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Comparison of the effects of laparoscopic catheterization and surgical incision catheterization on catheter-related complications and microinflammation in uremic peritoneal dialysis patients 腹腔镜置管与手术切口置管对尿毒症腹膜透析患者置管相关并发症及微炎症的影响比较
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.014
Wei Wu, Hong-Fa Zhu, Jiaxi Chen, Guan-zhou Liu
Objective To compare the effects of laparoscopic and surgical catheterization on catheter-related complications and microinflammation in uremic peritoneal dialysis (PD) patients. Methods According to different catheterization methods, 98 uremic patients who were scheduled to undergo peritoneal dialysis in the First People's Hospital of Jiande from January 2014 to March 2019 were divided into group A (38 cases), group B (60 cases). Laparoscopic catheterization was used in group A, and incision catheterization was used in group B. Surgical parameters, catheter complications, microinflammation and survival rate of early catheterization were observed in the two groups. Results The operation time of group A was (35.00±3.14)min, which was shorter than that of group B [(50.00±5.17)min], and the operation cost of group A was (5 800.0±318.9)CNY, which was higher than that of group B [(3 400.0±297.4)CNY], and the visual analogue score (VAS) of group A was (2.33±0.31)points, which was lower than that of group B [(3.25±0.49)points], there were statistically significant differences between the two groups (t=11.540, 9.317, 10.328, 36.578, all P 0.05). After catheterization, the levels of hs-CRP, IL-6 and TNF-alpha in group B were (12.52±3.75)mg/L, (12.02±3.76)ng/L, (15.92±5.72)ng/L, respectively, which were higher than those in group A [(9.63±2.36)mg/L, (9.11±3.54)ng/L, (13.41±5.61)ng/L] (t=4.244, 4.081, 4.510, all P<0.05). After 2 months of follow-up, the survival rate of dialysis tube technique was 89.47%(34/38) in group A and 71.67%(43/60) in group B, there was statistically significant difference between the two groups (χ2=4.382, P<0.05). Conclusion Application of laparoscopic catheterization in uremic PD patients has satisfactory effect, light pain, fewer complications, mild inflammation and high survival rate of early catheterization technology, which is worthy of clinical promotion. Key words: Uremia; Peritoneal dialysis; Laparoscopy; Catheterization; Postoperative complications; C-reactive protein; Interleukin-6; Tumor necrosis factor-alpha
目的比较腹腔镜与外科置管对尿毒症腹膜透析(PD)患者置管相关并发症及微炎症的影响。方法选取2014年1月~ 2019年3月建德市第一人民医院计划行腹膜透析的尿毒症患者98例,根据置管方式不同分为A组(38例)、B组(60例)。A组采用腹腔镜置管,b组采用切口置管,观察两组手术参数、导管并发症、微炎症及早期置管生存率。结果A组的操作时间(35.00±3.14)分钟,这是短于B组的(50.00±5.17)分钟,A组的操作成本是5(800.0±318.9)元,这是高于B组(400.0±297.4(3)元)和视觉模拟评分(血管)的A组(2.33±0.31)分,这是低于B组(3.25±0.49)分,两组有显著差异(t = 11.540, 9.317, 10.328, 36.578,所有P 0.05)。置管后B组hs-CRP、IL-6、tnf - α水平分别为(12.52±3.75)mg/L、(12.02±3.76)ng/L、(15.92±5.72)ng/L,均高于A组[(9.63±2.36)mg/L、(9.11±3.54)ng/L、(13.41±5.61)ng/L] (t=4.244、4.081、4.510,P均<0.05)。随访2个月后,A组透析管技术生存率为89.47%(34/38),B组为71.67%(43/60),两组比较差异有统计学意义(χ2=4.382, P<0.05)。结论应用腹腔镜置管技术治疗尿毒症患者效果满意,早期置管技术疼痛轻,并发症少,炎症轻微,成活率高,值得临床推广。关键词:尿毒症;腹膜透析;腹腔镜检查;导管插入术;术后并发症;c反应蛋白;白细胞介素- 6;肿瘤坏死因子
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引用次数: 0
Application effect of Zhixinxing health education mode in postoperative pain management of surgical patients 知新兴健康教育模式在外科病人术后疼痛管理中的应用效果
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.023
Sisi Wang, Qingqing Wang, Jianhong Huang, Y. Gu
目的 在手术患者术后疼痛管理中应用知信行健康教育模式,并分析知信行健康教育模式的应用效果。 方法 选择2017年3月至2019年3月舟山市妇幼保健医院接受的手术患者100例,采用随机数字表法分对照组与研究组各50例,分别予以常规教育护理、知信行健康教育模式。比较两组自我管理行为评分、术后疼痛评分、护理总满意率。 结果 研究组的自我管理行为评分[(83.81±5.21)分]高于对照组[(71.35±5.23)分],且研究组的术后疼痛评分[(2.72±0.16)分]低于对照组[(4.91±0.71)分],差异均有统计学意义(t=11.93、21.28,均P<0.05);研究组的护理总满意率(96.00%)高于对照组(84.00%),差异有统计学意义(χ2=4.00,P<0.05)。 结论 在手术患者术后疼痛管理中应用知信行健康教育模式,可以有效提高患者的自我管理水平,能够帮助其减轻机体疼痛感,且增加患者满意度。
Objective: To apply the knowledge, belief, and practice health education model in postoperative pain management of surgical patients, and analyze the application effect of the knowledge, belief, and practice health education model. Method: A total of 100 surgical patients who underwent surgery at Zhoushan Maternal and Child Health Hospital from March 2017 to March 2019 were selected. They were randomly divided into a control group and a study group with 50 patients each, and received routine education and nursing, as well as knowledge, belief, and practice health education models, using a random number table method. Compare the self-management behavior score, postoperative pain score, and overall nursing satisfaction rate between two groups. The self-management behavior score of the study group [(83.81 ± 5.21) points] was higher than that of the control group [(71.35 ± 5.23) points], and the postoperative pain score of the study group [(2.72 ± 0.16) points] was lower than that of the control group [(4.91 ± 0.71) points], with statistical significance (t=11.93, 21.28, all P<0.05); The total satisfaction rate of nursing care in the study group (96.00%) was higher than that in the control group (84.00%), and the difference was statistically significant( χ 2=4.00, P<0.05). Conclusion: The application of knowledge, belief, and practice health education model in postoperative pain management of surgical patients can effectively improve their self-management level, help them reduce body pain, and increase patient satisfaction.
