论著

早产儿呼吸窘迫综合征拔管后 NIPPV 和 NCPAP 作为无创呼吸支持过渡的临床效果对比

Comparison of the clinical effects of NIPPV and NCPAP as a noninvasive respiratory support for preterm infants after extubation

:516-522
 
       目的    探究经鼻间歇正压通气(NIPPV)和经鼻持续正压通气(NCPAP)作为早产儿呼吸窘迫综合征气管插管机械通气拔管后无创呼吸支持过渡的临床效果的差异。方法   纳入2021年1月—2023年6月在广东省吴川市妇幼保健计划生育服务中心治疗的新生儿呼吸窘迫综合征早产儿66例,用随机数字表法将患儿分为NIPPV组(33例)和NCPAP组(33例)。NIPPV组患儿予经鼻间歇正压通气作为过渡期无创呼吸支持,NCPAP组患儿则予以经鼻持续正压通气作为过渡期无创呼吸支持。对比两组患儿治疗前后血气分析结果、脱机失败率、无创呼吸支持时间、无创后吸氧时间、总给氧时间等指标。结果  接受无创呼吸支持12 h后,NIPPV组患儿的PaO2升至(76.46±1.10)mmHg,高于NCPAP组患儿的(75.51±2.15)mmHg(t=2.249,P=0.028)。此外,NIPPV组患儿的SaO2升至(96.36±0.52)%,也高于NCPAP组患儿的(96.07±0.59)%(t=2.138,P=0.034)。而NIPPV组患儿的PaCO2则降至(41.39±0.74)mmHg,较NCPAP组患儿的(41.87±0.95 )mmHg低(t=-2.230,P=0.025)。NIPPV组无创呼吸支持时间为(3.09±0.52)d,短于NCPAP组的(3.45±0.62)d,且该差异有统计学意义(t=2.584,P=0.012)。同样的,NIPPV组总给氧时间(9.52±0.76)天较NCPAP组的(10.00±0.79)天短,且该差异有统计学意义(t=-2.548,P=0.013)。而两组在脱机失败率、无创呼吸支持后吸氧时间、不良反应发生率等方面比较差异无统计学意义(均P>0.05)。结论   与NCPAP模式相比,早产儿拔管后应用NIPPV模式进行无创呼吸支持取得的临床效果更优。
      Objective  To explore the difference of clinical effect of nasal intermittent positive pressure ventilation(NIPPV)and nasal continuous positive pressure ventilation(NCPAP)as non-invasive respiratory support mode after extubation in preterm infants with endotracheal intubation.Methods   Sixty-six cases of preterm infants with neonatal respiratory distress syndrome treated in our hospital from January 2021 to June 2023 were included.All the subjects were randomly divided into NIPPV groupn=33)and NCPAP group(n=33).The blood gas analysis results,weaning failure rate,non-invasive respiratory support time,oxygen inhalation time after noninvasive ventilation,total oxygen administration time.were compared between the two groups.Results   After 12 hours of noninvasive respiratory support,PaO2 in the NIPPV group increased to(76.46±1.10)mmHg,which was significantly higher than that(75.51±2.15)mmHg in the NCPAP group(t=2.249,P=0.028).In addition,SaO2 in the NIPPV group increased to (96.36±0.52)%,which was also significantly higher than that(96.07±0.59)% in the NCPAP group(t=2.138,P=0.034).The PaCO2 in the NIPPV group decreased to (41.39±0.74)mmHg,which was lower than that(41.87±0.95)mmHg in the NCPAP group(t=-2.230,P=0.025).The  duration of  non-invasive  respiratory  support in the NIPPV group(3.09±0.52) days was shorter than that(3.45±0.62)days in the NCPAP group,and the difference was statistically significant(t=2.584,P=0.012).Similarly,the total duration of oxygen administration in the NIPPV group(9.52±0.76)days was shorter than that(10.00±0.79)days in the NCPAP group,and the difference was statistically significant(t=-2.548,P=0.013).There were no significant differences in weaning failure rate,oxygen inhalation time after noninvasive respiratory support,and incidence of adverse reactions between the two groups(P>0.05).Conclusions   Compared with NCPAP mode,NIPPV mode for non-invasive respiratory support in preterm infants after extubating has better clinical effect,and it is worthy of clinical application.
论著

宫腔镜病灶切除术与超声监测下吸宫术治疗剖宫产瘢痕部位妊娠的有效性比较

Comparison of effectiveness between hysteroscopic resection surgery and ultrasound-guided uterine aspiration in the treatment of cesarean scar pregnancy

