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find Keyword "长期" 35 results
  • Surgical Treatment of Primary Liver Cancer and Postoperative LongTerm Survival

    1术后生存41年,肝癌治疗史上的奇迹肝癌在我国是最常见的癌症之一,每年约10万人被夺去生命。此病进展迅速,预后很差,人们常将其称为“癌中之王”,或“不治之症”。 近年,肝癌研究不断取得突破进展,振奋人心。其中印象最深的是,复旦大学附属中山医院(原上海医科大学附属中山医院)在41年前为一肝癌患者成功施行了肝切除手术,至今已91岁高龄,仍健在。创造了肝癌外科治疗史上的奇迹。

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • Prognostic Factors of Severe Chronic Obstructive Pulmonary Disease in Elderly Patients:A Long-term Follow-up Study

    Objective To investigate the prognostic factors of severe chronic obstructive pulmonary disease ( COPD) in elderly patients, and to guide the clinical assessment and appropriate interventions. Methods A prospective cohort study was carried out from May 1993 to December 2010. A total of 178 elderly patients with severe COPD were recruited for baseline survey, and followed up for the living conditions, whether used non-invasive ventilation, and causes of death. A survival analysis was performed on all patients stratified by lung function. The significant factors on survival rate were analyzed. Results In this cohort the survival rates were 49% and 12% in five and ten years, respectively. The important factors for prognosis were age [ relative risk( RR) = 1. 043, 95% confidence intervals( 95% CI = 1. 010-1. 050] , forced expired volume in one second ( FEV1 , RR = 0. 019, 95% CI = 0. 007-0. 052) , FEV1% pred ( RR = 1. 045, 95% CI = 1. 012-1. 079) , lung function grade ( RR = 2. 542, 95% CI = 1. 310-4. 931) , body mass index ( BMI, RR= 0. 945, 95% CI = 0. 895-0. 952) , and pulmonary heart disease ( RR = 1. 872, 95% CI = 1. 188- 2. 959) . In severe COPD, non-invasive ventilation ( NIV, RR = 1. 167, 95% CI = 0. 041-1. 674) , pulmonary heart disease ( RR = 3. 805, 95% CI = 1. 336-10. 836) , FEV1 ( RR = 0. 081, 95% CI = 1. 001-1. 168) , and arterial partial of oxygen ( PaO2 , RR=0. 956, 95% CI =0. 920-0. 993) were the independent predictors.The patients using NIV had longer survival than those without NIV. The 5 and 10 years survival rate in the patients with NIV were 78% and 50% , much higher than those without ventilation which were 30% and 25% , respectively. In extremely severe COPD, FEV1 ( RR=1. 059, 95% CI =1. 015-1. 105) , arterial partial of carbon dioxide ( PaCO2 , RR=1. 037, 95% CI = 1. 001-1. 074) , age ( RR= 1. 054, 95% CI = 1. 013-1. 096) and pulmonary heart disease ( RR = 1. 892, 95% CI = 1. 125-3. 181) were the independent predictors. Conclusions Age, BMI, FEV1 , PaO2 , PaCO2 , pulmonary heart disease, and NIV were prognostic factors in elderly patients with severe COPD. The prognostic factors between severe and extremely severe COPD were not identical. Patients with severe COPD should be given early intervention, including progressive nutritional support, and long-term home oxygen therapy combining with NIV.

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • Daytime Risk Factors of Nocturnal Hyoxemia in COPD Patients Unqualified for Long-term Oxygen Therapy

    Objective To explore the daytime variables which are predictive to nocturnal hyoxemia among COPD patients unqualified for long-term oxygen therapy ( LTOT) . Methods Forty-eight stable COPD patients with SaO2≥90% were enrolled in this study and regarded as patients unqualified for LTOT. All patients underwent lung function examination during daytime. Their nocturnal oxygen saturation was monitored with overnight pulse oximetry ( OPO) . ResultsDaytime oxygen saturation was positively correlated with nocturnal mean SaO2 ( r =0. 79, P lt;0. 0001) , and negatively correlated with time spend with saturation below 90% ( TB90) ( r = - 0. 75, P lt; 0. 0001) . No significant relationship was found between lung function parameters and nocturnal SaO2 . The patients with daytime oxygen saturation between 90% and 95% were more likely to have lower nocturnal oxygen saturation and longer TB90 ( P lt;0. 05) .Conclusions Daytime oxygen saturation may effectively predict the occurrence of nocturnal hyoxemia in stable COPD patients unqualified for LTOT. To reduce COPD complications and improve prognosis, we suggest a relative indication of LTOT for patients with daytime oxygen saturation between 90% and 95% and with nocturnal hyoxemia.