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引用次数: 0
Therapeutic effect of acitretin combined with traditional Chinese Medicine on pustular psoriasis 阿曲汀联合中药治疗脓疱性银屑病疗效观察
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.013
L. Qin
Objective To observe the efficacy of acitretin combined with traditional Chinese medicine in the treatment of pustular psoriasis. Methods From July 2011 to October 2017, 91 patients with pustular psoriasis admitted to the Second People's Hospital of Changzhi were randomly divided into treatment group(n=31), control group Ⅰ (n=30) and control group Ⅱ(n=30) according to the digital table.The patients in the three groups were treated with acitretin combined with traditional Chinese medicine, oral acitretin and traditional Chinese medicine, respectively.The therapeutic effects, the time required for hypothermia, the time required for the complete disappearance of pustules and the average length of hospitalization were compared among the three groups. Results The total effective rate was 93.55%(29/31) in the treatment group, 70.00%(21/30) in the control group Ⅰ and 73.33%(22/30) in the control group Ⅱ.The total effective rate in the treatment group was significantly higher than that in the two control groups(χ2=5.720, 4.546, all P 0.05). The fever allaying time, completely disappearance time of pustules, average hospital stay in the treatment group were (4.24±0.86)d, (7.38±0.72)d, (23.46±0.61)d, respectively, which in the control group Ⅰ were (7.45±0.92)d, (10.45±0.52)d, (30.01±0.82)d, respectively, which in the control group Ⅱ were (8.56±0.78)d, (11.56±0.35)d, (31.53±0.68)d, respectively, which in the control group Ⅰ were significantly shorter than those in the control group Ⅱ(t=14.083, 19.037, 35.476, all P<0.05), which in the treatment group were significantly lower than those in the control group Ⅰ and the control group Ⅱ(t=20.529, 28.682, 48.826, 5.041, 9.699, 7.816, all P<0.05). Conclusion Acitretin capsule combined with traditional Chinese medicine is effective in the treatment of pustular psoriasis, which can control body temperature in a short time, shorten the time of disappearance of pustule, relieve the pain of patients, and shorten the time of hospitalization at the same time. Key words: Psoriasis; Skin diseases; Avera; Drugs, chinese herbal; Drug therapy, combination; Treatment outcome; Comparative study
目的观察阿曲汀联合中药治疗脓疱性银屑病的疗效。方法将长治市第二人民医院2011年7月至2017年10月收治的91例脓疱型银屑病患者,按数字表随机分为治疗组(n=31)、对照组Ⅰ(n=30)和对照组Ⅱ(n=30。三组患者分别采用阿曲汀联合中药、口服阿曲汀和中药治疗。比较三组患者的治疗效果、体温过低所需时间、脓疱完全消失所需时间和平均住院时间。结果治疗组总有效率为93.55%(29/31),对照组Ⅰ为70.00%(21/30),对照对照组Ⅱ为73.33%(22/30),治疗组的平均住院时间分别为(4.24±0.86)d、(7.38±0.72)d和(23.46±0.61)d,对照组Ⅰ分别为(7.45±0.92)d、,对照组Ⅰ明显短于对照组Ⅱ(t=14.083、19.037、35.476,均P<0.05),治疗组明显低于对照组Ⅰ和对照组Ⅱ(t=20.529,28.682,48.826,5.041,9.699,7.816,均P<0.05),缩短脓疱消失的时间,减轻患者的痛苦,同时缩短住院时间。关键词:银屑病;皮肤病;Avera;药物、中草药;药物治疗,联合用药;治疗结果;比较研究
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引用次数: 0
Application of failure mode and effect analysis in radiotherapy and chemotherapy for breast cancer patients 失效模式及效果分析在乳腺癌患者放化疗中的应用
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.026
S. Xu, Yan-ju Xiao
目的 探讨失效模式与效应分析(FMEA)在乳腺癌放化疗过程中的应用效果。 方法 回顾性分析温州医科大学附属第一医院2017年3月至2019年3月行放化疗的乳腺癌患者120例的临床资料,根据护理方法不同分为两组,观察组60例采用FMEA护理管理干预,对照组60例采用常规护理干预。评价两组患者干预后乳腺癌患者生命质量测定量表(FACT-B)、抑郁自评量表(SDS)及焦虑自评量表(SAS)评分情况,比较两组患者满意度、病情知晓情况,观察并发症发生情况。 结果 干预后,观察组各项生活质量评分均显著优于对照组(均P<0.05)。观察组病情知晓率、满意度分别为98.33%、95.83%,均显著高于对照组的83.33%、81.67%(χ2=8.107、5.175,均P<0.05)。观察组FACT-B、SDS、SAS评分分别为(130.26±14.42)分、(42.35±4.32)分、(38.35±4.66)分,均显著优于对照组的(112.25±8.93)分、(59.24±6.95)分、(51.42±6.23)分(t=5.236、3.236、11.865,均P<0.05)。观察组并发症发生率为11.67%,显著低于对照组的28.33%(χ2=5.208,P=0.022)。 结论 实施FMEA护理管理能有效提高乳腺癌患者放化疗过程中的生活质量,缓解患者心理和生理上的各种不适,提高患者的满意度,降低并发症发生率。
Objective To investigate the effect of failure mode and effect analysis (FMEA) in the process of radiotherapy and chemotherapy for breast cancer. Methods The clinical data of 120 patients with breast cancer who received radiotherapy and chemotherapy in the First Affiliated Hospital of Wenzhou Medical University from March 2017 to March 2019 were retrospectively analyzed. They were divided into two groups according to different nursing methods. The observation group (60 cases) used FMEA nursing management intervention, and the control group (60 cases) used routine nursing intervention. To evaluate the scores of breast cancer patients' quality of life measurement scale (FACT-B), self rating depression scale (SDS) and self rating anxiety scale (SAS) after intervention in the two groups, compare the