BACKGROUND Postoperative delirium is common in patients who undergo neurosurgery for craniocerebral injury.However,there is no specific medical test to predict postoperative delirium to date.AIM To explore risk factor...BACKGROUND Postoperative delirium is common in patients who undergo neurosurgery for craniocerebral injury.However,there is no specific medical test to predict postoperative delirium to date.AIM To explore risk factors for postoperative delirium in patients with craniocerebral injury in the neurosurgery intensive care unit(ICU).METHODS A retrospective analysis was performed in 120 patients with craniocerebral injury admitted to Hainan People’s Hospital/Hainan Hospital Affiliated to Hainan Medical University,The First Affiliated Hospital of Hainan Medical University,and The Second Affiliated Hospital of Hainan Medical University between January 2018 and January 2020.The patients were categorized into groups based on whether delirium occurred.Of them,25 patients with delirium were included in the delirium group,and 95 patients without delirium were included in the observation group.Logistic regression analysis was used to explore the association between sex,age,educational level,Glasgow coma scale(GCS),complications(with or without concussion,cerebral contusion,hypoxemia and ventricular compression)and site of injury and delirium.RESULTS The GCS score above 8 and concomitant disease of cerebral concussion,cerebral contusion,hypoxemia and ventricular compression,and damage to the frontal lobe were associated with delirium in patients admitted to neurosurgical intensive care unit(ICU)(all P<0.05).However,age,sex,administration more than three medicines,and educational level were not significantly associated with the onset of delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).Multivariate logistic regression analysis showed that GCS score above 8,cerebral concussion,cerebral contusion,hypoxemia,ventricle compression,and frontal lobe disorders were independent risk factors for delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).CONCLUSION GCS score,concussive concussion,cerebral contusion,hypoxemia,ventricle compression,and damage to frontal lobe are risk factors of postoperative delirium.展开更多
Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 20...Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 2017 to January 2019 were enrolled in the study. The selected patients were randomly divided into three groups: sodium lactate Ringer's solution group (LR group), saline group (NS group) and compound sodium chloride injection group (RS group), each group received the corresponding crystal liquid for fluid resuscitation, compare three groups Heart rate (HR), mean arterial pressure (MAP), cardiac output, procalcitonin (PCT), and C-reactive protein (CRP) before and after treatment, compared with the treatment of 24 hours of lactate clearance and APACHE II scores, and the overall hospitalization time and mortality rate of the three groups of patients were statistically compared;Results: (1) The difference of HR, MAP and cardiac output between the three groups before treatment was not statistically significant (P>0.05), treatment for 24h The HR of the post-Lactate Ringer's solution group was lower than that of the control group, and the MAP and cardiac output were higher than the control group (P<0.05). (2) The difference of PCT, CRP and BNP levels between the three groups before and after treatment was not statistically significant. (P>0.05);(3) Compared with the results, there was no statistically significant difference in the clearance rate of lactate clearance between the three groups (P>0.05). Three groups before and after treatment APACHE II score was not statistically significant difference comparison (P> 0.05). (4) Three groups The overall hospitalization time and mortality rate of the patients were not statistically significant (P>0.05). Conclusion: Lactate Ringer's solution can better maintain the circulation capacity and blood pressure, which can alleviate the clinical symptoms of patients with septic shock, but no obvious effect on lactic acid clearance. The effect of resuscitation with clinically available crystalloid sodium lactate Ringer's solution, saline and compound sodium chloride injection was not statistically significant in patients with septic shock.展开更多
文摘BACKGROUND Postoperative delirium is common in patients who undergo neurosurgery for craniocerebral injury.However,there is no specific medical test to predict postoperative delirium to date.AIM To explore risk factors for postoperative delirium in patients with craniocerebral injury in the neurosurgery intensive care unit(ICU).METHODS A retrospective analysis was performed in 120 patients with craniocerebral injury admitted to Hainan People’s Hospital/Hainan Hospital Affiliated to Hainan Medical University,The First Affiliated Hospital of Hainan Medical University,and The Second Affiliated Hospital of Hainan Medical University between January 2018 and January 2020.The patients were categorized into groups based on whether delirium occurred.Of them,25 patients with delirium were included in the delirium group,and 95 patients without delirium were included in the observation group.Logistic regression analysis was used to explore the association between sex,age,educational level,Glasgow coma scale(GCS),complications(with or without concussion,cerebral contusion,hypoxemia and ventricular compression)and site of injury and delirium.RESULTS The GCS score above 8 and concomitant disease of cerebral concussion,cerebral contusion,hypoxemia and ventricular compression,and damage to the frontal lobe were associated with delirium in patients admitted to neurosurgical intensive care unit(ICU)(all P<0.05).However,age,sex,administration more than three medicines,and educational level were not significantly associated with the onset of delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).Multivariate logistic regression analysis showed that GCS score above 8,cerebral concussion,cerebral contusion,hypoxemia,ventricle compression,and frontal lobe disorders were independent risk factors for delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).CONCLUSION GCS score,concussive concussion,cerebral contusion,hypoxemia,ventricle compression,and damage to frontal lobe are risk factors of postoperative delirium.
基金Hainan provincial health and family planning industry research project(1801032061A2004)
文摘Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 2017 to January 2019 were enrolled in the study. The selected patients were randomly divided into three groups: sodium lactate Ringer's solution group (LR group), saline group (NS group) and compound sodium chloride injection group (RS group), each group received the corresponding crystal liquid for fluid resuscitation, compare three groups Heart rate (HR), mean arterial pressure (MAP), cardiac output, procalcitonin (PCT), and C-reactive protein (CRP) before and after treatment, compared with the treatment of 24 hours of lactate clearance and APACHE II scores, and the overall hospitalization time and mortality rate of the three groups of patients were statistically compared;Results: (1) The difference of HR, MAP and cardiac output between the three groups before treatment was not statistically significant (P>0.05), treatment for 24h The HR of the post-Lactate Ringer's solution group was lower than that of the control group, and the MAP and cardiac output were higher than the control group (P<0.05). (2) The difference of PCT, CRP and BNP levels between the three groups before and after treatment was not statistically significant. (P>0.05);(3) Compared with the results, there was no statistically significant difference in the clearance rate of lactate clearance between the three groups (P>0.05). Three groups before and after treatment APACHE II score was not statistically significant difference comparison (P> 0.05). (4) Three groups The overall hospitalization time and mortality rate of the patients were not statistically significant (P>0.05). Conclusion: Lactate Ringer's solution can better maintain the circulation capacity and blood pressure, which can alleviate the clinical symptoms of patients with septic shock, but no obvious effect on lactic acid clearance. The effect of resuscitation with clinically available crystalloid sodium lactate Ringer's solution, saline and compound sodium chloride injection was not statistically significant in patients with septic shock.