目的:评价日常活动和手术应激评估(Estimation of physiologic ability and surgical stress,E-PASS)系统用于评估老龄患者消化道手术后并发症和转归的临床价值。方法:回顾性分析2011年7月至2013年7月西京医院消化外科所有65岁以上的患...目的:评价日常活动和手术应激评估(Estimation of physiologic ability and surgical stress,E-PASS)系统用于评估老龄患者消化道手术后并发症和转归的临床价值。方法:回顾性分析2011年7月至2013年7月西京医院消化外科所有65岁以上的患者的临床资料,计算其中行消化道手术者的E-PASS评分,并记录这些患者术后并发症的发生情况和患者术后的住院时间。分析E-PASS评分和几项该评分未涉及的因素与老龄患者消化道手术后并发症的发病率、死亡率、住院时间的相关性。结果:研究共纳入1236例老龄行消化道手术的患者,其中521例发生术后并发症(42.15%),8例死亡(0.65%)。患者术前E-PASS评分系统中,三项评分均与术后住院时间相关,术前风险评分(Preoperative risk score,PRS)和综合风险评分(Comprehensive risk score,CRS)与术后并发症的发病率和死亡率显著相关(P均<0.05)。E-PASS评分系统未包含的指标中,麻醉方法与术后并发症发生和住院时间无关,术后入ICU、术中使用血管活性药物和急诊手术与术后发病率、死亡率和住院时间相关(P均<0.05)。结论:E-PASS评分系统可用于预测老龄患者行消化道手术后并发症的发生情况和转归,纳入术后入ICU、术中使用血管活性药物和急诊手术三项指标可能进一步提高E-PASS评分系统的预测准确性。展开更多
Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were ran...Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were randomized into an observation group and a control group,with 47 cases in the observation group and 49 cases in the control group.The control group received oral oxiracetam capsules for treatment,and the observation group was given additional Tuina treatment.Before and after treatment,the mini-mental state examination(MMSE)was adopted to assess the patient’s cognitive function;the activities of daily living(ADL)scale was used to evaluate their ability to conduct daily activities;changes in the serum inflammatory factors and oxidative stress indicators were also detected.Results After treatment,the serum content of malondialdehyde(MDA)decreased in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05);the serum contents of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05);the serum contents of interleukin(IL)-1,tumor necrosis factor(TNF)-α,IL-6,and IL-8 declined in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After the intervention,the levels of systolic velocity(Vs)and mean velocity(Vm)of the middle cerebral artery elevated,and the pulsatility index(PI)dropped in patients in the two groups,showing significant intra-group differences(P<0.05);the levels of Vs and Vm in the observation group were higher than those in the control group,and the PI was lower in the observation group than in the control group,showing significant between-group differences(P<0.05).The MMSE and ADL scores increased in both groups after the intervention(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion In the treatment of mild VD,Tuina plus oxiracetam can improve the cerebral blood supply,ADL,and cognitive function;the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.展开更多
文摘Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were randomized into an observation group and a control group,with 47 cases in the observation group and 49 cases in the control group.The control group received oral oxiracetam capsules for treatment,and the observation group was given additional Tuina treatment.Before and after treatment,the mini-mental state examination(MMSE)was adopted to assess the patient’s cognitive function;the activities of daily living(ADL)scale was used to evaluate their ability to conduct daily activities;changes in the serum inflammatory factors and oxidative stress indicators were also detected.Results After treatment,the serum content of malondialdehyde(MDA)decreased in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05);the serum contents of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05);the serum contents of interleukin(IL)-1,tumor necrosis factor(TNF)-α,IL-6,and IL-8 declined in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After the intervention,the levels of systolic velocity(Vs)and mean velocity(Vm)of the middle cerebral artery elevated,and the pulsatility index(PI)dropped in patients in the two groups,showing significant intra-group differences(P<0.05);the levels of Vs and Vm in the observation group were higher than those in the control group,and the PI was lower in the observation group than in the control group,showing significant between-group differences(P<0.05).The MMSE and ADL scores increased in both groups after the intervention(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion In the treatment of mild VD,Tuina plus oxiracetam can improve the cerebral blood supply,ADL,and cognitive function;the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.