patients' satisfaction, condition awareness, and observe the occurrence of complications in the two groups. After the intervention, the quality of life scores of the observation group were significantly better than those of the control group (all P<0.05). The awareness rate and satisfaction rate of the observation group were 98.33% and 95.83%, respectively, which were significantly higher than 83.33% and 81.67% of the control group( χ 2=8.107 and 5.175, both P<0.05). The FACT-B, SDS, and SAS scores of the observation group were (130.26 ± 14.42), (42.35 ± 4.32), and (38.35 ± 4.66), respectively, which were significantly better than the control group's (112.25 ± 8.93), (59.24 ± 6.95), and (51.42 ± 6.23) scores (t=5.236, 3.236, and 11.865, all P<0.05). The incidence of complications in the observation group was 11.67%, significantly lower than the 28.33% in the control group( χ 2=5.208, P=0.022). Conclusion The implementation of FMEA nursing management can effectively improve the quality of life of breast cancer patients during radiotherapy and chemotherapy, alleviate their psychological and physiological discomfort, improve their satisfaction and reduce the incidence of complications.
{"title":"Application of failure mode and effect analysis in radiotherapy and chemotherapy for breast cancer patients","authors":"S. Xu, Yan-ju Xiao","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.05.026","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.05.026","url":null,"abstract":"目的 \u0000探讨失效模式与效应分析(FMEA)在乳腺癌放化疗过程中的应用效果。 \u0000 \u0000 \u0000方法 \u0000回顾性分析温州医科大学附属第一医院2017年3月至2019年3月行放化疗的乳腺癌患者120例的临床资料,根据护理方法不同分为两组,观察组60例采用FMEA护理管理干预,对照组60例采用常规护理干预。评价两组患者干预后乳腺癌患者生命质量测定量表(FACT-B)、抑郁自评量表(SDS)及焦虑自评量表(SAS)评分情况,比较两组患者满意度、病情知晓情况,观察并发症发生情况。 \u0000 \u0000 \u0000结果 \u0000干预后,观察组各项生活质量评分均显著优于对照组(均P<0.05)。观察组病情知晓率、满意度分别为98.33%、95.83%,均显著高于对照组的83.33%、81.67%(χ2=8.107、5.175,均P<0.05)。观察组FACT-B、SDS、SAS评分分别为(130.26±14.42)分、(42.35±4.32)分、(38.35±4.66)分,均显著优于对照组的(112.25±8.93)分、(59.24±6.95)分、(51.42±6.23)分(t=5.236、3.236、11.865,均P<0.05)。观察组并发症发生率为11.67%,显著低于对照组的28.33%(χ2=5.208,P=0.022)。 \u0000 \u0000 \u0000结论 \u0000实施FMEA护理管理能有效提高乳腺癌患者放化疗过程中的生活质量,缓解患者心理和生理上的各种不适,提高患者的满意度,降低并发症发生率。","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41385505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical value of plasma BNP combined with Tei index in evaluating left ventricular function in children with congenital heart disease before interventional therapy 血浆BNP联合Tei指数评价先天性心脏病患儿介入治疗前左心室功能的临床价值
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.003
Tugui Li, J. Chen
Objective To explore the clinical value of combined detection of plasma BNP and Tei index in evaluating left ventricular function in children with congenital heart disease before interventional therapy. Methods From April 2017 to April 2019, a total of 60 children with congenital heart disease who were going to receive interventional therapy in Dachong Hospital of Zhongshan and Boai Hospital of Zhongshan were selected as observation subjects, and the patients were divided into cardiac function class Ⅰ group and cardiac function class Ⅱ group according to NYHA cardiac function classification, with 30 cases in each group.At the same time, 30 normal children were selected as healthy control group.The differences of plasma BNP concentration, left ventricular ejection fraction(LVEF) and left ventricular Tei index in different group were compared.The correlation between the plasma concentration and the cardiac function was investigated, and the correlation between the plasma BNP concentration and the Tei index was analyzed. Results The concentration of serum BNP[(6.8±1.2)ng/L] and the Tei index of left ventricle (0.63±0.08) in the cardiac function class Ⅱ group were significantly higher than those in the cardiac function class Ⅰ group[(5.4±1.3)ng/L, (0.48±0.11)], and the differences were statistically significant (t=1.92, 3.01, all P<0.05). These two indicators of the two groups were higher than those of the healthy control group[(3.7±1.5)ng/L, (0.33±0.09)], the differences were statistically significant(t=2.14, 2.28, 4.19, 6.14, all P<0.05). In addition, the LVEF of the cardiac function class Ⅱ group was significantly lower than that of the cardiac function class Ⅰ group(t=5.00, P<0.05), and the LVEF of the two groups were significantly lower those that of the healthy control group(t=10.32, 4.51, all P<0.05). With the increase of severity of cardiac insufficiency, the BNP and Tei index gradually increased(F=3.054, 3.491, all P<0.05), and the LVEF value decreased gradually (F=12.50, P<0.05). At the same time, the linear correlation analysis showed that the plasma BNP concentration had a positive correlation with the left ventricular Tei index(r=0.69, P<0.01). Conclusion Plasma BNP combined with Tei index can quickly and accurately assess the left ventricular function in children with congenital heart disease before intervention.As a sensitive index for clinical detection, it has clinical application value. Key words: Heart defects, congenital; Angioplasty, balloon, coronary; Preoperative period; Natriuretic peptide, brain; Ventricular function, left; Child
