BACKGROUND Deep vein thrombosis(DVT)is a significant postoperative concern,particularly in patients undergoing surgery for gastrointestinal(GI)cancers.These patients often present multiple risk factors,including advan...BACKGROUND Deep vein thrombosis(DVT)is a significant postoperative concern,particularly in patients undergoing surgery for gastrointestinal(GI)cancers.These patients often present multiple risk factors,including advanced age and elevated body mass index(BMI),which can increase the likelihood of thromboembolic events.Effec-tive prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism(PE).This study investigates a compre-hensive DVT prevention protocol,combining mechanical and pharmacological strategies alongside early mobilization,to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.AIM To evaluate the effectiveness and safety of postoperative DVT prevention strate-gies in patients with GI cancer.METHODS A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022.All patients received a standardized DVT prevention protocol,which included risk assessment,mecha-nical prophylaxis,pharmacological prophylaxis,and early mobilization.The primary endpoint was the incidence of DVT within 30 days postoperatively.Se-condary outcomes included the occurrence of PE,bleeding complications,and adherence to the protocol.RESULTS The overall incidence of DVT was 7%(7/100 patients).One patient(1%)deve-loped PE.The adherence rate to the prevention protocol was 92%.Bleeding complications were observed in 3%of patients.Significant risk factors for DVT development included advanced age[odds ratio(OR):1.05;95%confidence interval(95%CI):1.01-1.09],higher BMI(OR:1.11;95%CI:1.03-1.19),and longer operative time(OR:1.007;95%CI:1.001-1.013).CONCLUSION Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence.Strict adherence and individualized risk assessment are crucial for optimizing outcomes.展开更多
目的探讨红细胞分布宽度(RDW)与新生儿持续性肺动脉高压(PPHN)预后之间的关系。方法回顾性分析2016年1月至2019年12月期间广东省妇幼保健院新生儿重症监护病房(NICU)收治的58例PPHN足月儿的临床资料(观察组),选择同期58例健康足月儿作...目的探讨红细胞分布宽度(RDW)与新生儿持续性肺动脉高压(PPHN)预后之间的关系。方法回顾性分析2016年1月至2019年12月期间广东省妇幼保健院新生儿重症监护病房(NICU)收治的58例PPHN足月儿的临床资料(观察组),选择同期58例健康足月儿作为对照组。比较两组受检新生儿的血红蛋白(HGB)、红细胞比容(HCT)、RDW水平及Apgar评分。比较死亡组(n=7)和存活组(n=51)患儿RDW水平。采用Logistic回归分析法分析PPHN死亡与RDW的关系,采用受试者工作特性(ROC)曲线分析用于确定RDW作为PPHN死亡预测指标的最佳截点,将25例RDW≥19.45%者纳入高RDW组,33例RDW<19.45%者纳入低RDW组,评估两组新生儿住院期间的死亡率。结果两组新生儿的血HGB及HCT比较差异均无统计学意义(P>0.05);观察组新生儿的RDW水平为(19.24±3.63)%,明显高于对照组的(14.54±3.17)%,1 min Apgar评分及5 min Apgar评分分别为(6.28±2.36)分、(7.89±2.22)分,明显低于对照组的(8.95±1.01)分、(9.81±0.18)分,差异均有统计学意义(P<0.05);死亡组新生儿的RDW水平为(21.95±4.28)%,明显高于存活组的(17.69±3.76)%,差异有统计学意义(P<0.05);Logistic回归模型分析提示,RDW是PPHN患儿死亡的独立危险因素(P<0.05);RDW预测PPHN死亡的最佳临界截点为19.45,ROC曲线下面积为0.79,敏感度为85.7%,特异性为78%;高RDW组患儿住院期间死亡率为24.00%,明显高于低RDW组的3.03%,差异有统计学意义(P<0.05)。结论红细胞分布宽度与新生儿持续性肺动脉高压预后关系密切,高水平的RDW提示PPHN预后差、病死率高。展开更多
目的对转诊及非转诊的早产儿视网膜病变(retinopathy of prematurity,ROP)患儿行激光光凝术治疗后的疗效进行比较。方法收集2017年1月至2019年12月本院新生儿重症监护室收治并诊断为ROP患儿790例,其中行激光光凝术治疗的患儿370例。本...目的对转诊及非转诊的早产儿视网膜病变(retinopathy of prematurity,ROP)患儿行激光光凝术治疗后的疗效进行比较。方法收集2017年1月至2019年12月本院新生儿重症监护室收治并诊断为ROP患儿790例,其中行激光光凝术治疗的患儿370例。本院出生患儿51例[男38例,女13例,胎龄(29.5±2.2)周],转诊患儿319例[男211例,女108例,胎龄(28.9±2.3)周]。收集临床资料包括性别、胎龄、出生体质量、诊断时胎龄及诊断时视网膜病变的分区及分期。治疗6个月后眼底检查提示解剖学治愈为治疗成功。结果两组患儿行激光光凝术后,总治愈率为77.0%(285/370)。本院出生组患儿及转诊组患儿术后治愈率分别为94.1%(48/51)、74.3%(237/319),两组治愈率比较差异有统计学意义(P<0.05)。在转诊组中,3期疾病明显更常见,甚至一部分患儿为4期病变;而在本院出生组患儿中,主要为2期病变,且无一例发展为4期病变。结论转诊患儿中,ROP的治疗成功率明显降低;这主要是因为接受治疗时,转诊患儿ROP更严重,转诊患儿治疗延迟所致。展开更多
