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大型非心脏手术后急性肾损伤发生率及其相关危险因素分析 被引量:1
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作者 梁钥 刘克玄 +2 位作者 赵秉诚 范子博 张广清 《临床军医杂志》 CAS 2023年第7期672-677,共6页
目的探讨大型非心脏手术后急性肾损伤(AKI)的发生率及其相关危险因素。方法回顾性分析南方医科大学南方医院自2008年2月至2021年12月收治的进行大型非心脏手术治疗的24890例患者的临床资料。根据患者术后是否发生AKI,将患者分入非AKI组... 目的探讨大型非心脏手术后急性肾损伤(AKI)的发生率及其相关危险因素。方法回顾性分析南方医科大学南方医院自2008年2月至2021年12月收治的进行大型非心脏手术治疗的24890例患者的临床资料。根据患者术后是否发生AKI,将患者分入非AKI组(术后未发生AKI)和AKI组(术后发生AKI)。比较非AKI组和AKI组的临床资料,采用Logistic回归分析AKI发生的危险因素。结果大型非心脏手术后发生AKI 1240例,发生率为4.98%(1240/24890);未发生AKI 23650例(95.02%,23650/24890)。两组年龄,性别,体质量指数,吸烟史,术前合并高血压、糖尿病、冠心病、心力衰竭、脑血管疾病(脑卒中或脑梗死等)、慢性肾病、慢性肝病比例,长期应用血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂、β⁃受体阻滞剂、利尿剂、钙通道阻滞剂、他汀类药物、胰岛素制剂比例,术前血清肌酐、血红蛋白、白蛋白、血清钠、血糖水平,美国麻醉医师协会分级,手术类型,手术时间,麻醉类型,有创动脉监测比例,平均动脉压,应用非甾体类消炎药比例,应用血管加压素比例,输液量,失血量,尿量,住院天数,术后发生感染、输血、卒中、心血管事件、死亡比例比较,差异均有统计学意义(P<0.05)。较高的年龄、男性、较大的体质量指数、合并心力衰竭、合并慢性肾病、应用血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂、应用钙通道阻滞剂、术前低白蛋白水平、术前高血糖水平、美国麻醉医师协会分级Ⅳ级、接受血管手术、接受腹部手术、较长的手术时间、较多的失血量是增加大型非心脏手术后AKI发生风险的危险因素(P<0.05),而应用他汀类药物是降低大型非心脏手术后AKI发生风险的保护因素(P<0.05)。结论大型非心脏手术后AKI的发生与高龄、男性、肥胖、合并心力衰竭和慢性肾病、应用血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和钙通道阻滞剂、低白蛋白、高血糖、美国麻醉医师协会分级、手术类型、失血量及手术时间有关。 展开更多
关键词 非心脏手术 急性肾损伤 危险因素
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Fluorine-fixing efficiency on calcium-based briquette: pilot experiment, demonstration and promotion 被引量:1
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作者 YANG Jiao-lan CHEN Dong-qing +4 位作者 LI Shu-min YUE Yin-ling JIN Xin zhao bing-cheng YING Bo 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第3期361-364,共4页
Background The fluorosis derived from coal burning is a very serious problem in China. By using fluorine-fixing technology during coal burning we are able to reduce the release of fluorides in coal at the source in or... Background The fluorosis derived from coal burning is a very serious problem in China. By using fluorine-fixing technology during coal burning we are able to reduce the release of fluorides in coal at the source in order to reduce pollution to the surrounding environment by coal burning pollutants as well as decrease the intake and accumulating amounts of fluorine in the human body. The aim of this study was to conduct a pilot experiment on calcium-based fluorine-fixing material efficiency during coal burning to demonstrate and promote the technology based on laboratory research. Methods A proper amount of calcium-based fluorine sorbent was added into high-fluorine coal to form briquettes so that the fluorine in high-fluorine coal can be fixed in coal slag and its release into atmosphere reduced. We determined figures on various components in briquettes and fluorine in coal slag as well as the concentrations of indoor air pollutants, including fluoride, sulfur dioxide and respirable particulate matter (RPM), and evaluated the fluorine-fixing efficiency of calcium-based fluorine sorbents and the levels of indoor air pollutants. Results Pilot experiments on fluorine-fixing efficiency during coal burning as well as its demonstration and promotion were carried out separately in Guiding and Longli Counties of Guizhou Province, two areas with coal burning fluorosis problems. If the calcium-based fluorine sorbent mixed coal was made into honeycomb briquettes the average fluorine-fixing ratio in the pilot experiment was 71.8%. If the burning calcium-based fluorine-fixing bitumite was made into a coalball, the average of fluorine-fixing ratio was 77.3%. The concentration of fluoride, sulfur dioxide and PM10 of indoor air were decreased significantly. There was a 10% increase in the cost of briquettes due to the addition of calcium-based fluorine sorbent. Conclusions The preparation process of calcium-based fluorine-fixing briquette is simple yet highly flammable and it is applicable to regions with abundant bitumite coal. As a small scale application, villagers may make fluorine-fixing coalballs or briquettes by themselves, achieving the optimum fluorine-fixing efficiency and reducing indoor air pollutants providing environmental and social benefits. 展开更多
关键词 coal burning fluorine-fixing air pollution demonstration and promotion pilot experiment
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