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胆红素与行瓣膜置换术后老年患者预后的相关性
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作者 卢沛珊 陈颖 +1 位作者 廖游玩 谢银均 《医疗装备》 2023年第14期68-70,共3页
目的 分析胆红素与行瓣膜置换术后老年患者预后的相关性。方法 回顾性分析2018年1月至2022年6月医院收治的1 750例风湿性心脏病患者的临床资料,采用分层研究的方法,以直接胆红素中位数及四分位数为界值将患者分为4组。收集患者临床资料... 目的 分析胆红素与行瓣膜置换术后老年患者预后的相关性。方法 回顾性分析2018年1月至2022年6月医院收治的1 750例风湿性心脏病患者的临床资料,采用分层研究的方法,以直接胆红素中位数及四分位数为界值将患者分为4组。收集患者临床资料,包括性别、年龄、高血压病史、糖尿病病史及美国纽约心脏病学会(NYHA)心功能分级、血常规、肝功能指标及超声心动图检查指标,记录患者手术类型及住院期间意外事件发生情况,并分析不同组间上述指标的差异。结果 收集患者1 750例,其中男576例,女1 174例,每组女性占比均高于男性,差异有统计学意义(P <0.05);不同组间高血压、糖尿病情况比较,差异无统计学意义(P> 0.05);患者择期行人工心脏瓣膜置换术,其中二尖瓣置换术1 665例、主动脉瓣置换术718例、三尖瓣置换术1 364例及冠状动脉旁路移植术84例。随直接胆红素水平升高,不同组间NYHA Ⅲ或Ⅳ级患者占比逐渐增大,差异有统计学意义(P<0.05);随直接胆红素水平升高,超声心动图检查结果显示患者的三尖瓣反流占比逐渐增大、肺动脉收缩压逐渐升高、左室射血分数逐渐降低,差异有统计学意义(P<0.05)。不同组间血常规(血红蛋白、肌酐、C-反应蛋白)及肝功能指标(谷丙转氨酶、白蛋白、总胆固醇、直接胆红素、总胆红素)比较,差异均有统计学意义(P<0.05),其中总胆固醇水平随直接胆红素水平升高而降低,总胆红素水平随直接胆红素水平升高而升高。患者直接胆红素水平升高与卒中的发生并无关系,差异无统计学意义(P>0.05);当患者的直接胆红素水平超过6.10μmol/L时患者发生透析及病死的比例明显增加,差异有统计学意义(P<0.05)。结论 胆红素水平升高影响行瓣膜置换术后老年患者预后情况,直接胆红素水平过高是相关危险因素。 展开更多
关键词 瓣膜性心脏病 瓣膜置换术 胆红素 高胆红素血症
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ICU转出患者家属转科应激现状及影响因素的研究 被引量:2
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作者 卢沛珊 廖游玩 +2 位作者 陈颖 高晶 谢银均 《国际医药卫生导报》 2022年第18期2595-2599,共5页
目的识别ICU转出患者家属转科应激的现状及影响因素。方法本研究采用横断面研究方法。选择2020年4月至2021年2月在广东省人民医院ICU治疗后成功转出ICU的120例患者家属为研究对象,其中男性53例、女性67例,年龄为(45.64±9.76)岁。... 目的识别ICU转出患者家属转科应激的现状及影响因素。方法本研究采用横断面研究方法。选择2020年4月至2021年2月在广东省人民医院ICU治疗后成功转出ICU的120例患者家属为研究对象,其中男性53例、女性67例,年龄为(45.64±9.76)岁。采用一般情况调查表及中文版ICU患者家属迁移应激量表,对其迁移应激状况进行调查。对影响转出ICU后其家属迁移应激状况的因素采用单因素及多因素分析进行分析。统计学方法采用独立样本t检验、方差分析、多元线性回归分析。结果ICU转出患者家属转科应激总分为(54.25±6.31)分,条目均分为(3.23±0.48)分。条目均分最高及最低的维度分别为转科准备[(3.78±0.51)分]、转科满意度[(2.75±0.31)分]。单因素分析显示:家属转科应激得分在不同家属性别、文化程度、宗教信仰及患者年龄、付费方式、ICU治疗时间之间差异均有统计学意义(均P<0.05)。多因素分析显示:影响家属转科应激的主要因素有家属文化程度、家属性别、患者年龄、患者ICU治疗时间(均P<0.05)。结论ICU转出患者家属转科应激水平处于中等偏上。护士在重视患者疾病恢复的同时,也应多关注家属的心理,特别是年龄较小、ICU住院时间较长患者的家属及学历较低的女性家属,给予积极的心理疏导。 展开更多
关键词 ICU 患者家属 转科应激 迁移应激
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The role of neutrophil to platelet ratio in predicting death in elderly patients with ST-elevation myocardial infarction receiving percutaneous coronary intervention
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作者 高晶 胡培航 +2 位作者 谢银均 卢沛珊 廖游玩 《South China Journal of Cardiology》 2023年第3期113-120,共8页
Background Despite receiving percutaneous coronary intervention(PCI),the mortality in elderly patients with ST-segment elevation myocardial infarction(STEMI)remains high.The aim of this study was to explore the progno... Background Despite receiving percutaneous coronary intervention(PCI),the mortality in elderly patients with ST-segment elevation myocardial infarction(STEMI)remains high.The aim of this study was to explore the prognostic value of neutrophil to platelet ratio(NPR)in elderly STEMI patients receiving PCI.Methods Patients≥65 years old with the diagnosis of STEMI who had received PCI was retrospectively enrolled between January 2010 and April 2016 in the Guangdong Provincial People's Hospital.The relationship between NPR and inhospital and 1-year mortality was evaluated.Results A total of 767 elderly patients with STEMI were included and divided into three groups according to the tertiles of NPR:<37(n=253),37-54(n=257),and≥54(n=257).Multivariate logistic regression