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Risk factors of lymph node metastasis in central region of thyroid micropapillary carcinoma-siftdesk 甲状腺微乳头状癌中央区淋巴结转移的危险因素分析
Pub Date : 1900-01-01 DOI: 10.25177/jas.4.2.ra.10814
Gang Zhang, Xing Zhao, Ming Zhao
Objective: To investigate the correlation between clinico-pathological features and lymph node metastasis of thyroid micropapillary carcinoma (PTMC). Methods: the clinico-pathological data of 142 cases of thyroid micropapillary carcinoma were collected, the relationship between sex, age, tumor location, multi-focality and cervical lymph node metastasis was analyzed. Results: There was a high rate of lymph node metastasis in male patients with PTMC. There was no significant correlation between age, multifocality and lymph node metastasis. Conclusion: The histological subtypes of PTMC have different clinicopathological characteristics and are important factors for cervical lymph node metastasis. Further evaluation of its histological classification is helpful for clinical treatment strategy.
目的:探讨甲状腺微乳头状癌(PTMC)临床病理特征与淋巴结转移的关系。方法:收集142例甲状腺微乳头状癌的临床病理资料,分析其性别、年龄、肿瘤部位、多灶性与颈部淋巴结转移的关系。结果:男性PTMC患者有较高的淋巴结转移率。年龄、多发灶性与淋巴结转移无明显相关性。结论:PTMC的组织学亚型具有不同的临床病理特征,是颈淋巴结转移的重要因素。进一步评价其组织学分型,有助于制定临床治疗策略。
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引用次数: 0
Risk Factors for Rescue Neuromuscular Blockade Reversal Using Sugammadex-siftdesk 使用sugammadex - sitftdesk逆转神经肌肉阻滞的危险因素
Pub Date : 1900-01-01 DOI: 10.25177/jas.4.2.ra.10809
Justin J. Turcotte, Mary E. King, Sohail N. Zaidi
Background: Previous studies have demonstrated the superiority of sugammadex over neostigmine for reversal of nondepolarizing neuromuscular blockade (NMB) reversal. However, its increased cost over neostigmine remains a barrier to use in many institutions. Aims: The purposes of this study were to compare the outcomes of patients receiving neostigmine alone vs. patients receiving neostigmine and sugammadex and to identify the risk factors for patients requiring sugammadex as a rescue neuromuscular blockade reversal agent. Methods: A retrospective observational study of general anesthesia cases using rocuronium or vecuronium for NMB at a single regional medical center from January 1, 2019 to March 30, 2021 was performed. Demographics, surgical details, and outcomes of patients receiving neostigmine only (N) were compared to those of patients receiving neostigmine followed by sugammadex (NS). A conditional logistic regression model was developed to identify predictors of patients requiring a rescue dose of sugammadex for NMB reversal. Results: A total of 7104 patients were included (N=6684, NS=420). In comparison to patients in the N group, those in the NS group experienced shorter duration from last NMB administration to first reversal, longer PACU recovery times, longer length of stay, and higher rates of reintubation. After risk adjustment, patients receiving NS were more likely to be female, of non-white race, have increased BMIs, and a greater comorbidity burden than those requiring N only. In comparison to patients undergoing general surgery, those undergoing thoracic surgery are at increased risk for requiring NS. A model for predicting which patients would receive NS was generated with an AUC of 0.681 (95% CI: 0.654-0.708), sensitivity of 78% and specificity of 48%. Conclusion: These findings may assist anesthesiologists in identifying which patients are likely to require sugammadex for rescue NMB reversal after use of neostigmine and are therefore suitable candidates for using sugammadex as a first-line therapy.
背景:先前的研究表明,在逆转非去极化神经肌肉阻断(NMB)逆转方面,糖马德优于新斯的明。然而,与新斯的明相比,它的成本增加仍然是许多机构使用的障碍。目的:本研究的目的是比较单独接受新斯的明与接受新斯的明和糖氨madex的患者的预后,并确定需要糖氨madex作为神经肌肉阻断逆转剂的患者的危险因素。方法:对2019年1月1日至2021年3月30日在某地区医疗中心使用罗库溴铵或维库溴铵全麻治疗NMB的病例进行回顾性观察研究。将仅接受新斯的明(N)的患者的人口统计学、手术细节和结果与同时接受新斯的明(NS)的患者进行比较。我们建立了一个条件logistic回归模型,以确定患者是否需要给药来逆转NMB。结果:共纳入7104例患者(N=6684, NS=420)。与N组患者相比,NS组患者从最后一次NMB给药到第一次逆转的时间更短,PACU恢复时间更长,住院时间更长,再插管率更高。风险调整后,接受NS治疗的患者更可能是女性,非白种人,bmi增加,比只需要N治疗的患者有更大的合并症负担。与接受普通外科手术的患者相比,接受胸外科手术的患者需要NS的风险增加。建立了预测患者接受NS的模型,AUC为0.681 (95% CI: 0.654-0.708),敏感性为78%,特异性为48%。结论:这些发现可以帮助麻醉师确定哪些患者在使用新斯的明后可能需要使用糖玛德来逆转NMB,因此适合使用糖玛德作为一线治疗的候选者。
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引用次数: 0
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SDRP Journal of Anesthesia & Surgery
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