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  • 视盘血管瘤长期观察和晚期治疗

    Release date:2016-09-02 06:03 Export PDF Favorites Scan
  • Effect of Releasable Sutures on Trabeculectomy: A Meta-Analysis

    Objective To evaluate the effect of releasable sutures on shallow anterior chamber, filtering bleb and long-term intraocular pressure (IOP). Methods We searched MEDLINE (1971 to 2007), OVID (1971 to 2007) and National Science and Technology Library (1971 to 2007). Randomized controlled trials (RCTs) of the effect of releasable sutures on trabeculectomy were collected. Study selection and assessment, data collection and analyses were undertaken and cross-checked by two reviewers. Meta-analyses were performed with The Cochrane Collaboration’s RevMan 4.2.10 software. Results Six RCTs involving 341 eyes were included. Significant differences were observed in the reduction of postoperative shallow anterior chamber (RD –0.23, 95%CI –0.31 to –0.14, Plt;0.000 01) and functional filtering blebs (RD –0.15, 95%CI –0.27 to –0.02, P=0.02). But, no differences were observed for the control of long-term IOP (SMD –0.13, 95%CI –0.37 to 0.10, P=0.27). Conclusion The evidence currently available showed that releasable sutures could reduce the incidence of shallow anterior chamber and has no beneficial effect in controlling long-term IOP. The current evidence is insufficient to define the efficacy of maintaining functional filtering blebs. Further large-scale, high-quality randomized controlled trials are needed.

    Release date:2016-09-07 02:12 Export PDF Favorites Scan
  • Analyze the Reason for the Success of Weaning of Patients with Longterm Mechanical Ventilation

    目的:分析长期机械通气患者脱机成败原因,提高脱机成功率。方法:针对本院2003年5月至2008年10月近6年ICU172例长期机械通气患者成败原因进行分析。结果:总脱机成功率90.69%。脱机失败率 9.31%。结论:长期机械通气患者多存在多种因素的共同参与,如营养不良、全身衰弱、呼吸功能不全、通气泵衰竭和心理因素等,增加了脱机的难度,进而出现撤机困难。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • 芦山地震卧床伤员预防肺部感染的效果观察

    目的探讨芦山地震中卧床伤员应用呼吸训练器改善肺功能、预防肺部感染的临床效果。 方法将地震综合病房在2013年4月20日-5月20日期间收治的60例需长期卧床的芦山地震伤员按照其是否接受使用呼吸训练器分为对照组和观察组各30例,对照组行常规护理,观察组在常规护理基础上应用呼吸训练器行呼吸训练,观察1个月后各组伤员肺部感染的发生率。 结果观察组伤员卧床期间的肺部感染率为3.3%,明显低于对照组肺部感染率20.0%,差异有统计学意义(χ2=4.043,P=0.044)。 结论长期卧床伤员使用呼吸训练器能够有效改善肺功能,减少肺部感染。

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  • C反应蛋白检测在长期住院精神病患者细菌性感染性疾病诊断中的应用价值

    目的探讨C反应蛋白(CRP)检测对长期住院的精神病患者患细菌性感染性疾病的临床诊断应用价值。 方法将2013年5月-2014年6月长期住院的精神病患者中已确诊的细菌性感染性患者184例分为急性上呼吸道感染组52例,急性支气管炎组41例,细菌性肺炎组37例,细菌性肠炎组21例,尿路感染组18例,败血症组15例。采用免疫荧光法,分别测定各组全血CRP含量、白细胞总数(WBC)、中性粒细胞(Neu)水平并比较各组的阳性率。 结果184例患细菌性感染性疾病的长期住院的精神病患者中CRP总阳性率91.3%,明显高于WBC总阳性率52.7%,Neu总阳性率60.9%,CRP同WBC、Neu总阳性率比较差异有统计学意义(P<0.01)。各组CRP阳性率由高到低为细菌性肺炎组(97.3%)、细菌性肠炎组(95.2%)、急性支气管炎组(90.2%)、尿路感染组(88.9%)、急性上呼吸道感染组(88.5%)、败血症组(86.7%),各细菌性感染组CRP同WBC、Neu阳性率比较差异具有统计学意义(P<0.05),但各组间CRP阳性率比较差异无统计学意义(P>0.05)。 结论与WBC、NEU相比,CRP检测对长期住院精神病患者患细菌性感染性疾病具有更好的临床诊断应用价值。

