目的 构建急性药物中毒性脑病患者重症监护室(intensive care unit, ICU)住院时间延长的预测模型并评价其效能。方法 选择重症监护医疗信息集市(MIMIC)-Ⅳ2.2数据库中148例急性药物中毒性脑病患者作为研究对象,收集患者临床资料,根据IC...目的 构建急性药物中毒性脑病患者重症监护室(intensive care unit, ICU)住院时间延长的预测模型并评价其效能。方法 选择重症监护医疗信息集市(MIMIC)-Ⅳ2.2数据库中148例急性药物中毒性脑病患者作为研究对象,收集患者临床资料,根据ICU住院时间分非延长组(≤48 h)与延长组(>48 h)。采用最小绝对收缩和选择算子(LASSO)回归联合Logistic回归筛选变量,构建和绘制列线图。分别采用受试者工作特征曲线下面积(AUC)、Hosmer-Lemeshow校准曲线和决策曲线分析(DCA)评价模型的区分度、校准度及临床适用度。结果 患者ICU住院时间1~15 d,其中ICU住院时间延长69例,采取LASSO回归与Logistic回归相结合方法筛选预测变量。结果显示SOFA评分、心率、合并心血管疾病、使用机械通气4个变量为独立危险因素,依据以上预测变量构建和绘制列线图,列线图的AUC为0.837,95%CI 0.774~0.900;Bootstrap内部验证AUC 0.873,95%CI 0.817~0.930,说明该列线图预测模型具有较好的预测能力。校准曲线和Hosmer-Lemeshow检验(χ^(2)=6.392,P=0.603)均显示该模型具有较高的一致性和拟合度;DCA结果表明,患者可从模型中净获益(阈值范围0.05~1.00),具有较好的临床适用性。结论 本研究开发的模型性能良好,有助于评估急性药物中毒性脑病患者ICU住院时间的延长风险。展开更多
Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupunct...Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation an alysis and Chi-square test were applied to an a lyze the comm only used acupoi nts, meridia n affiliatio ns and body regi on distributi ons, comm only used methods and acupoi nt correlati ons, treatme nt method correlati ons, the efficacy of acupuncture- moxibusti on plus the three-step an algesic ladder for can cer pain, and in dicators. Results: Zusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibusti on plus the three-step an algesic ladder showed certai n adva ntage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rati ng scale (NRS), visual an alog scale (VAS) and Kar nofsky performa nee status (KPS) scores all showed sign ifica nt changes after interventions (all P<0.01);there was no significant change in the score of quality of life (QOL) after interventions (P>0.05). Conclusion: Zusa nli (ST 36), Ashi point and Sanyin jiao (SP 6) are comm only selected in acup un cture-moxibusti on treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step an algesic ladder can boost the treatme nt efficacy.展开更多
文摘Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation an alysis and Chi-square test were applied to an a lyze the comm only used acupoi nts, meridia n affiliatio ns and body regi on distributi ons, comm only used methods and acupoi nt correlati ons, treatme nt method correlati ons, the efficacy of acupuncture- moxibusti on plus the three-step an algesic ladder for can cer pain, and in dicators. Results: Zusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibusti on plus the three-step an algesic ladder showed certai n adva ntage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rati ng scale (NRS), visual an alog scale (VAS) and Kar nofsky performa nee status (KPS) scores all showed sign ifica nt changes after interventions (all P<0.01);there was no significant change in the score of quality of life (QOL) after interventions (P>0.05). Conclusion: Zusa nli (ST 36), Ashi point and Sanyin jiao (SP 6) are comm only selected in acup un cture-moxibusti on treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step an algesic ladder can boost the treatme nt efficacy.
