目的从文献计量学的角度分析肝移植术麻醉的研究热点及趋势,探究肝移植术麻醉的发展及现状。方法检索Web of Science(核心合集)数据库2012至2021年肝移植术麻醉的文献,利用文献计量学方法对年出版文章数量、高发文期刊、高被引论文方面...目的从文献计量学的角度分析肝移植术麻醉的研究热点及趋势,探究肝移植术麻醉的发展及现状。方法检索Web of Science(核心合集)数据库2012至2021年肝移植术麻醉的文献,利用文献计量学方法对年出版文章数量、高发文期刊、高被引论文方面进行统计分析。运用VOSviewer软件进行主题词共现聚类视图和标签视图分析。结果共纳入肝移植术麻醉研究文献469篇,年出版文献量呈波状趋势,其中《TRANSPLANTATION PROCEEDINGS》是主要文献来源。发表在《BRTISH JOURNAL OF ANAESTHESIA》的Perioperative acute kidney injury是引用频次最高的文献。关键词共现聚类分析肝移植术麻醉研究热点,包括麻醉药物器官保护的基础研究、术前评估、肝移植合并其他器官移植、围术期器官并发症、肝移植患者麻醉药理学、围术期容量管理,其中体外膜肺氧合、血栓弹力图、肝缺血、疼痛管理、围术期管理等越来越受到关注。结论肝移植术麻醉的研究热点从基础研究转向整个围术期器官功能保护的研究,为指导肝移植术麻醉、提高术后生存率提供依据。展开更多
Background It is known that the hypothalamic-pituitary-adrenal （HPA） axis is highlighted by stimulation, such as sepsis, trauma, etc, when corticortropin increases and plasma cortisol levels enhance. Relative adrena...Background It is known that the hypothalamic-pituitary-adrenal （HPA） axis is highlighted by stimulation, such as sepsis, trauma, etc, when corticortropin increases and plasma cortisol levels enhance. Relative adrenal insufficiency is not uncommon in critically ill patients and may occur in severe sepsis patients with high plasma cortisol levels. It has been demonstrated that a short corticotropin test has a good prognostic value and is helpful in identifying patients with septic shock at high risk for death, but it has not been established for all severe sepsis patients, especially in China. The aim of this study is to explore the relationship between adrenal function and prognosis in patients with severe sepsis. Methods This prospective study was conducted between July and December 2004 in 6 teaching hospitals. Two hundred and forty patients with severe sepsis were enrolled in this study. A short corticotropin stimulation test was performed in all patients by intravenous injection of 250 pg of corticotropin. Blood samples were taken immediately before the test （TO）, 30 （T30） and 60 （T60） minutes afterward, and the plasma cortisol concentration was measured by radio-immunoassay. At the onset of severe sepsis, the following parameters were recorded： age, sex, Acute Physiology and Chronic Health Evaluation （APACHE） II, heart rate, mean arterial pressure （MAP）, arterial partial pressure of oxygen （PaO2）/fraction of inspired oxygen （FiO2）, peripheral blood of hemoglobin, platelets and leukocyte concentration and the number of organ failure. Patients were designated into two groups （survival and non-survival groups） according to the 28-day mortality. Relative adrenal insufficiency was defined as the difference between TO and the highest value of T30 or T60 （△Tmax） ≤9 μg/dl. Results （1） Two hundred and forty patients with severe sepsis were included in this study, with 134 patients in the survival group and 106 in the non-survival group. The 28-day mortality was 44.2%. （2） Between the survival group and non-survival group age, APACHE II, peripheral blood of platelets, the number of organ failures, TO and ATmax showed significant differences. TO was （23±10） μg/dl and （36＋18） μg/dl in the survival group and nonsurvival group respectively. △Tmax was （18±9） and （10±8） μg/dl in the survival group and non-survival group respectively. The areas under the ROC curve for TO and ATmax were both 0.72, and the area under the ROC curve for APACHE II was 0.70. By multivariate analysis age, TO, the number of organ failures and relative adrenal insufficiency （△Tmax ≤9 μg/dl） were independent predictors of death. （3） The incidence of relative adrenal insufficiency was 38.3% in total, 19.4% in the survival group and 62.3% in the non-survival group （P〈0.001）. The 28-day mortality was 71.7% among the relative adrenal insufficiency patients but 27.0% among normal adrenal function patients. Conclusions The prevalence of relative adrenal insufficiency is high in severe sepsis. Relative adrenal insufficiency has a good prognostic value for severe sepsis.展开更多
Critical care medicine began in 1982 in China and is still in a phase of rapid development. Despite theinadequate resources compared with-those of developed countries, critical care medicine has been recognized as a s...Critical care medicine began in 1982 in China and is still in a phase of rapid development. Despite theinadequate resources compared with-those of developed countries, critical care medicine has been recognized as a specialty by the government and by other specialties. National critical care societies are dedicated to promoting professional education and the academic improvement of critical care medicine in China. Although critical care services and clinical research are still underdeveloped due to scarce resources, great improvement is expected in the near future.展开更多