目的探讨血浆BNP与Tei指数联合检测在先心病介入治疗前评价患儿左心室功能的临床价值。方法选取2017年4月至2019年4月在中山市大冲医院和中山市博爱医院行介入治疗的先天性心脏病患儿60例作为观察对象,根据NYHA心功能分级将患儿分为心功能分级Ⅰ组和心功能分级Ⅱ组,每组各30例。同时选取30例正常儿童作为健康对照组。比较各组患者血浆BNP浓度、左室射血分数(LVEF)及左室Tei指数的差异。探讨血浆BNP浓度与心功能的相关性,分析血浆BNP浓度与Tei指数的相关性。结果心功能分级Ⅱ组血清BNP浓度[(6.8±1.2)ng/L]、左心室Tei指数(0.63±0.08)均显著高于心功能分级Ⅰ组[(5.4±1.3)ng/L,(0.48±0.11)],差异均有统计学意义(t=1.92, 3.01,均P<0.05)。两组患者这两项指标均高于健康对照组[(3.7±1.5)ng/L,(0.33±0.09)],差异均有统计学意义(t=2.14、2.28、4.19、6.14,均P<0.05)。心功能分级Ⅱ组LVEF显著低于心功能分级Ⅰ组(t=5.00, P<0.05),两组LVEF均显著低于健康对照组(t=10.32, 4.51,均P<0.05)。随着心功能不全严重程度的加重,BNP、Tei指数逐渐升高(F=3.054、3.491,均P<0.05), LVEF值逐渐降低(F=12.50, P<0.05)。同时,线性相关分析显示血浆BNP浓度与左室Tei指数呈正相关(r=0.69, P<0.01)。结论干预前血浆BNP联合Tei指数能快速、准确地评价先天性心脏病患儿左心室功能。作为临床检测的敏感指标,具有临床应用价值。关键词:心脏缺陷;先天性;血管成形术,球囊,冠状动脉;术前时期;利钠肽,脑;左为心室功能;孩子
{"title":"Clinical value of plasma BNP combined with Tei index in evaluating left ventricular function in children with congenital heart disease before interventional therapy","authors":"Tugui Li, J. Chen","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.05.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.05.003","url":null,"abstract":"Objective \u0000To explore the clinical value of combined detection of plasma BNP and Tei index in evaluating left ventricular function in children with congenital heart disease before interventional therapy. \u0000 \u0000 \u0000Methods \u0000From April 2017 to April 2019, a total of 60 children with congenital heart disease who were going to receive interventional therapy in Dachong Hospital of Zhongshan and Boai Hospital of Zhongshan were selected as observation subjects, and the patients were divided into cardiac function class Ⅰ group and cardiac function class Ⅱ group according to NYHA cardiac function classification, with 30 cases in each group.At the same time, 30 normal children were selected as healthy control group.The differences of plasma BNP concentration, left ventricular ejection fraction(LVEF) and left ventricular Tei index in different group were compared.The correlation between the plasma concentration and the cardiac function was investigated, and the correlation between the plasma BNP concentration and the Tei index was analyzed. \u0000 \u0000 \u0000Results \u0000The concentration of serum BNP[(6.8±1.2)ng/L] and the Tei index of left ventricle (0.63±0.08) in the cardiac function class Ⅱ group were significantly higher than those in the cardiac function class Ⅰ group[(5.4±1.3)ng/L, (0.48±0.11)], and the differences were statistically significant (t=1.92, 3.01, all P<0.05). These two indicators of the two groups were higher than those of the healthy control group[(3.7±1.5)ng/L, (0.33±0.09)], the differences were statistically significant(t=2.14, 2.28, 4.19, 6.14, all P<0.05). In addition, the LVEF of the cardiac function class Ⅱ group was significantly lower than that of the cardiac function class Ⅰ group(t=5.00, P<0.05), and the LVEF of the two groups were significantly lower those that of the healthy control group(t=10.32, 4.51, all P<0.05). With the increase of severity of cardiac insufficiency, the BNP and Tei index gradually increased(F=3.054, 3.491, all P<0.05), and the LVEF value decreased gradually (F=12.50, P<0.05). At the same time, the linear correlation analysis showed that the plasma BNP concentration had a positive correlation with the left ventricular Tei index(r=0.69, P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Plasma BNP combined with Tei index can quickly and accurately assess the left ventricular function in children with congenital heart disease before intervention.As a sensitive index for clinical detection, it has clinical application value. \u0000 \u0000 \u0000Key words: \u0000Heart defects, congenital; Angioplasty, balloon, coronary; Preoperative period; Natriuretic peptide, brain; Ventricular function, left; Child","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease 扩大肿块切除术治疗甲状腺单一良性疾病的临床疗效
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.019
Jian Xu, Yuanjiang Zhang, K. Jin
