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find Author "冯晓东" 3 results
  • Interpretation of European Stroke Organization (ESO) and European Academy of Neurology (EAN) Joint Guideline on Post-stroke Cognitive Impairment

    Post-stroke cognitive impairment (PSCI) is the most common dysfunction after stroke, which seriously affects patients’ quality of life and survival time. To strengthen the management and prevention of PSCI, the European Stroke Organization and the European Academy of Neurology jointly developed the guidelines for PSCI in 2021. This paper introduces the background, compilation method and structure, management suggestions and expert consensus of PSCI, the next research direction, etc. Compared with the current prevention and treatment measures of PSCI in China, it aims to provide methodological reference for Chinese scholars to develope PSCI guidelines and reference evidence for clinical prevention and treatment of PSCI.

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  • FUNCTION RECONSTRUCTION OF ANTERIOR AND MIDDLE COLUMN IN THORACOLUMBAR SPINAL TUBERCULOSIS BY ONE-STAGE ANTERIOR RADICAL DEBRIDEMENT

    Objective To summarize the effect of one-stage anterior debridement of infection in function reconstruction of anterior and middle column for the treatment of thoracolumbar spinal tuberculosis. Methods From January 2001 to January 2007, 65 patients with thoracolumbar spinal tuberculosis were treated with one-stage anterior debridement, decompression, autogenous bone grafts and internal fixation. There were 43 males and 22 females with an average age of 40.2 years (range, 19-64 years), including 18 cases of thoracic tuberculosis (T4-10), 44 cases of thoracolumbar tuberculosis (T11-L2) and 3 cases of lumbar tuberculosis (L3-5). The disease course was 3 months to 10 years (median 10 months). One segment was involved in 7 cases, two segments in 54 cases and three segments in 4 cases. In 14 cases with spinalcord injury, there were 5 cases of grade C and 9 cases of grade D according to Frankel classification. The kyphotic Cobb angle was 20-65° (41° on average). Results The operative time was 120-210 minutes (170 minutes on average), and the blood loss was 300-1 500 mL (600 mL on average). Fifty-eight patients were followed up for 1-6 years (23 months on average). Abscess occurred in 2 cases at 40 days and 3 months, and healed after symptomatic management. The other incisions achieved heal ing by first intention. The X-ray films showed bony fusion 4-12 months (6 months on average) after operation. No tuberculosis recurred. At 12 months after operation, pain disappeared, and there were 7 cases of grade D and 7 cases of grade E according to Frankel classification. The kyphotic Cobb angle was 0-33° (24° on average), showing statistically significant difference (P lt; 0.05) when compared with preoperation. Conclusion Early reconstruction of load-bearing function and stabil ity of anterior and middle column in the treatment of spinal tuberculosis is great significant. The appl ication of one-stage anterior surgery with debridement, decompression, autogenous bone grafts and internal fixation in the operative treatment of thoracolumbar tuberculosis is safe and effective after a rigorous anti-tuberculosis treatment.

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 经鼻高流量氧疗治疗急性呼吸衰竭的随机对照试验

    目的评价经鼻高流量氧疗治疗急性呼吸衰竭的临床效果。方法选择重症医学科收治的急性呼吸衰竭患者,用随机数字表法分为标准氧疗组、经鼻高流量氧疗组、无创通气组三组,分别给予面罩吸氧、经鼻高流量氧疗、无创正压机械通气治疗。观察患者 28 天气管插管率、90 天全因死亡率、治疗 48 h 后氧合状况。结果共纳入 116 例患者,其中经鼻高流量氧疗组 40 例,标准氧疗组 39 例,无创通气组 37 例。经鼻高流量氧疗组患者 28 天气管插管率明显低于标准氧疗组(22.5% 比 51.3%,OR=0.28,95%CI 0.10~0.73)和无创通气组(22.5% 比 48.6%,OR=0.31,95%CI 0.12~0.82);三组 90 天全因死亡率差异无统计学意义(分别为 15.0%、25.6% 和 24.3%,P=0.456)。治疗 48 h 后,高流量氧疗组 PaO2 较标准氧疗组、无创通气组显著升高(P=0.006),高流量氧疗组比标准氧疗组提高 PaO2/FiO2 更有优势(OR=4.02,95%CI 1.64~9.85),但高流量氧疗与无创通气 PaO2/FiO2 差异无统计学意义(P>0.05),三组患者 PaCO2、pH、呼吸频率差异无统计学意义(P>0.05)。结论与标准氧疗、无创通气相比,经鼻高流量氧疗能显著降低急性呼吸衰竭患者 28 天气管插管率,且有降低患者 90 天全因死亡率的趋势。经鼻高流量氧疗提高患者氧合比标准氧疗更有优势,和无创通气效果相当。

    Release date:2020-11-24 05:41 Export PDF Favorites Scan
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