目的探讨床旁长程视频脑电监测技术在重症颅脑损伤患者术后的应用效果。方法回顾性分析2021年1月至2023年1月期间南阳市第二人民医院收治的150例重症颅脑损伤患者的临床资料,所有患者均行大骨瓣减压手术治疗、床旁长程视频脑电监测,按...目的探讨床旁长程视频脑电监测技术在重症颅脑损伤患者术后的应用效果。方法回顾性分析2021年1月至2023年1月期间南阳市第二人民医院收治的150例重症颅脑损伤患者的临床资料,所有患者均行大骨瓣减压手术治疗、床旁长程视频脑电监测,按照监测结果进行Synek脑电分级,依据格拉斯哥预后量表(GOS)评分分为预后不良组107例和预后良好组43例,采用Spearman分析Synek脑电分级与急性生理与慢性健康评分Ⅱ(APACHEⅡ)、格拉斯哥昏迷量表(GCS)评分的相关性。结果入院7 d,预后良好组患者的APACHEⅡ分值为(8.62±1.68)分,明显低于预后不良组的(10.75±1.55)分,GCS分值为(9.02±1.06)分,明显高于预后不良组的(8.39±1.22)分,差异均有统计学意义(P<0.05);入院7 d,预后良好组患者的Synek脑电分级状况以Ⅰ级、Ⅱ级为主,明显优于以Ⅲ级、Ⅳ级为主的预后不良组,差异有统计学意义(P<0.05);经Spearman分析结果显示,入院当天Synek脑电分级与APACHEⅡ分值呈正相关(r=0.749,P<0.05),与GCS分值呈负相关(r=-0.615,P<0.05),入院7 d Synek脑电极分级与GOS分值呈负相关(r=-0.468,P<0.05)。结论床旁长程视频脑电监测技术在入院当天应用可有助于评估重症颅脑损伤患者病情程度,便于临床调整治疗方案以提高治疗效果。展开更多
Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prol...Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prolong the time before deterioration of lung cancer symptoms,in comparison to chemotherapy alone.Methods:A prospective,double-blind,randomized,controlled trial was conducted from December 14,2017 to August 28,2020.A total of 180 patients with stage ⅠB-ⅢA NSCLC from 5 hospitals in Shanghai were randomly divided into chemotherapy combined with CHM(chemo+CHM) group(120 cases) or chemotherapy combined with placebo(chemo+placebo) group(60 cases) using stratified blocking randomization.The European Organization for Research and Treatment of Cancer(EORTC) Quality-of-Life-Core 30 Scale(QLQ-C30) was used to evaluate the patient-reported outcomes(PROs) during postoperative adjuvant chemotherapy in patients with early-stage NSCLC.Adverse events(AEs) were assessed in the safety analysis.Results:Out of the total 180 patients,173 patients(116in the chemo+CHM group and 57 in the chemo+placebo group) were included in the PRO analyses.The initial mean QLQ-C30 Global Health Status(GHS)/QoL scores at baseline were 57.16±1.64 and 57.67±2.25 for the two respective groups(P>0.05).Compared with baseline,the chemo+CHM group had an improvement in QLQ-C30GHS/QoL score at week 18 [least squares mean(LSM) change 17.83,95% confidence interval(CI) 14.29 to 21.38].Conversely,the chemo+placebo group had a decrease in the score(LSM change-13.67,95% CI-22.70 to-4.63).A significant between-group difference in the LSM GHS/QoL score was observed,amounting to 31.63 points(95% CI25.61 to 37.64,P<0.001).The similar trends were observed in physical functioning,fatigue and appetite loss.At week 18,patients in the chemo+CHM group had a higher proportion of improvement or stabilization in GHS/QoL functional and symptom scores compared to chemo+placebo group(P<0.001).The median time to deterioration was longer in the chemo+CHM group for GHS/QoL score [hazard ratio(HR)=0.33,95% CI 0.23 to 0.48,P<0.0010],physical functioning(HR=0.43,95% CI 0.25 to 0.75,P=0.0005),fatigue(HR=0.47,95% CI 0.30 to 0.72,P<0.0001) and appetite loss(HR=0.65,95% CI 0.42to 1.00,P=0.0215).The incidence of AEs was lower in the chemo+CHM group than in the chemo+placebo group(9.83% vs.15.79%,P=0.52).Conclusion:The staged CHM therapy could help improve the PROs of postoperative patients with early-stage NSCLC during adjuvant chemotherapy,which is worthy of further clinical research.(Registry No.NCT03372694)展开更多