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  • Research on the Correlation between Admission Serum Potassium Level and Long-term Prognosis in Patients with Unstable Angina

    ObjectiveTo investigate the relationship between admission serum potassium level and long-term prognosis in patients with unstable angina. MethodsWe studied the data of 1 412 patients with unstable angina who received coronary angiography examinations and completed the follow-up between July 2008 and September 2012. Serum potassium level within the first 24 hours after admission was collected. According to the serum potassium level, the patients were divided into three groups:those with a serum potassium level lower than 3.5 mmol/L, those with a level between 3.5 and 5.0 mmol/L and those with a level higher than 5.0 mmol/L. Then, we analyzed the relationship between admission serum potassium level and long-term prognosis in patients with unstable angina. ResultsThere was a U-shaped relationship between admission serum potassium level and long-term mortality that persisted after multivariable adjustment in patients with unstable angina. The all-cause mortality risk was the lowest in the group of patients with a potassium level of 3.5 to 5.0 mmol/L, whereas mortality was higher in patients with potassium level lower than 3.5 mmol/L and higher than 5.0 mmol/L [HR=1.89, 95%CI (1.13, 3.17), P=0.016; HR=1.64, 95%CI (0.40, 6.77), P=0.493]. Compared with patients with a serum potassium level between 3.5 and 5.0 mmol/L, the cardiovascular mortality risk was significantly higher in those patients with a potassium level lower than 3.5 mmol/L [HR=1.99, 95%CI (1.01, 3.94), P=0.048]. ConclusionThere is a U-shaped relationship between admission serum potassium level and long-term all-cause mortality rate, and the all-cause mortality rate and cardiovascular mortality risk was the lowest in patients with a potassium level between 3.5 and 5.0 mmol/L.

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  • MEDIUM-AND LONG-TERM effectiveness OF THIRD-GENERATION CERAMIC-ON-CERAMIC TOTAL HIP ARTHROPLASTY FOR END-STAGE HIP DISEASE

    ObjectiveTo evaluate the medium-and long-term effectiveness of the 3rd-generation ceramic-on-ceramic total hip arthroplasty (THA) for end-stage hip disease. MethodsA retrospective analysis was made on the clinical data of 142 patients (148 hips) who underwent the 3rd-generation ceramic-on-ceramic THA between May 2001 and May 2005. There were 78 males and 64 females, aged 57.2 years on average (range, 23-81 years). Preoperative diagnosis was avascular necrosis of femoral head in 73 patients (77 hips), degenerative osteoarthritis in 35 patients (36 hips), femoral neck fracture in 18 patients (18 hips), rheumatoid arthritis in 14 patients (15 hips), and septic hip sequelae in 2 patients (2 hips). The preoperative Harris hip score was 58.3±12.9. ResultsAll incisions healed by first intention without complication. All patients were followed up 8.8 years on average (range, 7-12 years). At the last follow-up, the Harris hip score (92.5±10.2) was significantly higher than that at pre-operation (t=-25.29, P=0.00). At the last follow-up, there were 4 hips with groin pain, 6 hips with thigh pain. Complications occurred in 6 cases (6 hips), including loosening cups in 2 hips, hip dislocation in 2 hips, ceramic head fracture in 1 hip, and squeaking in 1 hip. The revision rate was 1.35% (3/148). X-ray film showed that acetabular cup loosening in 2 hips, discontinuous radiolucent line in 4 hips, and new bone formation in 88 hips; discontinuous radiolucent line around femoral component was observed in 25 hips, endosteal new bone formation in 95 hips, cortical bone hypertrophy in 2 hips, and femoral component subsidence in 9 hips (less than 2 mm). ConclusionThird-generation ceramic-on-ceramic THA is an effective treatment for end-stage hip disease, and can achieve satisfactory medium-and long-term effectiveness and a high implant survival rate.

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