:500-504
 
       目的   比较宫腔镜病灶切除术与超声监测下吸宫术治疗剖宫产瘢痕部位妊娠(CSP)的有效性。   回顾性分析2021年7月—2023年10月在南宁市妇幼保健院确诊为I、Ⅱ型CSP并接受治疗的129例患者,停经时间在38~83 d,中位停经时间48 d。其中42例患者接受了宫腔镜病灶切除术治疗(A组),87例患者接受超声监测下吸宫术治疗(B组),比较两组患者术后1、3、7、14 d的人绒毛膜促性腺激素水平以及手术出血量、手术时间、住院时间、住院花费。结果   两组患者在术后1 d,血清HCG水平下降,下降幅度均超过50%,且A组患者术后1 d血清HCG的下降幅度及下降速率大于B组患者(P<0.05);术后3、7、14 d,两组血清HCG水平仍持续下降。另外,A组患者手术出血量、手术时间、住院时间、住院花费分别为(15.35±14.53)mL、(60.73±53.05)min、(4.33±1.90)d、(6 689.23±2 216.19)元;B组患者手术出血量、手术时间、住院时间、住院费用分别为(26.09±29.24)mL、(51.59±54.46)min、(4.82±1.83)d、(6 270.34±2 547.85)元。A组患者术中出血量低于B组、住院时间短于B组(P<0.05),手术时间及住院费用与B组比较差异无统计学意义(P均>0.05)。结论   宫腔镜病灶切除术与超声监测下吸宫术均能有效治疗CSP,但宫腔镜病灶切除术在术后血清HCG的下降幅度及下降速率、术中出血量、住院时间等方面优于超声监测下吸宫术,而且手术时间和住院费用并没有显著增加。
       Objective  To compare the efficacy between hysteroscopic  resection surgery and ultrasound-guided uterine aspiration in the treatment of cesarean scar pregnancy(CSP).Methods  A  retrospective analysis was performed in 129 patients diagnosed with CSP(type I or Ⅱ)and treated in Nanning Maternal and Child Health Hospital from July 2021 to October 2023.Their duration of amenorrhea was between 38~83 d,with a median of 48 days.Among them,42  patients were treated with hysteroscopic resection surgery therapy(group A),87 patients were treated with ultrasound-guided uterine aspiration therapy and(group B).Then,the levels of human chorionic gonadotropin(HCG),the amount of the intraoperative bleeding volume,surgical time,hospitalization time,and hospitalization expenses were compared between the two groups at one,three,seven and 14 days postoperativey.Results  After one day of surgery,the serum HCG levels of two groups significantly decreased,with a decrease of more than 50%,and the magnitude and  rate of  decrease in  serum HCG levels of group A were  significantly larger than those of group B(P<0.05);After three,seven,and 14 day of surgery,serum HCG levels continued to decrease.Furthermore,the intraoperative bleeding volume,surgical time,hospitalization time,hospitalization expenses in group A were(15.35±14.53)mL,(60.73±53.05)min,(4.33±1.90)d,(6 689.23±2 216.19)yuan,respectively.That in group B were(26.09±29.24)mL,(51.59±54.46)min,(4.82±1.83)d,(6 270.34±2 547.85)yuan,respectively.Compared to group B,the intraoperative bleeding volume of group A was significantly lower(P<0.05),and the hospitalization time is shorter,while there was no significant difference in surgical time and hospitalization expenses.Conclusions  Both of hysteroscopic resection surgery and ultrasound-guided uterine aspiration can treat cesarean scar pregnancy effectively,but the former is superior to the latter in terms of the magnitude and rate of decrease in serum HCG levels after surgery,intraoperative bleeding volume,and hospitalization time,with no significant increase in surgical time and hospitalization expenses.
论著

无管化微创 PCNL 治疗嵌顿性输尿管上段结石的效果

The effect of tubeless minimally invasive PCNL in the treatment of incarcerated upper ureteral calculi

