Background:Acquired brain injury(ABI)is caused by trauma or nontrauma to the brain after birth.Increased intracranial pressure in patients with traumatic or nontraumatic brain injury affects the cerebral perfusion pre...Background:Acquired brain injury(ABI)is caused by trauma or nontrauma to the brain after birth.Increased intracranial pressure in patients with traumatic or nontraumatic brain injury affects the cerebral perfusion pressure.After traumatic brain injury,there is an increase in air content in the brain and an increase in volume of blood flow to the brain,which can cause increased intracranial pressure,herniation of brain tissue,impaired cerebral perfusion,and brain damage.Most patients with traumatic brain injury die from uncontrolled increases in intracranial pressure.Near-infrared spectroscopy(NIRS)and central venous pressure(CVP)monitoring are also associated with cerebral perfusion.This study aimed to determine the relationship between the Glasgow Coma Scale(GCS)scores and CVP and NIRS values in patients with ABI.Methods:This prospective analytical study used a cross-sectional design to compareGCS scores with CVP and NIRS values in patients with traumatic and nontraumatic brain injury in the intensive care unit(ICU)of Haji Adam Malik Hospital Medan.GCS,CVP,and NIRS descriptive data in patients with brain injury were presented in terms of mean and standard deviation if the data were normally distributed,or median(interquartile range)values if the data were not normally distributed.The relationship between GCS scores and CVP and NIRS values was assessed using the Pearson correlation test if the data were normally distributed,or the Spearman test if the data were not normally distributed.Results:In this study,the mean GCS score and CVP values were 7.04±2.69 and 5.63±25.82 mmHg,respectively.The right tissue oxygen saturation(StO2)was 55.61%±18.72%,and the left StO2 was 57.57%±17.48%with normally distributed data.There was no correlation between GCS scores and CVP values(P=0.829),and no correlation between moderate GCS scores and right and left StO2(P=0.343;P=0.121);however,there was a significantly strong positive correlation between severe GCS scores and right and left StO2(P=0.028,r=0.656;P=0.005,r=0.777).Conclusion:There was no significant correlation between GCS scores and CVP values,and no correlation between moderate GCS scores and NIRS values;however,there was a significantly strong positive correlation between severe GCS scores and NIRS values in patients with ABI at the ICU of Haji Adam Malik Hospital Medan.展开更多
目的系统评价成人术中获得性压力损伤(intraoperative acquired pressure injury,IAPI)风险预测模型,以期为构建更高质量的IAPI风险预测模型提供参考。方法检索中国生物医学文献数据库,中国知网及PubMed,Web of Science等中英文数据库...目的系统评价成人术中获得性压力损伤(intraoperative acquired pressure injury,IAPI)风险预测模型,以期为构建更高质量的IAPI风险预测模型提供参考。方法检索中国生物医学文献数据库,中国知网及PubMed,Web of Science等中英文数据库中有关IAPI风险预测模型的相关研究,语种限定为中文和英文,检索时限为建库至2022年11月4日。由2名研究者独立筛选文献和提取数据,并应用预测模型研究的偏倚风险评估工具分析纳入文献的偏倚风险和适用性。结果共纳入13项成人IAPI风险预测模型构建研究,涉及17个模型,手术时间、年龄、合并糖尿病、体质量指数、血清白蛋白水平是最常见的预测因子。17个模型中有14个模型的受试者工作特征曲线下面积(area under the curve,AUC)为0.616~0.984,另外3个模型没有报告AUC结果。13项研究中10项适用性较好,其余3项适用性不清楚。13项研究偏倚风险较高,偏倚主要是因为纳入研究为回顾性研究、基于单变量分析筛选预测因子及预测结局未采用指南或者标准化的定义等。结论现有成人IAPI风险预测模型适用性较好,但偏倚风险较高,构建尚不完善,需在后期的构建中关注对不同风险评估方法有效性的研究,以便得到更好高准确度的风险预测模型,为制订相关预防策略提供参考依据。展开更多