Objective To investigate the clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease of different sizes. Methods From June 2008 to June 2011, 132 patients with single benign thyroid lesion in the Second People′s Hospital of Changshu were selected as observation group.According to the size of the lump, 132 patients with single benign thyroid disease were divided into two groups: ≤2cm group(64 patients) and >2cm group(68 patients). In addition, 62 patients with single benign thyroid lesion underwent subtotal thyroidectomy at the same time were randomly selected as control group.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost and postoperative complications (hoarseness, water bucking, low calcium, hypothyroidism, tumor recurrence) of the two groups were recorded and compared with the control group. Results The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost of ≤2cm group were less or shorter than those of the control group[(3.6±0.4)cm vs.(4.5±0.6)cm, (40.1±9.6)min vs.(76.2±15.3)min, (52.2±17.8)mL vs.(82.1±16.8)mL, (49.8±15.7)mL vs.(78.1±12.4)mL, (4.9±0.9)d vs.(6.1±1.2)d, (7125.2±219.4)CNY vs.(8321.2±308.1)CNY, t=9.935, 15.917, 9.690, 11.205, 6.363, 25.161, all P 0.05). The operating time, hospital cost of >2cm group were less than those of the control group[(49.6±12.7)min vs.(76.2±15.3)min, (7 641.6±382.4)CNY vs.(8 321.2±308.1)CNY, t=10.820, 11.090, all P 0.05). The incidences of postoperative hoarseness, water bucking, low calcium and hypothyroidism of ≤2cm group had no statistically significant differences compared with those of the control group (χ2=2.175, 0.443, 1.105, 1.670, all P>0.05). The patients were followed-up for 7-10 years, the postoperative recurrence rate in >2cm group was higher than that in the control group[10.3%(7/68) vs.1.6%(1/62), χ2=4.232, P<0.05]. Conclusion Compared with conventional subtotal thyroidectomy, extended lumpectomy in the treatment of patients with small single benign thyroid disease(≤2cm) has good effect.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost, postoperative hoarseness and postoperative hypothyroidism are less than subtotal thyroidectomy.And it don't increase tumor recurrence rate of ipsilateral thyroid gland.So it is worthy of clinical application.But it is not suitable for larger single benign thyroid disease (>2cm) because of higher recurrence rate. Key words: Thyroid diseases; Neoplasms; Thyroidectomy; Hypothyroidism; Postoperative complications
目的探讨扩大结节切除术治疗不同大小甲状腺良性疾病的临床疗效。方法选择常熟市第二人民医院2008年6月至2011年6月收治的132例甲状腺良性病变患者作为观察组。根据肿块大小,132例甲状腺良性疾病患者分为≤2cm组(64例)和>2cm组(68例)。此外,随机选择62例同时行甲状腺次全切除术的甲状腺良性病变患者作为对照组。记录两组的切口大小、手术时间、术中出血量、术后引流量、住院天数、住院费用和术后并发症(声音嘶哑、水肿、低钙、甲状腺功能减退、肿瘤复发),并与对照组进行比较。结果切口大小、手术时间、术中出血量、术后引流量、住院天数、,≤2cm组的住院费用小于或短于对照组[(3.6±0.4)cm vs.(4.5±0.6)cm,(40.1±9.6)min vs.(76.2±15.3)min,(52.2±17.8)mL vs.(82.1±16.8)mL,(49.8±15.7)mL vs(78.1±12.4)mL,[(4.9±0.9)d vs.(6.1±1.2)d,[(7125.2±219.4)CNY vs.(8321.2±308.1)CNY,t=9.935,15.917,9.690,11.205,6.363,25.161,均P<0.05),2cm以上组住院费用低于对照组[(49.6±12.7)minvs.(76.2±15.3)min,(7641.6±382.4)CNY vs.(8321.2±308.1)CNY,t=10.820,11.090,均P<0.05](χ2=2.175,0.443,1.105,1.670,均P>0.05)。随访7-10年,>2cm组术后复发率高于对照组[10.3%(7/68)vs.1.6%(1/62),χ2=4.232,P2cm),因为复发率较高。关键词:甲状腺疾病;肿瘤;甲状腺切除术;甲状腺功能减退;术后并发症
{"title":"Clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease","authors":"Jian Xu, Yuanjiang Zhang, K. Jin","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.05.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.05.019","url":null,"abstract":"Objective \u0000To investigate the clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease of different sizes. \u0000 \u0000 \u0000Methods \u0000From June 2008 to June 2011, 132 patients with single benign thyroid lesion in the Second People′s Hospital of Changshu were selected as observation group.According to the size of the lump, 132 patients with single benign thyroid disease were divided into two groups: ≤2cm group(64 patients) and >2cm group(68 patients). In addition, 62 patients with single benign thyroid lesion underwent subtotal thyroidectomy at the same time were randomly selected as control group.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost and postoperative complications (hoarseness, water bucking, low calcium, hypothyroidism, tumor recurrence) of the two groups were recorded and compared with the control group. \u0000 \u0000 \u0000Results \u0000The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost of ≤2cm group were less or shorter than those of the control group[(3.6±0.4)cm vs.(4.5±0.6)cm, (40.1±9.6)min vs.