:398-402
 
       目的   探讨无管化微创PCNL(经皮肾镜取石术)治疗嵌顿性输尿管上段结石的效果。方法   将中山大学附属第一医院惠亚医院2019年12月—2021年12月收治的95例嵌顿性输尿管上段结石患者按照随机数字表法分组,给予对照组47例患者经尿道输尿管镜碎石术(TURL)治疗、观察组48例患者无管化微创PCNL治疗,观察两组手术一般状况、血清学指标、肾脏血流动力学以及并发症发生情况。结果   观察组手术时间、术后血尿以及住院时间均短于对照组,观察组术中出血量少于对照组,观察组结石清除率高于对照组(P<0.05);术后1 d观察组肾损伤分子-1(KIM-1)、中性粒细胞明胶相关脂脂质运载蛋白(NGAL)以及胱抑素C(Cys-C)水平低于对照组(P<0.05);两组肾动脉收缩期血流速度(Vs)以及舒张末期血流速度(Vd)对比差异无统计学意义(P>0.05);观察组并发症发生率(4.16%)低于对照组(19.15%)P<0.05)。结论   无管化微创PCNL可改善嵌顿性输尿管上段结石手术一般状况,减轻患者肾脏损伤,提高结石清除率,不影响肾脏血流,且并发症更少。
       Objective  To explore the effect of tubeless minimally invasive(percutaneous nephrolithotomy,PCNL)in the treatment of impacted upper ureteral stones.Methods  A total of 95 patients with impacted upper ureteral stones admitted to our hospital from December 2019 to December 2021 were grouped according to the random number table method.Control group of 47 cases were treated with transurethral ureteroscopy lithotripsy(TURL),48 patients in the observation group were given tubeless minimally invasive PCNL treatment.The general surgical conditions,serological indicators,renal hemodynamics and complications of the two groups were observed.Results  The operation time,postoperative hematuria and hospitalization time of the observation group were shorter than those of the control group,the intraoperative bleeding volume of the observation group was less than that of the control group,and the stone free rate of the observation group was higher than that of the control group(P<0.05).One day after surgery,the levels of kidney injury molecule-1(KIM-1),lipocalin(NGAL)and cystatin C(Cys-C)in the observation groupwere lower than those in the control group(P<0.05);the renal artery systolic blood flow velocity(Vs)and end-diastolic blood flow velocity(Vd)had no statistical significance(P>0.05);the incidence of complications in the observation group(4.16%)was lower than that in the control group(19.15%)(P<0.05).Conclusions  Tubeless minimally invasive PCNL can improve the general conditions of surgery,reduce kidney damage,increase stone free rate,does not affect renal blood flow,and has fewer complications.
论著

支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况分析

Analysis of the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia treated with bronchoscopy combined with nebulized inhalation of medication

:377-381
 
        目的   探究支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况。方法   选取94例肺炎支原体肺炎患儿为研究对象,以随机数字表法分为A组、B组,各47例,分别实施布地奈德雾化吸入治疗、支气管镜肺泡灌洗联合布地奈德雾化吸入治疗,比较两组症状持续时间、治疗后肺部影像改善情况、炎症指标水平及不良反应发生率。结果  B组体温恢复时间(2.73±0.51)d、咳嗽消失时间(5.98±1.24)d、住院时间(10.96±3.36)d,A组分别为(3.14±0.83)(7.06±2.33)(13.27±3.18)d,B组较A组短(t=2.885、2.809、3.423,均P<0.05);治疗后B组40.43%阴影完全消失、34.04%阴影显著缩小、23.40%阴影有所缩小、2.13%阴影改善不明显,A组分别为21.28%、36.17%、25.53%、17.02%,B组肺部阴影改善情况优于A组(Z=8.311,P<0.05);治疗前B组白细胞计数(WBC)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平与A组相近(P>0.05);治疗后B组WBC(7.71±1.94)×109 /L、hs-CRP(4.96±1.44)mg/L、PCT(84.32±21.40)pg/mL,A组分别为(9.05±2.48)×109 /L、(6.17±1.85)mg/L、(105.46±34.02)pg/mL,B组水平较A组低(t=2.918、3.538、3.606,均P<0.05);B组不良反应发生率为8.52%,A组为4.26%,B与A组相近(χ 2 =0.178,P>0.05)。结论   对肺炎支原体肺炎患儿实施支气管镜联合雾化吸入药物治疗,可缩短康复时间,促进肺部阴影消退,降低其炎症指标水平,且未增加不良反应发生率。
     Objective  To investigate the effect of bronchoscopy combined with nebulized inhalation of medication on the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia(MPP).Methods  A total of 94 children with MPP were selected as the research subjects and randomly divided into Group A and Group B using a random number table,with 47 cases in each group.They were treated with budesonide nebulization inhalation therapy and bronchoalveolar lavage combined with budesonide nebulization inhalation therapy,respectively.The duration of symptoms,improvement of lung imaging before and after treatment,levels of inflammatory indicators,and incidence of adverse  reactions were compared between the two groups.The results showed that the temperature recovery time was(2.73±0.51)days,cough disappearance time was(5.98±1.24)days,and hospitalization time was(10.96±3.36)days in Group B,(3.14±0.83)days,(7.06±2.33)days,and(13.27±3.18)days in Group A,respectively.Durpation in Group B was shorter than Group A(t=2.885,2.809,3.423,all P<0.05). After treatment,40.43% of the shadows in Group B completely disappeared,34.04% of the shadows significantly reduced,23.40% of the shadows reduced,and 2.13% of the shadows showed no significant improvement,better than 21.28%,36.17%,25.53%,and 17.02% in Group A(Z=8.311,P<0.05). Before treatment,the white blood cell count(WBC),high-sensitivity C-reactive protein(hs CRP),and procalcitonin(PCT)levels in group B were similar to those in Group A(P>0.05).After treatment,the WBC(7.71±1.94)×109 /L,hs CRP(4.96±1.44)mg/L,and PCT(84.32±21.40)pg/mL in Group B were lower than those in Group A(9.05±2.48)×109 /L,(6.17±1.85)mg/L,and(105.46±34.02)pg/mL,respectivelyt=2.918,3.538,3.606,all P<0.05).The incidence of adverse reactions in Group B was 8.52%,while in Group A it was 4.26%.The incidence of adverse reactions in group B was similar to that in group A(χ 2 =0.178,P>0.05).Conclusions  Bronchoscopy combined with nebulized inhalation therapy for children with MPP can shorten the recovery time,promote the disappearance of lung shadows,reduce their inflammatory index levels,and without increasing the incidence of adverse reactions.
中医研究

