation between the expression of inflammatory factors in human peripheral blood and inflamm-aging.Methods In this experiment,the young and old volunteers were recruited to detect mRNA and protein levels of IL-6,IL-8,TNF-α and IL-1β in peripheral blood.Results The results indicated that mRNA expression levels of IL-6,TNF-α and IL-8 in the old individuals were higher than the young individuals,and the protein concentration followed the same trend,with acceptable P value suggesting a great statistically significant difference.In addition,the relative expression profiles of mRNA and protein concentrations of inflammatory cytokines were analyzed by heat map,and the same results were found.Conclusions It shows that the expression level of inflammatory cytokines up-regulates along with age goes on over 65,which has the potential of inflammatory biomarkers of aging.
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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