analysis showed an independent correlation between elevated NPR and in-hospital death[odds ratio(OR)=1.02,95%confidential interval(CI):1.01-1.03,P<0.001].The receiver operating characteristic curve(AUC)analysis demonstrated a relatively high predictive value for NPR in identifying in-hospital death(AUC=0.765,95%CI:0.704-0.825,P<0.001,sensitivity=77.1%,specificity=69.0%,optimal cut-off value=54).As for 1-year mortality,multivariate Cox survival analysis revealed that NPR[hazard ratio(HR)=1.003,95%CI:1.001-1.004,P<0.001],as a continuous variable,and NPR>54(HR=2.70,95%CI 1.72-4.22,P<0.001),as a categorial variable,were both independent predictors for 1-year mortality.Conclusions NPR is a feasible predictor of poor prognosis for elderly patients with STEMI receiving PCI. 展开更多
关键词 ST-elevation myocardial infarction NEUTROPHIL PLATELET MORTALITY elderly population
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Factors associated with relocation stress for the families of patients transferred from intensive care units after cardiac valvular and aortic surgery
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作者 XIE Yin-jun LU Pei-shan +1 位作者 LIAO You-wan GAO Jing 《South China Journal of Cardiology》 CAS 2021年第4期271-278,共8页
Background Relocation stress is common among the families of patients transferred from intensive care units.However,few studies investigated the factors associated with relocation stress for the families of patients a... Background Relocation stress is common among the families of patients transferred from intensive care units.However,few studies investigated the factors associated with relocation stress for the families of patients after cardiac valvular and aortic surgery.The objective of this study was to investigate the relocation stress status and associated factors in the family members of patients transferred out of the intensive care unit(ICU)after cardiac valvular and aortic surgery.Methods A total of 120 family members of patients,who were successfully transferred out of ICU after cardiac valvular and aortic surgery from October 2020 to February 2021 in our institution,were included.Their demographic characteristics,clinical characteristics and relocation stress assessment results were collected.Risk factors for relocation stress were investigated using linear regression models.Results The overall mean scores of our research subjects on relocation stress was 55.68±4.658.Univariate analysis and multivariable linear regression analysis revealed that family members.age,patients.residence,and duration of ICU stay were risk factors of post-ICU relocation stress in family members of patients after cardiac valvular and aortic surgery(P<0.05).Conclusions The relocation stress in family members of patients transferred from ICU after cardiac valvular and aortic surgery was moderate to high.Younger age of family members,patients living in rural areas,and longer duration of ICU stay are associated with a higher level of relocation stress.Healthcare providers should concern the relocation stress in family members of patients transferred from ICU after cardiac valvular and aortic surgery,and appropriate intervention measures should be carried out. 展开更多
关键词 relocation stress postoperative cardiac surgery ICU family members influencing factors
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