目的:观察上唇咬诊试验(Upper Lip Bite Test,ULBT)预测肥胖患者困难气管插管的临床应用价值。方法:气管内全麻下行择期外科手术的肥胖患者[体重指数(body mass index,BMI)大于30 kg/m2]200例,参与本研究的麻醉医生分为三组,M组负责术...目的:观察上唇咬诊试验(Upper Lip Bite Test,ULBT)预测肥胖患者困难气管插管的临床应用价值。方法:气管内全麻下行择期外科手术的肥胖患者[体重指数(body mass index,BMI)大于30 kg/m2]200例,参与本研究的麻醉医生分为三组,M组负责术前评估患者的改良的Mallampati分级,U组负责术前评估患者ULBT分级,C组负责评估患者喉镜暴露声门时的Cormack and Lehane分级。改良的Mallampati、Cormack and Lehane、ULBT三类分级中Ⅰ、Ⅱ级视为非困难插管,Ⅲ、Ⅳ级视为困难插管。记录M、U组预测试验的灵敏度、特异性、阳性预测值、阴性预测值和精确度,并进行统计学分析。结果:我们对200例围手术期肥胖患者进行了观测,126例患者改良的Mallampati分级Ⅰ、Ⅱ级,74例Ⅲ、Ⅳ级。177例患者ULBT分级Ⅰ、Ⅱ级,23例Ⅲ级。ULBT在特异性、精确度、阳性预测值三方面均优于改良的Mallampati分级(P<0.05)。灵敏度、阴性预测值两组差异无统计学意义(P>0.05)。结论:ULBT用于肥胖患者围手术期气道评估,方法简单、有效,有一定的临床应用价值。展开更多
In the present study, we aimed to assess the effect of combined estrogen cream on young girls’ labial adhesions, and to identify the possible factors affecting the treatment outcome. We retrospectively included 123 c...In the present study, we aimed to assess the effect of combined estrogen cream on young girls’ labial adhesions, and to identify the possible factors affecting the treatment outcome. We retrospectively included 123 children with labial adhesions.Variables were collected, including treatment outcomes, conjugated estrogen usage, and dosage, whether it was combined with manual or surgical separation, whether to use erythromycin, and whether to be accompanied with vulvitis. Chi-square test, Fisher’s exact test, and t-test were used to analyze the correlation between influencing factors and treatment outcome in univariate analysis.We used logistic regression analysis to explore the key influencing factors. The use of conjugated estrogen in combination with manual or surgical separation(P = 0.001), and the degree of labial adhesions(P = 0.011) had significant effects on the final treatment outcome.The frequency of conjugated estrogen treatment, whether erythromycin was used in combination during treatment, and whether the children were accompanied by vulvitis had no significant effect on the treatment outcome(P > 0.05). After the logistic regression,we found that whether it was combined with manual or surgical separation(P = 0.000, OR = 0.078, 95% CI = 0.030–0.203), and the degree of labial adhesions in children(P = 0.003, OR = 5.324, 95% CI = 1.767–16.041) were independently related to the effect of conjugated estrogen treatment. The therapeutic effect of conjugated estrogen alone was better for mild adhesion. However,severe adhesions need to consider with manual or surgical separation in combination with conjugated estrogen treatment. It is not recommended to combine erythromycin with routine clinical treatment. Conjugated estrogen once a day can also achieve a good therapeutic effect.展开更多
文摘目的:观察上唇咬诊试验(Upper Lip Bite Test,ULBT)预测肥胖患者困难气管插管的临床应用价值。方法:气管内全麻下行择期外科手术的肥胖患者[体重指数(body mass index,BMI)大于30 kg/m2]200例,参与本研究的麻醉医生分为三组,M组负责术前评估患者的改良的Mallampati分级,U组负责术前评估患者ULBT分级,C组负责评估患者喉镜暴露声门时的Cormack and Lehane分级。改良的Mallampati、Cormack and Lehane、ULBT三类分级中Ⅰ、Ⅱ级视为非困难插管,Ⅲ、Ⅳ级视为困难插管。记录M、U组预测试验的灵敏度、特异性、阳性预测值、阴性预测值和精确度,并进行统计学分析。结果:我们对200例围手术期肥胖患者进行了观测,126例患者改良的Mallampati分级Ⅰ、Ⅱ级,74例Ⅲ、Ⅳ级。177例患者ULBT分级Ⅰ、Ⅱ级,23例Ⅲ级。ULBT在特异性、精确度、阳性预测值三方面均优于改良的Mallampati分级(P<0.05)。灵敏度、阴性预测值两组差异无统计学意义(P>0.05)。结论:ULBT用于肥胖患者围手术期气道评估,方法简单、有效,有一定的临床应用价值。
基金National Natural Science Foundation of China (Grant No. 81603203)Health Commission of Guangdong Province (Grant No. A2016400)+1 种基金Guangdong Pharmaceutical Association Program (Grant No. 2015FS10 and 2015SW05)Guangzhou Institute of Pediatrics/Guangzhou Women and Children’s Medical Center (Grant No. YIP-2018-020)。
文摘In the present study, we aimed to assess the effect of combined estrogen cream on young girls’ labial adhesions, and to identify the possible factors affecting the treatment outcome. We retrospectively included 123 children with labial adhesions.Variables were collected, including treatment outcomes, conjugated estrogen usage, and dosage, whether it was combined with manual or surgical separation, whether to use erythromycin, and whether to be accompanied with vulvitis. Chi-square test, Fisher’s exact test, and t-test were used to analyze the correlation between influencing factors and treatment outcome in univariate analysis.We used logistic regression analysis to explore the key influencing factors. The use of conjugated estrogen in combination with manual or surgical separation(P = 0.001), and the degree of labial adhesions(P = 0.011) had significant effects on the final treatment outcome.The frequency of conjugated estrogen treatment, whether erythromycin was used in combination during treatment, and whether the children were accompanied by vulvitis had no significant effect on the treatment outcome(P > 0.05). After the logistic regression,we found that whether it was combined with manual or surgical separation(P = 0.000, OR = 0.078, 95% CI = 0.030–0.203), and the degree of labial adhesions in children(P = 0.003, OR = 5.324, 95% CI = 1.767–16.041) were independently related to the effect of conjugated estrogen treatment. The therapeutic effect of conjugated estrogen alone was better for mild adhesion. However,severe adhesions need to consider with manual or surgical separation in combination with conjugated estrogen treatment. It is not recommended to combine erythromycin with routine clinical treatment. Conjugated estrogen once a day can also achieve a good therapeutic effect.