文摘目的探讨床旁长程视频脑电监测技术在重症颅脑损伤患者术后的应用效果。方法回顾性分析2021年1月至2023年1月期间南阳市第二人民医院收治的150例重症颅脑损伤患者的临床资料,所有患者均行大骨瓣减压手术治疗、床旁长程视频脑电监测,按照监测结果进行Synek脑电分级,依据格拉斯哥预后量表(GOS)评分分为预后不良组107例和预后良好组43例,采用Spearman分析Synek脑电分级与急性生理与慢性健康评分Ⅱ(APACHEⅡ)、格拉斯哥昏迷量表(GCS)评分的相关性。结果入院7 d,预后良好组患者的APACHEⅡ分值为(8.62±1.68)分,明显低于预后不良组的(10.75±1.55)分,GCS分值为(9.02±1.06)分,明显高于预后不良组的(8.39±1.22)分,差异均有统计学意义(P<0.05);入院7 d,预后良好组患者的Synek脑电分级状况以Ⅰ级、Ⅱ级为主,明显优于以Ⅲ级、Ⅳ级为主的预后不良组,差异有统计学意义(P<0.05);经Spearman分析结果显示,入院当天Synek脑电分级与APACHEⅡ分值呈正相关(r=0.749,P<0.05),与GCS分值呈负相关(r=-0.615,P<0.05),入院7 d Synek脑电极分级与GOS分值呈负相关(r=-0.468,P<0.05)。结论床旁长程视频脑电监测技术在入院当天应用可有助于评估重症颅脑损伤患者病情程度,便于临床调整治疗方案以提高治疗效果。
基金Supported by Project of Shanghai Municipal Commission of Science and Technology(Nos.16401970700 and 22Y31920400)。
文摘Objective:To investigate whether the combination of chemotherapy with staged Chinese herbal medicine(CHM) therapy could enhance health-related quality of life(QoL) in non-small-cell lung cancer(NSCLC)patients and prolong the time before deterioration of lung cancer symptoms,in comparison to chemotherapy alone.Methods:A prospective,double-blind,randomized,controlled trial was conducted from December 14,2017 to August 28,2020.A total of 180 patients with stage ⅠB-ⅢA NSCLC from 5 hospitals in Shanghai were randomly divided into chemotherapy combined with CHM(chemo+CHM) group(120 cases) or chemotherapy combined with placebo(chemo+placebo) group(60 cases) using stratified blocking randomization.The European Organization for Research and Treatment of Cancer(EORTC) Quality-of-Life-Core 30 Scale(QLQ-C30) was used to evaluate the patient-reported outcomes(PROs) during postoperative adjuvant chemotherapy in patients with early-stage NSCLC.Adverse events(AEs) were assessed in the safety analysis.Results:Out of the total 180 patients,173 patients(116in the chemo+CHM group and 57 in the chemo+placebo group) were included in the PRO analyses.The initial mean QLQ-C30 Global Health Status(GHS)/QoL scores at baseline were 57.16±1.64 and 57.67±2.25 for the two respective groups(P>0.05).Compared with baseline,the chemo+CHM group had an improvement in QLQ-C30GHS/QoL score at week 18 [least squares mean(LSM) change 17.83,95% confidence interval(CI) 14.29 to 21.38].Conversely,the chemo+placebo group had a decrease in the score(LSM change-13.67,95% CI-22.70 to-4.63).A significant between-group difference in the LSM GHS/QoL score was observed,amounting to 31.63 points(95% CI25.61 to 37.64,P<0.001).The similar trends were observed in physical functioning,fatigue and appetite loss.At week 18,patients in the chemo+CHM group had a higher proportion of improvement or stabilization in GHS/QoL functional and symptom scores compared to chemo+placebo group(P<0.001).The median time to deterioration was longer in the chemo+CHM group for GHS/QoL score [hazard ratio(HR)=0.33,95% CI 0.23 to 0.48,P<0.0010],physical functioning(HR=0.43,95% CI 0.25 to 0.75,P=0.0005),fatigue(HR=0.47,95% CI 0.30 to 0.72,P<0.0001) and appetite loss(HR=0.65,95% CI 0.42to 1.00,P=0.0215).The incidence of AEs was lower in the chemo+CHM group than in the chemo+placebo group(9.83% vs.15.79%,P=0.52).Conclusion:The staged CHM therapy could help improve the PROs of postoperative patients with early-stage NSCLC during adjuvant chemotherapy,which is worthy of further clinical research.(Registry No.NCT03372694)
