呼吸道合胞病毒、人偏肺病毒和流感病毒的感染特点分析及成人感染住院的相关因素分析

目的比较呼吸道合胞病毒(RSV)、人偏肺病毒(hMPV)和流感感染特点并分析成人感染住院的相关因素。方法收集2021年1月-2023年1月在流感/RSV/hMPV流行季节期间住院治疗的急性呼吸道感染的成年患者共202例,其中流感组104例,RSV组68例,MPV30例。比较三组的临床感染特征,并使用Logistics回归分析成人感染住院的相关危险因素。结果与流感患者相比,RSV和hMPV患者有更多的潜在风险因素,包括年龄大于65岁,合并症如心脏疾病、肾脏疾病、COPD更多。RSV患者住院前出现症状的时间最长,住院时间最长,入住重症监护室的比例最高,住院期间接受氧气补充的概率更高。多因素Logistics回归分析显示年龄≥65岁(调整OR=3.19,95%CI=1.44~4.17,P=0.034)、合并慢性心脏疾病(调整OR=2.01,95%CI=1.98~5.42,P=0.012)、合并慢性肾脏疾病(调整OR=2.12,95%CI=1.45~4.34,P=0.001)、合并COPD(调整OR=2.26,95%CI=0.78~3.23,P=0.122)、重度COPD(调整OR=1.85,95%CI=1.21~2.93,P=0.016)、治疗时出现COPD加重(整调OR=1.87,95%CI=1.46~5.32,P=0.015)、出现败血症(调整OR=2.12,95%CI=0.93~4.87,P=0.001)为成人住院的危险因素。结论虽然流感的发病率更高,但在住院成人中,RSV和hMPV的潜在风险因素更多,住院时间更长,这表明需要采取有效的干预措施。与流感、RSV、hMPV成人患者住院相关的危险因素为年龄≥65岁,患者合并慢性心脏疾病、慢性肾脏疾病、重度COPD,治疗时COPD加重、出现败血症。

Gunsight sutures significantly reduce surgical-site infection after ileostomy reversal compared with linear sutures

Background:Surgical-site infection(SSI)was one of the most common post-operative morbidities of ileostomy reversal.Although several skin-closure procedures had been developed to reduce the rate of SSI,the optimal procedure remains unclear.In this study,we compared the effect of two surgical techniques for wound closure following ileostomy reversal:gunsight suture(GS)and linear suture(LS).Methods:A total of 233 patients who underwent loop ileostomy at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2017 were enrolled into our study.These patients were divided into two groups:the LS group and the GS group.We compared the clinical characteristics between the two groups and analyzed the data using IBM SPSS to identify risk factors for SSI.Results:Both groups successfully underwent surgery.The rate of SSI was significantly lower in the GS group(n=2,0.02%)than in the LS group(n=16,12.00%,P=0.007).The length of hospital stay after the operation in the GS group was significantly shorter than that in the LS group(8.163.2 vs 10.865.4 days,P<0.001).Multivariate analysis showed that GS was an independent protective risk factor for SSI(odds ratio=0.212,P=0.048).Conclusions:Compared with the LS technique,the GS technique can significantly decrease the rate of SSI and shorten the length of hospital stay after surgery.The GS technique may be recommended for wound closure following ileostomy reversal.