穴位贴敷疗法干预矮小症现代文献分析

Modern literature analysis of acupoint application therapy for short stature

:260-267
 
       目的   分析现代文献中穴位贴敷疗法干预矮小症研究现状,为临床治疗该病提供依据。方法   整理近2018年1月—2023年12月6年间国内医学期刊上公开发表的关于穴位贴敷疗法治疗矮小症的中文文献,对文献年代分布、发表期刊、研究内容、贴敷穴位、贴敷药物、贴敷的时间、频次、治疗时间、观察指标、中西医结合治疗矮小症、不良反应等进行统计分析。   最终纳入的文献共10篇,近6年间均有相关文献发表;发表期刊《中医儿科杂志》《新中医》《中国现代医生》《中医外治杂志》《中国中西医结合儿科学》;研究内容涉及矮小症分型、穴位贴敷联合重组人生长激素法、畲医法、中药内服法、拉伸操法、营养干预指导、推拿等方法治疗矮小症。结论   穴位贴敷疗法联合其他疗法在临床上对儿童矮小症的改善效果显著,不良反应轻微,相信随着矮小症成因的进一步明确,穴位贴敷疗法治疗矮小症的机制会更加清晰,为改善矮小症提供科学理论依据,同时,为矮小症等相关疾病的治疗提供新思路。
      Objective  To analyze the research status of acupoint application therapy in short stature from January 2018 to December 2023,and to provide basis for clinical treatment of the disease.Methods  To review the Chinese literature published in domestic medical journals in recent 6 years on the treatment of short stature by acupoint application therapy,including the distribution of time and journals,the research contents,the acupoint application,the drug application,the application time,the treatment frequency and duration,the observation index,treatment of short stature with integrated traditional,Chinese and Western medicine and adverse reactions were statistically analyzed.Results  There were 10 articles in this review,and all of them were published in the past 6 years,published journal were Pediatrics of Traditional Chinese medicine,new Traditional Chinese medicine,modern Chinese doctor,Journal of external treatment of traditional Chinese medicine,Pediatrics of integrated traditional Chinese and Western medicine in China.The research content involved the short stature classification,acupoint application combined with  recombinant human growth hormone therapy,the She medical therapy,traditional Chinese medicine,stretching manipulation,nutrition intervention guidance,massage and other methods.Conclusions  The combination of acupoint application therapy and other therapies has a significant clinical effect on the improvement of short stature in children,with slight adverse reactions.It is believed that with the further clarification of the causes of short stature,the mechanism of point application therapy for short stature will be more clear and provide scientific basis for improving short stature.At the same time,it may provide a new idea for the treatment of dwarfism and other related diseases.
论著

阴道分娩后尿失禁患者疾病应对方式及其相关影响因素分析

Analysis of disease coping strategies and related influencing factors in patients with urinary incontinence after vaginal delivery