(76.2±15.3)min, (52.2±17.8)mL vs.(82.1±16.8)mL, (49.8±15.7)mL vs.(78.1±12.4)mL, (4.9±0.9)d vs.(6.1±1.2)d, (7125.2±219.4)CNY vs.(8321.2±308.1)CNY, t=9.935, 15.917, 9.690, 11.205, 6.363, 25.161, all P 0.05). The operating time, hospital cost of >2cm group were less than those of the control group[(49.6±12.7)min vs.(76.2±15.3)min, (7 641.6±382.4)CNY vs.(8 321.2±308.1)CNY, t=10.820, 11.090, all P 0.05). The incidences of postoperative hoarseness, water bucking, low calcium and hypothyroidism of ≤2cm group had no statistically significant differences compared with those of the control group (χ2=2.175, 0.443, 1.105, 1.670, all P>0.05). The patients were followed-up for 7-10 years, the postoperative recurrence rate in >2cm group was higher than that in the control group[10.3%(7/68) vs.1.6%(1/62), χ2=4.232, P<0.05]. \u0000 \u0000 \u0000Conclusion \u0000Compared with conventional subtotal thyroidectomy, extended lumpectomy in the treatment of patients with small single benign thyroid disease(≤2cm) has good effect.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost, postoperative hoarseness and postoperative hypothyroidism are less than subtotal thyroidectomy.And it don't increase tumor recurrence rate of ipsilateral thyroid gland.So it is worthy of clinical application.But it is not suitable for larger single benign thyroid disease (>2cm) because of higher recurrence rate. \u0000 \u0000 \u0000Key words: \u0000Thyroid diseases; Neoplasms; Thyroidectomy; Hypothyroidism; Postoperative complications","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49397075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Study on the diagnostic value of multimodal ultrasound in thyroid microcarcinoma 多模态超声对甲状腺微癌诊断价值的探讨
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.016
Yanhua Zhao, Qinglan Zhang, Xiao-Qiang Zhou
Objective To study the diagnostic value of multimodal ultrasound in thyroid microcarcinoma(TMC). Methods The clinical data of 203 TMC patients in the Sixth Hospital of Shanxi Medical University from March 2015 to January 2019 were retrospectively analyzed.The preoperative multimodal ultrasound results [high frequency ultrasonography(HFU), color Doppler (DU), ultrasonic elastography (UE)] were collected, the postoperative pathological results were seen as the gold standard, and the consistency of multimodal ultrasound diagnosis and the pathological results was analyzed, the diagnosis effect index of multimodal ultrasound was calculated, ROC curve was used to analyze the diagnostic value of multimodal ultrasound for TMC. Results The diagnostic results of HFU, UE were highly consistent with the postoperative pathological results (0.8 0.9). DU had medium diagnostic value for TMC (0.7≤AUC≤0.9). Conclusion Multimodal ultrasonography has high diagnostic value for TMC, and it can be used in many fields such as clinical diagnosis, efficacy evaluation and reexamination due to its good repeatability and non-invasive. Key words: Thyroid neoplasms; Ultrasonography; Ultrasonography, doppler, color; Elasticity imaging techniques; ROC curve; Area under curve; Diagnosis; Case-control studies
目的探讨多模态超声对甲状腺微癌的诊断价值。方法回顾性分析山西医科大学第六医院2015年3月至2019年1月收治的203例TMC患者的临床资料。收集术前多模态超声结果[高频超声(HFU)、彩色多普勒(DU)、超声弹性成像(UE)],以术后病理结果为金标准,分析多模态超声诊断与病理结果的一致性,计算多模态超声诊断效果指标,采用ROC曲线分析多模态超声对TMC的诊断价值。结果HFU、UE的诊断结果与术后病理结果高度吻合(0.8 - 0.9)。DU对TMC的诊断价值中等(0.7≤AUC≤0.9)。结论多模态超声对TMC具有较高的诊断价值,可用于临床诊断、疗效评价及复查等多个领域,重复性好,无创。关键词:甲状腺肿瘤;超声;彩超,多普勒;弹性成像技术;ROC曲线;曲线下面积;诊断;病例对照研究
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引用次数: 0
Clinical observation of recombinant human growth hormone in the treatment of growth hormone deficiency 重组人生长激素治疗生长激素缺乏症的临床观察
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.008
Chun-ya Ni
Objective To investigate the clinical effect of recombinant human growth hormone (rhGH) in the treatment of children with growth hormone deficiency and its effect on thyroid function. Methods From June 2016 to June 2018, 81 children with growth hormone deficiency in Da Jiangdong Hospital of Hangzhou were selected.The rhGH was given 1 time before bedtime, and the treatment course was 6 months.The growth and development, bone metabolism and thyroid function were compared before treatment, 3 months and 6 months after treatment. Results The height and growth rate at 3 months after treatment [(131.76±2.28)cm, (10.40±0.87)cm/year] and at 6 months after treatment [(134.83)cm, (11.74±0.72)cm/year] were higher than those before treatment [(127.32±3.49)cm, (4.32±1.08)cm/year] (F=7.973, P=0.000, F=12.314, P=0.000), which at 6 months after treatment