武汉大学学报(医学版)最新文献

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Coronavirus disease 2019 combined with venous thromboembolism: Clinical features and prevention 冠状病毒病2019合并静脉血栓栓塞:临床特点及预防

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0270

P. Tang, H. Deng, H. Liu, J. Li, X. Yu, J. Zhuang, Y. Zhang, Q. Deng, Q. Li, J. Chen

Objective: To analyze the clinical characteristics and control methods of coronavirus disease 2019 (COVID-19) complicated with venous thromboembolism(VTE), and to provide scientific basis for disease prevention, diagnosis and treatment. Methods: We retrospectively studied the cases of COVID-19 complicated with VTE in Renmin Hospital of Wuhan University from January 30, 2020 to March 19, 2020, and their clinical features, results of exmaninations, treatment methods, complications, and prognosis were reviewed. Results: Among the 1 448 COVID-19 patients, 17(1.17%) were VTE positive, 60-69 years old patients were more common. The main clinical types were critical (64.7%) and severe (35.7%) types. The main clinical symptoms were lower extremity swelling (70.6%) and pain (35.7%);58.8% of the patients had a history of high risk factors related to VTE. Most VTE patients were peripheral (58.8%) and involved bilateral limbs (41.2%). The proportion of neutrophils, D-dimer and fibrin degradation products at the last examination were lower than those on admission to the hospital, while the total number and proportion of lymphocytes were higher. Of the 17 VTE cases, 64.7% received venous catheterization, 58.8% received endotracheal intubation or tracheotomy, and 2 patients received extracorporeal membrane oxygenation (ECMO). The rate of bleeding was as high as 53%, and the risk of cardiovascular and cerebrovascular accidents was very high;the prognosis of the patients was poor, and the mortality rate was 23.5%. The cure rate was 17.6%, and the improvement rate was 47.1%. Two patients were still in critically ill. Conclusion: Venous thromboembolism was common in elderly COVID-19 patients with severe types and critical types. Most patients were male and characterized by atypical symptoms, and the early active VTE risk assessment and prevention procedures should be adopted. The risk for bleeding and cardiovascular/cerebrovascular accidents was high, although most cases had good outcomes after active treatment. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

目的:分析2019冠状病毒病(COVID-19)合并静脉血栓栓塞(VTE)的临床特点及控制方法，为疾病的预防、诊断和治疗提供科学依据。方法:回顾性分析2020年1月30日至2020年3月19日武汉大学人民医院新冠肺炎合并静脉血栓栓塞患者的临床特点、检查结果、治疗方法、并发症及预后。结果:1 448例COVID-19患者中，静脉血栓栓塞(VTE)阳性17例(1.17%)，以60 ~ 69岁患者多见。主要临床分型为危重型(64.7%)和重症型(35.7%)。主要临床症状为下肢肿胀(70.6%)和疼痛(35.7%);58.8%的患者有静脉血栓栓塞相关高危因素史。大多数静脉血栓栓塞患者为外周性(58.8%)，累及双侧肢体(41.2%)。末次检查中性粒细胞、d -二聚体和纤维蛋白降解产物比例低于入院时，淋巴细胞总数和比例高于入院时。17例静脉血栓栓塞患者中，64.7%接受静脉置管，58.8%接受气管插管或气管切开术，2例接受体外膜氧合(ECMO)。出血率高达53%，发生心脑血管意外的风险很高;患者预后较差，死亡率为23.5%。治愈率为17.6%，改良率为47.1%。两名患者仍处于危重状态。结论:老年COVID-19重症和危重型患者静脉血栓栓塞较为常见。患者多为男性，症状不典型，应采取早期主动静脉血栓栓塞风险评估和预防措施。出血和心脑血管事故的风险很高，尽管大多数病例在积极治疗后预后良好。©2021，武汉大学医学杂志编辑委员会。版权所有。

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引用次数: 0

Values of prognostic nutritional index in predicting the outcomes of COVID-19 patients 预后营养指数在预测COVID-19患者预后中的价值

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0304

D. Xie, D. Wen, Y. Liu

Objective: To assess the association between prognostic nutritional index (PNI) and survival in patients hospitalized for coronavirus disease 2019 (COVID-19). Methods: In this retrospective study, we collected data of COVID-19 patients in Wuhan Jinyintan Hospital. The PNI were calculated on the basis of blood test results. Results: The PNI in severe patients was significantly lower than that in mild group (29.7 versus 46.8, P<0.001);while the PNI value also showed signifcant difference between death group and survival group (28.15 versus 38.1, P<0.001). ROC analysis revealed that PNI was important for the diagnosis of severe COVID-19, and could be used as an independent predictor of survival in severe patients (P<0.01). Conclusion: Low prognostic nutritional index was remarkably associated with a poor prognosis in severe patients with SARS-CoV-2 pneumonia. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

