背景:随着人均寿命的延长、生活质量要求的提高,越来越多高龄者(年龄≥80岁)有行全髋关节置换术(total hip arthroplasty,THA)的需求。围术期并发症的风险评估对手术安全至关重要,但对高龄患者尚没有有效的评估手段。目的:研究分析非髋...背景:随着人均寿命的延长、生活质量要求的提高,越来越多高龄者(年龄≥80岁)有行全髋关节置换术(total hip arthroplasty,THA)的需求。围术期并发症的风险评估对手术安全至关重要,但对高龄患者尚没有有效的评估手段。目的:研究分析非髋部骨折高龄患者行初次THA围术期内科相关并发症。方法:回顾性总结并分析我院2011年11月至2016年11月收治的34例行初次THA的高龄患者(38髋),排除术前诊断为髋部骨折者。记录患者麻醉方式、各系统合并症、术前评估结果、术中情况、术后检查及并发症等。结果:1例患者因急性心肌梗死死亡,其存在稳定性心绞痛、高血压、糖尿病、I°房室传导阻滞及完全性右束支传导阻滞,且长期服用小剂量糖皮质激素。1例患者术后存在组织灌注不足并出现急性肾损伤,经保守治疗后肾功能恢复;统计显示术后肾小球滤过率(glomerular filtration rate,GFR)与术前GFR明显相关,男性患者术后GFR显著低于女性。本研究患者围术期未出现下肢深静脉血栓形成、肺部感染、肝功能异常、症状性脑梗死及切口感染等并发症。结论:目前并无明确证据显示单纯年龄为80岁及以上是围术期内科并发症的独立危险因素,但高龄患者可因合并多种内科疾病而显著增加择期THA围术期内科并发症风险。因此,术前应完善主要器官功能及合并症评估。术前器官功能评估大致正常且无合并症者可考虑行THA,虽然脏器功能评估无明显异常,但合并多种内科疾病者仍应高度警惕围术期并发症。展开更多
Objective To highlight the current understanding of mixed phenotype acute leukemia （MPAL）.Data sources We collected the relevant articles in PubMed （from 1985 to present）,using the terms ＂mixed phenotype acute le...Objective To highlight the current understanding of mixed phenotype acute leukemia （MPAL）.Data sources We collected the relevant articles in PubMed （from 1985 to present）,using the terms ＂mixed phenotype acute leukemia＂,＂hybrid acute leukemia＂,＂biphenotypic acute leukemia＂,and ＂mixed lineage leukemia＂.We also collected the relevant studies in WanFang Data base （from 2000 to present）,using the terms ＂mixed phenotype acute leukemia＂ and ＂hybrid acute leukemia＂.Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient＇s unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.展开更多
文摘背景:随着人均寿命的延长、生活质量要求的提高,越来越多高龄者(年龄≥80岁)有行全髋关节置换术(total hip arthroplasty,THA)的需求。围术期并发症的风险评估对手术安全至关重要,但对高龄患者尚没有有效的评估手段。目的:研究分析非髋部骨折高龄患者行初次THA围术期内科相关并发症。方法:回顾性总结并分析我院2011年11月至2016年11月收治的34例行初次THA的高龄患者(38髋),排除术前诊断为髋部骨折者。记录患者麻醉方式、各系统合并症、术前评估结果、术中情况、术后检查及并发症等。结果:1例患者因急性心肌梗死死亡,其存在稳定性心绞痛、高血压、糖尿病、I°房室传导阻滞及完全性右束支传导阻滞,且长期服用小剂量糖皮质激素。1例患者术后存在组织灌注不足并出现急性肾损伤,经保守治疗后肾功能恢复;统计显示术后肾小球滤过率(glomerular filtration rate,GFR)与术前GFR明显相关,男性患者术后GFR显著低于女性。本研究患者围术期未出现下肢深静脉血栓形成、肺部感染、肝功能异常、症状性脑梗死及切口感染等并发症。结论:目前并无明确证据显示单纯年龄为80岁及以上是围术期内科并发症的独立危险因素,但高龄患者可因合并多种内科疾病而显著增加择期THA围术期内科并发症风险。因此,术前应完善主要器官功能及合并症评估。术前器官功能评估大致正常且无合并症者可考虑行THA,虽然脏器功能评估无明显异常,但合并多种内科疾病者仍应高度警惕围术期并发症。
文摘Objective To highlight the current understanding of mixed phenotype acute leukemia （MPAL）.Data sources We collected the relevant articles in PubMed （from 1985 to present）,using the terms ＂mixed phenotype acute leukemia＂,＂hybrid acute leukemia＂,＂biphenotypic acute leukemia＂,and ＂mixed lineage leukemia＂.We also collected the relevant studies in WanFang Data base （from 2000 to present）,using the terms ＂mixed phenotype acute leukemia＂ and ＂hybrid acute leukemia＂.Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient＇s unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.