were higher than those 3 months after treatment (height: t=9.586, 16.405, growth rate: t=39.457, 51.448, P=0.000). There was no statistically significant difference in BMI among before treatment [(17.21±4.28)kg/m2], 3 months after treatment [(17.86±5.14)kg/m2] and 6 months after treatment [(18.01±4.35)kg/m2] (F=0.762, P=0.391). The serum levels of BGP and ALP at 3 months after treatment [(7.19±0.38)ng/mL, (129.34±8.97)U/L] and at 6 months after treatment [(7.94±0.63)ng/mL, (154.67±10.42)U/L] were higher than those before treatment [(6.38±0.57)ng/mL, (108.49±6.51)U/L] (F=8.971, P=0.000, F=15.427, P=0.000), and the levels of BGP and ALP at 6 months after treatment were higher than those 3 months after treatment (t=9.175, P=0.000, t=16.581, P=0.000). There were no statistically significant differences in serum FT3, TSH and FT4 levels before treatment, 3 months after treatment and 6 months after treatment (F=0.893, P=0.287, F=0.472, P=0.517, F=1.084, P=0213). Conclusion rhGH has significant clinical effects on children with growth hormone deficiency, and has no significant effect on thyroid function, which is worthy of clinical reference. Key words: Growth disorders; Human growth hormone; Thyroid function tests
目的探讨重组人生长激素(rhGH)治疗儿童生长激素缺乏症的临床疗效及其对甲状腺功能的影响。方法选择2016年6月至2018年6月杭州市大江东医院生长激素缺乏症患儿81例。rhGH于睡前给药1次,疗程6个月。比较治疗前、治疗后3个月和6个月的生长发育、骨代谢和甲状腺功能。结果治疗后3个月的身高和生长速度[(131.76±2.28)cm,(10.40±0.87)cm/年]和治疗后6个月的[(134.83)cm,治疗后6个月高于治疗后3个月(身高:t=9.586,16.405,生长速度:t=39.457,51.448,P=0.000),治疗前BMI差异无统计学意义[(17.21±4.28)kg/m2],治疗后3个月[(17.86±5.14)kg/m2]和治疗后6个月[[(18.01±4.35)kg/m2](F=0.762,P=0.391)(F=8.971,P=0.000,F=15.427,P=0.000),且治疗后6个月BGP和ALP水平高于治疗后3个月(t=9.175,P=0.0000,t=16.581,P=0.000。结论rhGH治疗儿童生长激素缺乏症疗效显著,对甲状腺功能无明显影响,值得临床参考。关键词:生长障碍;人体生长激素;甲状腺功能测试
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引用次数: 0
Diagnostic performance of T-SPOT test for pediatric tuberculosis T-SPOT试验对儿童结核病的诊断价值
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.005
Pin-Hui Wang, Yong-qiang Deng
Objective To investigate the diagnostic performance of T-SPOT test for pediatric tuberculosis (TB). Methods The results of T-SPOT and PPD in 67 TB children and 71 TB-excluded children that diagnosed and treated in the People's Hospital of Jianyang from June 2014 to May 2017 were retrospectively analyzed.The diagnostic efficacy and consistency of the two tests, and the diagnostic efficacy of combined examination were evaluated. Results The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden′s index of T-SPOT were 88.1%, 94.4%, 93.7%, 89.3%, 15.6, 0.13, 0.83, respectively.While the above parameters of PPD were 68.7%, 74.6%, 71.9%, 71.6%, 2.71, 0.42, 0.43, respectively.T-SPOT had higher sensitivity, specificity, positive predictive value, negative predictive value compared with PPD, and the differences were statistically significant(χ2=7.44, 10.54, 10.51, 7.45, all P 0.05). The positive rate of T-SPOT was higher in 5-18 years old group than that in 0-4 years old group(95.1% vs.76.2 %, χ2=5.01, P 0.05). Conclusion T-SPOT outperformed PPD in diagnostic assistance of pediatric TB overall.The diagnostic superiority is noticeable in the>4-18 years old other than the 0-4 years old.Compared with T-SPOT alone, combined tests should not be regarded to have increased sensitivity. Key words: T-lymphocytes; Enzyme-linked immunospot assay; Tuberculosis, pulmonary; Mycobacterium tuberculosis; Tuberculin test; Diagnosis; Child
目的探讨T-SPOT试验对儿童肺结核(TB)的诊断价值。方法回顾性分析2014年6月至2017年5月在简阳市人民医院诊治的67例肺结核患儿和71例肺结核排除患儿的T-SPOT和PPD结果。评估了两种检查的诊断效果和一致性,以及联合检查的诊断疗效。结果T-SPOT的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比和Youden指数分别为88.1%、94.4%、93.7%、89.3%、15.6、0.13和0.83。PPD的上述参数分别为68.7%、74.6%、71.9%、71.6%、2.71、0.42、0.43。T-SPOT与PPD相比具有更高的敏感性、特异性、阳性预测值、阴性预测值,差异有统计学意义(χ2=7.44,10.54,10.51,7.45,均P 0.05),5~18岁组T-SPOT阳性率高于0~4岁组(95.1%vs.76.2%,χ2=5.01,P 0.05)。诊断优势在>4-18岁的人群中明显高于0-4岁的人群。与单独的T-SPOT相比,联合测试不应被认为具有增加的灵敏度。关键词:T淋巴细胞;酶联免疫斑点法;肺结核;结核分枝杆菌;结核菌素试验;诊断;儿童