文摘BACKGROUND Deep vein thrombosis(DVT)is a significant postoperative concern,particularly in patients undergoing surgery for gastrointestinal(GI)cancers.These patients often present multiple risk factors,including advanced age and elevated body mass index(BMI),which can increase the likelihood of thromboembolic events.Effec-tive prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism(PE).This study investigates a compre-hensive DVT prevention protocol,combining mechanical and pharmacological strategies alongside early mobilization,to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.AIM To evaluate the effectiveness and safety of postoperative DVT prevention strate-gies in patients with GI cancer.METHODS A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022.All patients received a standardized DVT prevention protocol,which included risk assessment,mecha-nical prophylaxis,pharmacological prophylaxis,and early mobilization.The primary endpoint was the incidence of DVT within 30 days postoperatively.Se-condary outcomes included the occurrence of PE,bleeding complications,and adherence to the protocol.RESULTS The overall incidence of DVT was 7%(7/100 patients).One patient(1%)deve-loped PE.The adherence rate to the prevention protocol was 92%.Bleeding complications were observed in 3%of patients.Significant risk factors for DVT development included advanced age[odds ratio(OR):1.05;95%confidence interval(95%CI):1.01-1.09],higher BMI(OR:1.11;95%CI:1.03-1.19),and longer operative time(OR:1.007;95%CI:1.001-1.013).CONCLUSION Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence.Strict adherence and individualized risk assessment are crucial for optimizing outcomes.
文摘目的探讨红细胞分布宽度(RDW)与新生儿持续性肺动脉高压(PPHN)预后之间的关系。方法回顾性分析2016年1月至2019年12月期间广东省妇幼保健院新生儿重症监护病房(NICU)收治的58例PPHN足月儿的临床资料(观察组),选择同期58例健康足月儿作为对照组。比较两组受检新生儿的血红蛋白(HGB)、红细胞比容(HCT)、RDW水平及Apgar评分。比较死亡组(n=7)和存活组(n=51)患儿RDW水平。采用Logistic回归分析法分析PPHN死亡与RDW的关系,采用受试者工作特性(ROC)曲线分析用于确定RDW作为PPHN死亡预测指标的最佳截点,将25例RDW≥19.45%者纳入高RDW组,33例RDW<19.45%者纳入低RDW组,评估两组新生儿住院期间的死亡率。结果两组新生儿的血HGB及HCT比较差异均无统计学意义(P>0.05);观察组新生儿的RDW水平为(19.24±3.63)%,明显高于对照组的(14.54±3.17)%,1 min Apgar评分及5 min Apgar评分分别为(6.28±2.36)分、(7.89±2.22)分,明显低于对照组的(8.95±1.01)分、(9.81±0.18)分,差异均有统计学意义(P<0.05);死亡组新生儿的RDW水平为(21.95±4.28)%,明显高于存活组的(17.69±3.76)%,差异有统计学意义(P<0.05);Logistic回归模型分析提示,RDW是PPHN患儿死亡的独立危险因素(P<0.05);RDW预测PPHN死亡的最佳临界截点为19.45,ROC曲线下面积为0.79,敏感度为85.7%,特异性为78%;高RDW组患儿住院期间死亡率为24.00%,明显高于低RDW组的3.03%,差异有统计学意义(P<0.05)。结论红细胞分布宽度与新生儿持续性肺动脉高压预后关系密切,高水平的RDW提示PPHN预后差、病死率高。
文摘目的对转诊及非转诊的早产儿视网膜病变(retinopathy of prematurity,ROP)患儿行激光光凝术治疗后的疗效进行比较。方法收集2017年1月至2019年12月本院新生儿重症监护室收治并诊断为ROP患儿790例,其中行激光光凝术治疗的患儿370例。本院出生患儿51例[男38例,女13例,胎龄(29.5±2.2)周],转诊患儿319例[男211例,女108例,胎龄(28.9±2.3)周]。收集临床资料包括性别、胎龄、出生体质量、诊断时胎龄及诊断时视网膜病变的分区及分期。治疗6个月后眼底检查提示解剖学治愈为治疗成功。结果两组患儿行激光光凝术后,总治愈率为77.0%(285/370)。本院出生组患儿及转诊组患儿术后治愈率分别为94.1%(48/51)、74.3%(237/319),两组治愈率比较差异有统计学意义(P<0.05)。在转诊组中,3期疾病明显更常见,甚至一部分患儿为4期病变;而在本院出生组患儿中,主要为2期病变,且无一例发展为4期病变。结论转诊患儿中,ROP的治疗成功率明显降低;这主要是因为接受治疗时,转诊患儿ROP更严重,转诊患儿治疗延迟所致。