目的:探讨2019冠状病毒病(COVID-19)住院患者预后营养指数(PNI)与生存率的关系。方法:采用回顾性研究方法，收集武汉市金银潭医院新冠肺炎患者资料。PNI是根据血液检测结果计算的。结果:重症患者PNI值显著低于轻症组(29.7比46.8,P<0.001)，死亡组与生存组PNI值也有显著差异(28.15比38.1,P<0.001)。ROC分析显示PNI对重症COVID-19的诊断有重要意义，可作为重症患者生存的独立预测因子(P<0.01)。结论:低预后营养指数与SARS-CoV-2重症肺炎患者预后不良显著相关。©2021，武汉大学医学杂志编辑委员会。版权所有。

引用次数: 0

Evaluation of psychological status of 82 patients with rectal cancer after operation in Wuhan epidemic area of COVID‑19 and the value of WeChat follow‑up by doctors 武汉新冠肺炎疫区82例直肠癌术后患者心理状态评价及医生微信随访价值

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0465

Z. Li, J. Chen, Y. Zhou, J. Li, F. Xiong, J. Xu, C. Chen, Q. Wang, Yilei Zhang

Objective: To investigate the postoperative psychological status of rectal cancer patients during the outbreak of coronavirus disease 2019 (COVID‑19) epidemic in Wuhan, and to evaluate the outcomes of WeChat follow‑up. Methods: A total of 41 patients with rectal cancer after operation were included into observation group and were followed up by doctors through WeChat, and another 41 postoperative cases without WeChat follow⁃up were set as control group. The Symptom Checklist 90 (SCL‑90), Self‑Rating Depression Scale (SDS), Self‑Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate all the patients' postoperative psychological status before discharge from hospital and two months later. Results: After two months, the scores of SCL‑90, SAS, and SDS, respectively,of all patients showed significantly changes (t=1.487, 1.203, and 1.578, respectively, all P 0.05), but the total scores of PSQI in observation group showed a significant decrease after two months' WeChat follow⁃up and were lower than in control group (t=8.369, P<0.05). Conclusion: During the outbreaking of COVID⁃19 epidemic in Wuhan, the scores of SCL‑90, SAS, and SDS in the post⁃operative patients were all decreased, but the total scores of PSQI in WeChat follow‑up group was significantly lower than that in the control group. Doctors' active WeChat follow‑up on patients can alleviate their fear, anxiety, depression, and especially, and improve their sleep quality. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

目的:了解2019冠状病毒病(COVID - 19)在武汉流行期间直肠癌患者术后的心理状态，并评价微信随访结果。方法:将41例直肠癌术后患者作为观察组，由医生通过微信进行随访;将41例术后无微信随访的患者作为对照组。采用症状自评量表(SCL - 90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和匹兹堡睡眠质量指数(PSQI)评估所有患者术后出院前和2个月后的心理状态。结果:随访2个月后，所有患者的SCL - 90、SAS、SDS评分均有显著变化(t=1.487、1.203、1.578,P均为0.05)，观察组患者PSQI总分在随访2个月后显著降低，且低于对照组(t=8.369, P<0.05)。结论:武汉新冠肺炎疫情期间，手术后患者SCL - 90、SAS、SDS评分均下降，但微信随访组PSQI总分显著低于对照组。医生对患者积极的微信随访可以减轻他们的恐惧、焦虑、抑郁，尤其是改善他们的睡眠质量。©2021，武汉大学医学杂志编辑委员会。版权所有。

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引用次数: 0

Impact of the COVID⁃19 outbreak on depression and anxiety among perinatal women in Wuhan 新冠肺炎疫情对武汉市围产期妇女抑郁焦虑的影响