{"title":"Diagnostic performance of T-SPOT test for pediatric tuberculosis","authors":"Pin-Hui Wang, Yong-qiang Deng","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.05.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.05.005","url":null,"abstract":"Objective \u0000To investigate the diagnostic performance of T-SPOT test for pediatric tuberculosis (TB). \u0000 \u0000 \u0000Methods \u0000The results of T-SPOT and PPD in 67 TB children and 71 TB-excluded children that diagnosed and treated in the People's Hospital of Jianyang from June 2014 to May 2017 were retrospectively analyzed.The diagnostic efficacy and consistency of the two tests, and the diagnostic efficacy of combined examination were evaluated. \u0000 \u0000 \u0000Results \u0000The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden′s index of T-SPOT were 88.1%, 94.4%, 93.7%, 89.3%, 15.6, 0.13, 0.83, respectively.While the above parameters of PPD were 68.7%, 74.6%, 71.9%, 71.6%, 2.71, 0.42, 0.43, respectively.T-SPOT had higher sensitivity, specificity, positive predictive value, negative predictive value compared with PPD, and the differences were statistically significant(χ2=7.44, 10.54, 10.51, 7.45, all P 0.05). The positive rate of T-SPOT was higher in 5-18 years old group than that in 0-4 years old group(95.1% vs.76.2 %, χ2=5.01, P 0.05). \u0000 \u0000 \u0000Conclusion \u0000T-SPOT outperformed PPD in diagnostic assistance of pediatric TB overall.The diagnostic superiority is noticeable in the>4-18 years old other than the 0-4 years old.Compared with T-SPOT alone, combined tests should not be regarded to have increased sensitivity. \u0000 \u0000 \u0000Key words: \u0000T-lymphocytes; Enzyme-linked immunospot assay; Tuberculosis, pulmonary; Mycobacterium tuberculosis; Tuberculin test; Diagnosis; Child","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42464787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical effect of directional soft-channel puncture and suction drainage in the treatment of spontaneous cerebral hemorrhage in basal ganglia and its influence on neurological function 定向软通道穿刺抽吸引流治疗基底节自发性脑出血的临床疗效及其对神经功能的影响
Pub Date : 2020-03-01 DOI: 10.3760/CMA.J.ISSN.1008-6706.2020.05.018
J. Xiong
Objective To investigate the clinical effect of directional soft-channel puncture and suction drainage in the treatment of spontaneous cerebral hemorrhage in basal ganglia and its influence on neurological function. Methods From January 2017 to December 2018, 61 patients with spontaneous cerebral hemorrhage in basal ganglia were selected in the First People's Hospital of Jiande.According to the random table method, they were divided into control group (30 cases) and observation group (31 cases). The control group was treated conservatively, while the observation group was treated with directional soft-channel puncture and suction drainage combined with conventional therapy.The therapeutic effects, NIHSS score, ADL score, brain edema volume change and complications were compared before treatment, 1 week after treatment and 2 weeks after treatment. Results The total effective rate of the observation group (96.77%) was higher than that of the control group (76.67%) (χ2=3.989, P<0.05). The NIHSS score of the observation group was (16.54±2.19)points at one week after treatment and (9.12±1.24)points at two weeks after treatment, which were lower than those of the control group [(19.98±1.65)points and (13.25±2, 37)points] (t=6.911, 8.568, all P<0.05). The ADL score of the observation group was (43.42±5.67)points at one week after treatment and (63.98±3.46)points at two weeks after treatment, which were higher than those of the control group [(37.89±2.86)points and (52.37±4.10)points] (t=4.785, 11.967, all P<0.05). The volume of brain edema of the observation group was (12.08±2.14)mL at 1 week after treatment and (4.37±0.89)mL at 2 weeks after treatment, which were lower than those of the control group [(16.89±3.20)mL and (9.74±1.07)mL] (t=6.922, 21.339, all P<0.05). The incidence of complications in the observation group (6.45%) was lower than that in the control group (30.00%) (χ2=5.720, P<0.05). Conclusion Directional soft-channel puncture and suction drainage is effective in the treatment of spontaneous cerebral hemorrhage in basal ganglia, which can reduce the degree of neurological deficit and with fewer complications, and it is worthy of clinical study. Key words: Cerebral hemorrhage; Paracentesis; Neurological deficit; Activity of daily living; Brain edema volume; Complications
目的探讨定向软通道穿刺抽吸引流治疗基底节区自发性脑出血的临床疗效及其对神经功能的影响。方法选择建德市第一人民医院2017年1月至2018年12月收治的61例基底节区自发性脑出血患者,按随机表法分为对照组(30例)和观察组(31例)。对照组采用保守治疗,观察组采用定向软通道穿刺吸引引流结合常规治疗。比较治疗前、治疗后1周和治疗后2周的疗效、NIHSS评分、ADL评分、脑水肿体积变化及并发症。结果观察组总有效率(96.77%)高于对照组(76.67%)(χ2=3.989,均低于对照组[(19.98±1.65)分和(13.25±2.37)分](t=6.911,8.568,均P<0.05),高于对照组[(37.89±2.86)分和(52.37±4.10)分](t=4.785、11.967,均P<0.05),观察组治疗后1周脑水肿体积为(12.08±2.14)mL,观察组并发症发生率(6.45%)低于对照组(30.00%)(χ2=5.720,P<0.05)神经节,可以降低神经功能缺损的程度,并发症少,值得临床研究。关键词:脑出血;胸腔穿刺术;神经系统缺陷;日常生活活动;脑水肿体积;并发症
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引用次数: 0
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中国基层医药
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