文摘目的从文献计量学的角度分析肝移植术麻醉的研究热点及趋势,探究肝移植术麻醉的发展及现状。方法检索Web of Science(核心合集)数据库2012至2021年肝移植术麻醉的文献,利用文献计量学方法对年出版文章数量、高发文期刊、高被引论文方面进行统计分析。运用VOSviewer软件进行主题词共现聚类视图和标签视图分析。结果共纳入肝移植术麻醉研究文献469篇,年出版文献量呈波状趋势,其中《TRANSPLANTATION PROCEEDINGS》是主要文献来源。发表在《BRTISH JOURNAL OF ANAESTHESIA》的Perioperative acute kidney injury是引用频次最高的文献。关键词共现聚类分析肝移植术麻醉研究热点,包括麻醉药物器官保护的基础研究、术前评估、肝移植合并其他器官移植、围术期器官并发症、肝移植患者麻醉药理学、围术期容量管理,其中体外膜肺氧合、血栓弹力图、肝缺血、疼痛管理、围术期管理等越来越受到关注。结论肝移植术麻醉的研究热点从基础研究转向整个围术期器官功能保护的研究,为指导肝移植术麻醉、提高术后生存率提供依据。
基金the 135 Science Foundation of Jiangsu Province(No.2002)New Century Excellent Talents Foundation of the Ministry of Education(No.SCET-04-0476).
文摘Background It is known that the hypothalamic-pituitary-adrenal （HPA） axis is highlighted by stimulation, such as sepsis, trauma, etc, when corticortropin increases and plasma cortisol levels enhance. Relative adrenal insufficiency is not uncommon in critically ill patients and may occur in severe sepsis patients with high plasma cortisol levels. It has been demonstrated that a short corticotropin test has a good prognostic value and is helpful in identifying patients with septic shock at high risk for death, but it has not been established for all severe sepsis patients, especially in China. The aim of this study is to explore the relationship between adrenal function and prognosis in patients with severe sepsis. Methods This prospective study was conducted between July and December 2004 in 6 teaching hospitals. Two hundred and forty patients with severe sepsis were enrolled in this study. A short corticotropin stimulation test was performed in all patients by intravenous injection of 250 pg of corticotropin. Blood samples were taken immediately before the test （TO）, 30 （T30） and 60 （T60） minutes afterward, and the plasma cortisol concentration was measured by radio-immunoassay. At the onset of severe sepsis, the following parameters were recorded： age, sex, Acute Physiology and Chronic Health Evaluation （APACHE） II, heart rate, mean arterial pressure （MAP）, arterial partial pressure of oxygen （PaO2）/fraction of inspired oxygen （FiO2）, peripheral blood of hemoglobin, platelets and leukocyte concentration and the number of organ failure. Patients were designated into two groups （survival and non-survival groups） according to the 28-day mortality. Relative adrenal insufficiency was defined as the difference between TO and the highest value of T30 or T60 （△Tmax） ≤9 μg/dl. Results （1） Two hundred and forty patients with severe sepsis were included in this study, with 134 patients in the survival group and 106 in the non-survival group. The 28-day mortality was 44.2%. （2） Between the survival group and non-survival group age, APACHE II, peripheral blood of platelets, the number of organ failures, TO and ATmax showed significant differences. TO was （23±10） μg/dl and （36＋18） μg/dl in the survival group and nonsurvival group respectively. △Tmax was （18±9） and （10±8） μg/dl in the survival group and non-survival group respectively. The areas under the ROC curve for TO and ATmax were both 0.72, and the area under the ROC curve for APACHE II was 0.70. By multivariate analysis age, TO, the number of organ failures and relative adrenal insufficiency （△Tmax ≤9 μg/dl） were independent predictors of death. （3） The incidence of relative adrenal insufficiency was 38.3% in total, 19.4% in the survival group and 62.3% in the non-survival group （P〈0.001）. The 28-day mortality was 71.7% among the relative adrenal insufficiency patients but 27.0% among normal adrenal function patients. Conclusions The prevalence of relative adrenal insufficiency is high in severe sepsis. Relative adrenal insufficiency has a good prognostic value for severe sepsis.
文摘Critical care medicine began in 1982 in China and is still in a phase of rapid development. Despite theinadequate resources compared with-those of developed countries, critical care medicine has been recognized as a specialty by the government and by other specialties. National critical care societies are dedicated to promoting professional education and the academic improvement of critical care medicine in China. Although critical care services and clinical research are still underdeveloped due to scarce resources, great improvement is expected in the near future.