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0582

X. Wan, J. Hou, M. Hu

Objective: To evaluate the effect and analysis of coronavirus disease 2019 (COVID‑19) on depression and anxiety of perinatal women in Wuhan. Methods: A total of 176 perinatal women were selected, who were delivered in Renmin Hospital of Wuhan University from January 24 to March 29, 2020. The general information of the patients was evaluated. The anxiety self‑assessment scale (SAS) and depression self‑assessment (SDS) were used before delivery. The Edinburgh Postpartum Depression Scale (EPDS) was used to assess depression from 10 days to 14 days after delivery. The main factors affecting maternal depression and anxiety were investigated and analyzed. Results: During the outbreak of COVID‑19, the incidence of anxiety (SAS score ≥50) was 47.73% (84 cases), and the incidence of depression (SDS score ≥0.5) was 54.55% (96 cases) before delivery. The incidence of depression (EPDS score≥0.5) was 44.89% (79 cases) after delivery. The prenatal SAS score was related to depression after delivery ( r =0.641, P <0.001), and the prenatal SDS score was also related to depression after delivery ( r =0.740, P <0.001). Logistic analysis indicated that worrying about the risk of COVID‑19 infection ( OR =3.816, 95% CI :1.688⁃8.627, P =0.001), poor sleep quality ( OR =2.448, 95% CI : 1.053~5.694, P =0.038) and dyspnea in mask ( OR =2.464, 95% CI : 1.009⁃6.014, P =0.048) were the main risk factors for postpartum depression in pregnant women during outbreak of COVID‑19. Conclusion: The outbreak of COVID‑19 increased the incidence of maternal depression and anxiety during perinatal period, which was significantly related to the combination of multiple risk factors caused by the outbreak of COVID‑19. These provide an effective prevention strategy for preventing the postpartum depression during the outbreak of COVID‑19. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

目的:评价和分析新型冠状病毒病2019 (COVID - 19)对武汉市围产期妇女抑郁和焦虑的影响。方法:选取2020年1月24日至3月29日在武汉大学人民医院分娩的围产期产妇176例。评估患者的一般信息。分娩前采用焦虑自评量表(SAS)和抑郁自评量表(SDS)。采用爱丁堡产后抑郁量表(EPDS)评估产后10 ~ 14天的抑郁情况。对影响产妇抑郁、焦虑的主要因素进行调查分析。结果:在COVID - 19暴发期间，分娩前焦虑(SAS评分≥50)发生率为47.73%(84例)，抑郁(SDS评分≥0.5)发生率为54.55%(96例)。产后抑郁(EPDS评分≥0.5)发生率为44.89%(79例)。产前SAS评分与产后抑郁相关(r =0.641, P <0.001)，产前SDS评分与产后抑郁相关(r =0.740, P <0.001)。Logistic分析显示，担心感染风险(OR =3.816, 95% CI:1.688⁃8.627,P =0.001)、睡眠质量差(OR =2.448, 95% CI: 1.053~5.694, P =0.038)和口罩呼吸困难(OR =2.464, 95% CI: 1.009⁃6.014,P =0.048)是COVID - 19暴发期间孕妇产后抑郁的主要危险因素。结论:COVID - 19的爆发增加了围产期孕产妇抑郁和焦虑的发生率，这与COVID - 19爆发导致的多种危险因素共同作用显著相关。这些都为预防COVID - 19爆发期间的产后抑郁症提供了有效的预防策略。©2021，武汉大学医学杂志编辑委员会。版权所有。

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引用次数: 1

Echocardiographic findings and clinical features of COVID‑19 patients COVID - 19患者的超声心动图表现和临床特征

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0605

H. Wang, Q. Deng, Y. Zhang, W. Hu, Y. Cheng, X. Zhou, J. Yan, H. Ping, B. Hu

Objective: To analyze the echocardiographic manifestations and clinical features of 98 patients with COVID‑19, and to explore whether there is potential myocardial injury in COVID‑19 patients. Methods: Patients diagnosed with COVID‑19 in Renmin Hospital of Wuhan University were retrospectively investigated. Echocardiography was performed on all the patients. Diameters of chamber, thickness of ventricular wall were measured routinely to explore whether there were structural changes, while left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) were assessed for function evaluation. Signs of pericardial effusion and pulmonary hypertension were also focused on in our study. At the same time, clinical data related to the myocardial injury was collected, including Troponin I (cTnI), creatine kinase‑MB (CKMB), and N‑terminal pro‑brain natriuretic peptide (NT‑pro BNP). Patients were divided into the severe group and the non‑severe group, and the differences of ultrasound results and clinical data between the two groups were analyzed. Results: No typical echocardiographic signs of viral myocarditis were observed in our study, such as ventricular enlargement, thickening of the ventricular wall and cardiac dysfunction. Positive findings in echocardiography observed mainly included signs of pericardial effusion and pulmonary hypertension. By comparing the clinical data of the two groups, the age of the severe group was significantly older (median age 66.0 years [IQR: 56.0‑77.0] vs 59.0 years [IQR: 42.0‑69.0], P=0.02), and the levels of CRP, procalcitonin and D‑Dimer were significantly increased in the severe group. Conclusion: Although the echocardiography of patients with COVID‑19 had no typical manifestations, the level of myocardial markers was significantly increased in severe patients, suggesting the potential myocardial injury. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