:211-215
 
       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例,评估所有患者的应对方式,根据结果分为积极应对组与消极应对组,设计基线资料调查表,详细统计两组患者的基线资料并比较,重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估,78例阴道分娩后尿失禁患者疾病消极应对有40例,占比51.28%;积极应对组与消极应对组患者的产次(χ 2 =4.110,P=0.043)、文化水平(Z=2.094,P=0.036)、家庭关怀度(Z=2.069,P=0.040)与自我效能(Z=2.249,P=0.025)比较差异有统计学意义,组间年龄(t=0.096,P=0.924)、孕次(t=1.257,P=0.212)、体质指数(BMI)(t=0.125,P=0.901)、工作(χ 2 =0.778,P=0.378)、家庭月人均收入(χ 2 =0.044,P=0.834)、漏尿(χ 2 =0.040,P=0.842)比较差异无统计学意义;经回归分析发现,家庭关怀度低(OR=1.799,P=0.041)、自我效能低(OR=1.942,P=0.026)、经产妇(OR=2.554,P=0.045)及文化水平低(OR=1.837,P=0.038)均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高,可能与产次、文化水平、家庭关怀度及自我效能有关。
       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery.Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected.The coping strategies of all patients were evaluated,and they were divided into a positive coping group and a negative coping group based on the results.A baseline data questionnaire was designed,and the baseline data of the two groups of patients were compared in detail.The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery.Results After evaluation,40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies,accounting for 51.28%.The parity of patients in the positive and negative coping groups(χ 2 =4.110,P=0.043),educational level(Z=2.094,P=0.036),family care(Z=2.069,P=0.040),and self-efficacy(Z=2.249,P=0.025)among the groups were different.Age between groups(t=0.096,P=0.924),gestational age(t=1.257,P=0.212),body mass index(t=0.125,P=0.901),and work experience(χ 2 =0.778,P=0.378),monthly per capita income of households(χ 2 =0.044,P=0.834),urinary leakage(χ 2 =0.040,P=0.842)had no statistically significant difference in comparison.Through regression analysis,it was found that low family care(OR=1.799,P=0.041),low self-efficacy(OR=1.942,P=0.026),postpartum women(OR=2.554,P=0.045),and low educational level(OR=1.837,P=0.038)were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery.Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease,which may be related to parity,educational level,family care and self-efficacy.
论著

膝骨关节炎患者术前衰弱列线图预测模型的建立

Establishment of a preoperative frailty nomogram prediction model in patients with knee osteoarthritis

:179-186
 
       目的   基于Nomogram初步构建膝骨关节炎(KOA)患者术前衰弱的风险预测模型。方法   便利选取172例于2021年12月—2022年8月在广州市某三甲医院关节外科接受择期膝关节置换术的KOA患者为研究对象,依据衰弱的发生与否分为衰弱组(n=111)和非衰弱组(n=61),通过单因素分析筛选变量,纳入Logistic回归分析,并构建列线图模型。结果   单因素分析结果显示年龄、BMI、膝关节疼痛年限、合并症、抑郁、焦虑、疼痛、睡眠障碍、营养状况等在不同组间比较差异存在统计学的意义(P<0.05)。多因素Logistic回归分析表明,BMI异常(OR=3.360)、膝关节疼痛年限>5年(OR=14.188)、抑郁(OR=5.608)、睡眠障碍(OR=25.480)是KOA患者术前衰弱的独立危险因素(P<0.05)。基于此,建立了预测膝骨关节炎患者术前衰弱风险的列线图预测模型。结果显示C-index为0.915,校正曲线接近理想曲线,ROC曲线下面积(AUC)为0.919(95%CI:0.878~0.961),可见该预测模型具有较好的区分度和准确度。结论   根据BMI、膝关节疼痛年限、抑郁以及睡眠障碍这四个独立危险因素,可以准确地预测膝骨关节炎患者术前衰弱的风险。
    Objective  To develop a nomogram for predicting the risk of preoperative frailty in knee osteoarthritis patients.Methods  A convenience sample of 172 patients who underwent elective knee arthroplasty at a Grade-A hospital in Guangzhou from December 2021 to August 2022 was selected.The patients were divided into two groups based on the presence of preoperative frailty:frailty group(n=111)and non-frailty group(n=61).The variables with statistical differences were screened by univariate analysis for multivariate logistic regression analysis,and the nomogram prediction model was established.Results  Univariate analysis identified significant differences between the groups in age,BMI,years of knee pain,complications,depression,anxiety,pain,sleep disturbance,and nutrition(P<0.05).Multivariate logistic regression showed that abnormal BMI(OR=3.360),years of knee pain > 5(OR=14.188),depression(OR=5.608),and sleep disorders(OR=25.480)were independent  risk factors for preoperative frailty in knee osteoarthritis patients(P<0.05).Based on these findings,a nomogram prediction model was established.Model verification results demonstrated that the nomogram had good differentiation and accuracy in predicting the risk of preoperative frailty,with a C-index of 0.915,an area under the ROC curve of 0.919(95% CI:0.878~0.961),and a calibration curve slope close to 1.Conclusions  The nomogram,based on four independent risk factors(BMI,years of knee pain,depression,and sleep disturbance),effectively predicts the risk of preoperative frailty in knee osteoarthritis patients.
论著