目的:分析98例COVID - 19患者的超声心动图表现及临床特征，探讨COVID - 19患者是否存在潜在的心肌损伤。方法:对武汉大学人民医院诊断为COVID - 19的患者进行回顾性调查。所有患者均行超声心动图检查。常规测量室径、室壁厚度，观察是否有结构改变，评估左室射血分数(LVEF)和三尖瓣环平面收缩偏移(TAPSE)，评价功能。心包积液和肺动脉高压的征象也是我们研究的重点。同时收集与心肌损伤相关的临床资料，包括肌钙蛋白I (cTnI)、肌酸激酶MB (CKMB)、N端脑利钠肽前体(NT - pro BNP)。将患者分为重症组和非重症组，分析两组超声检查结果及临床资料的差异。结果:本研究未见病毒性心肌炎的典型超声心动图征象，如心室增大、室壁增厚和心功能障碍。超声心动图阳性表现主要包括心包积液和肺动脉高压。对比两组临床资料，重症组患者年龄明显偏大(中位年龄66.0岁[IQR: 56.0 ~ 77.0] vs中位年龄59.0岁[IQR: 42.0 ~ 69.0]， P=0.02)，且重症组CRP、降钙素原、D -二聚体水平明显升高。结论:虽然COVID - 19患者超声心动图无典型表现，但重症患者心肌标志物水平明显升高，提示可能存在心肌损伤。©2021，武汉大学医学杂志编辑委员会。版权所有。

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引用次数: 0

Laboratory test analysis of sixty-two COVID-19 patients 62例新冠肺炎患者实验室检测分析

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2020-11-15 DOI: 10.14188/J.1671⁃8852.2020.0220

Dan Li, Menglong Wang, Bing He, Yao Xu, Xiaoyang Zhou, Wen-jing Li, Wenfeng Lu, Jun Wan

引用次数: 9

CT features and dynamic changes of different clinical types of COVID-19 不同临床类型COVID-19的CT特征及动态变化

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2020-11-15 DOI: 10.14188/J.1671⁃8852.2020.0179

Hongmei Yu, Shenglan Li, Gang Deng, Miao Liu, Fu-Qiang Xing, Liguo Jiang, Yi Jiang

引用次数: 1

A case report of a critically ill COVID-19 patient with prolonged mechanical ventilation in prone position and literature review COVID-19危重患者俯卧位长时间机械通气1例报告并文献复习

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2020-11-15 DOI: 10.14188/J.1671⁃8852.2020.0151

Xiaowei Wu, Bin Song, Wen-juan Wu, W. Zou

A review To report one case of severe coronavirus disease 2019 (COVID19) with prolonged mech ventilation in prone position, and to review the related literature A case of severe COVID19 underwent prolonged(8 days) prostrate ventilation due to clin needs was retrospectively analyzed, and the literature was reviewed Respiratory compliance and oxygenation index were improved after prolonged prostration, but the outcomes were poor due to septic shock and multiple organ failure After sedation, COVID19 patients with mech ventilation can be considered to receive prone position ventilation after exclusion of contraindication If the patient′s oxygenation and respiratory mechanics improve, the time of prone position can be prolonged according to the situation

回顾性分析1例重症冠状病毒病(covid - 19)患者因临床需要延长(8天)俯卧通气，并复习相关文献。回顾性分析1例重症covid - 19患者延长俯卧通气后呼吸顺应性和氧合指数均有所改善，但镇静后因感染性休克和多器官功能衰竭而预后较差。covid - 19机械通气患者排除禁忌证后可考虑接受俯卧位通气。若患者氧合及呼吸力学改善，可根据情况延长俯卧位通气时间

引用次数: 0

Mental health status of medical staff during the outbreak of coronavirus disease 2019 2019冠状病毒病爆发期间医护人员的心理健康状况

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2020-09-15 DOI: 10.14188/J.1671-8852.2020.0154

Yueying Wang, X. Jia, Jiquan Song, Xuanzhen Lu, Zeng Li, K. Ouyang, Jun Xie

A review

引用次数: 5

Clinical application value of immunochromatography in detecting SARS-CoV-2 IgM and IgG antibodies 免疫层析法检测SARS-CoV-2 IgM和IgG抗体的临床应用价值

Q4 Medicine

Medical Journal of Wuhan University

Pub Date : 2020-09-15 DOI: 10.14188/J.1671-8852.2020.0193

Tengfei Bao, Junjuan Gu, Ying-juan Liu, Yongwei Duan, Xin Jin, Yawen Chen, Yirong Li, W. Xie

引用次数: 1

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