不同湿化方法对喉癌患者术后气道湿化效果的网状 Meta 分析

Effects of airway humidification for postoperative with laryngeal cancer:A network Meta-analysis

:89-98
 
       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR(95%CI)=537.70(4.18,124 511.88)、0(0,0.52),P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR(95%CI)=8.55(1.40,73.35),P<0.05];其余比较差异无统计学意义(P>0.05)。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。
       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer.Methods  PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively.Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation.The network Meta analysis was performed using ADDIS 1.16.5 softwares.Results  A total of 18 articles and 1596 patients were inciuded.The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR(95%CI)=537.70(4.18,124 511.88),0(0,0.52),P<0.05].In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR(95%CI)=8.55(1.40,73.35),P<0.05],the others were not statistically different(P0.05).Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness.Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients.
综述

浆细胞性乳腺炎的中西医结合治疗进展

Progress of integrated traditional Chinese and Western medicine treatment of plasma cell mastitis

:56-61
 
       近年来浆细胞性乳腺炎的发病率逐渐升高,已占乳腺疾病的4%~5%,该病易反复发作,经久不愈,抗生素、糖皮质激素、抗结核药、他莫昔芬等治疗效果不明显,单纯手术切除如切除范围小极易复发,而切除范围大则乳腺外形变化较大,严重者甚至需要切除乳腺。乳腺外形的缺损改变对患者身心健康造成伤害。随着研究不断深入,采用中西医结合治疗浆细胞性乳腺炎,可取得较好的治疗效果,降低复发率,而且对乳腺外观无影响。该文通过对文献的整理,对中西医结合治疗浆细胞性乳腺炎进行论述。
       In recent years,the incidence of plasma cell mastitis has gradually increased,accounting for 4 % ~ 5 % of breast diseases.The disease is prone to repeated attacks and unhealed for a long time.The treatment effect of antibiotics,glucocorticoids,anti-tuberculosis drugs and tamoxifen is not obvious.Simple surgical  resection is easy to  relapse if the  resection range is small,while the shape of the breast changes greatly,if the resection range is large.And even the breast needs to be removed in severe cases.The defect change of breast shape is harmful to the physical and mental health of patients.With the deepening of research,the combination of traditional Chinese and Western medicine in the treatment of plasma cell mastitis can achieve better therapeutic effect,reduce the recurrence rate,and has no effect on the appearance of breast.This article discusses the treatment of plasma cell mastitis with integrated traditional Chinese and Western medicine by sorting out the literature.
综述

机器学习算法在术后谵妄风险评估中的应用进展

Progress in the application of machine learning algorithms in the risk assessment of postoperative delirium

:42-47
 
      近年来,人工智能技术(AI)的发展正在逐渐改变传统的医疗行业,机器学习作为人工智能技术中的主流被越来越多地应用于分析复杂的医学数据,为疾病的诊断、预后风险评估、诊疗决策的制定等方面提供了便利。文章对国内外机器学习算法在术后谵妄中的应用进行综述,以期为术后谵妄预测模型的构建提供新的思路,为临床早期评估术后谵妄提供新的依据。
    In recent years,the development of artificial intelligence(AI)is gradually changing the traditional medical industry.Machine learning,as the mainstream of artificial intelligence technology,is increasingly applied to analyze complex data in medical research.It provides convenience for disease diagnosis,risk assessment and diagnosis and treatment decision making.This paper reviews the application of machine learning algorithms in postoperative delirium at home and abroad,in order to provide a new idea for the construction of postoperative delirium prediction model and a new basis for early clinical evaluation of postoperative delirium.
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