目的系统评价骨科患者术中压力性损伤(IAPI)的影响因素。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、PubMed、Scopus、Web of Science、Embase、Cochrane Library、CINAHL数据库中关于骨科IAPI影响因素...目的系统评价骨科患者术中压力性损伤(IAPI)的影响因素。方法计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、PubMed、Scopus、Web of Science、Embase、Cochrane Library、CINAHL数据库中关于骨科IAPI影响因素的研究,检索时间范围为建库至2022年7月25日。由2名研究者独立筛选文献、提取数据和质量评价后,运用R软件4.1.3进行Meta分析。结果初期检索到非重复的中英文文献6731篇,最终纳入16篇文献,总计样本量为8404例。Meta分析结果显示,年龄≥60岁(OR=4.14,95%CI:2.60~6.61,P<0.001)、营养不良(OR=2.75,95%CI:2.03~3.73,P<0.001)、超重(OR=1.24,95%CI:1.13~1.35,P<0.001)、肥胖(OR=2.99,95%CI:2.30~3.88,P<0.001)、糖尿病(OR=4.92,95%CI:1.78~13.62,P=0.001)、其他疾病史(OR=3.60,95%CI:2.87~4.51,P<0.001)、术中低体温(OR=4.54,95%CI:3.45~5.97,P<0.001)、术中敲击或牵引(OR=1.96,95%CI:1.55~2.48,P<0.001)、手术时间≥2 h(OR=10.17,95%CI:1.55~66.88,P=0.017)和非仰卧位(OR=5.99,95%CI:3.20~11.23,P<0.001)与骨科IAPI风险增加有关。结论年龄≥60岁、营养不良、超重、肥胖、糖尿病、基础疾病、术中低体温、术中敲击或牵引、手术时间≥2 h、非仰卧位是骨科患者IAPI的危险因素。展开更多
文摘Background:Acquired brain injury(ABI)is caused by trauma or nontrauma to the brain after birth.Increased intracranial pressure in patients with traumatic or nontraumatic brain injury affects the cerebral perfusion pressure.After traumatic brain injury,there is an increase in air content in the brain and an increase in volume of blood flow to the brain,which can cause increased intracranial pressure,herniation of brain tissue,impaired cerebral perfusion,and brain damage.Most patients with traumatic brain injury die from uncontrolled increases in intracranial pressure.Near-infrared spectroscopy(NIRS)and central venous pressure(CVP)monitoring are also associated with cerebral perfusion.This study aimed to determine the relationship between the Glasgow Coma Scale(GCS)scores and CVP and NIRS values in patients with ABI.Methods:This prospective analytical study used a cross-sectional design to compareGCS scores with CVP and NIRS values in patients with traumatic and nontraumatic brain injury in the intensive care unit(ICU)of Haji Adam Malik Hospital Medan.GCS,CVP,and NIRS descriptive data in patients with brain injury were presented in terms of mean and standard deviation if the data were normally distributed,or median(interquartile range)values if the data were not normally distributed.The relationship between GCS scores and CVP and NIRS values was assessed using the Pearson correlation test if the data were normally distributed,or the Spearman test if the data were not normally distributed.Results:In this study,the mean GCS score and CVP values were 7.04±2.69 and 5.63±25.82 mmHg,respectively.The right tissue oxygen saturation(StO2)was 55.61%±18.72%,and the left StO2 was 57.57%±17.48%with normally distributed data.There was no correlation between GCS scores and CVP values(P=0.829),and no correlation between moderate GCS scores and right and left StO2(P=0.343;P=0.121);however,there was a significantly strong positive correlation between severe GCS scores and right and left StO2(P=0.028,r=0.656;P=0.005,r=0.777).Conclusion:There was no significant correlation between GCS scores and CVP values,and no correlation between moderate GCS scores and NIRS values;however,there was a significantly strong positive correlation between severe GCS scores and NIRS values in patients with ABI at the ICU of Haji Adam Malik Hospital Medan.
文摘目的系统评价成人术中获得性压力损伤(intraoperative acquired pressure injury,IAPI)风险预测模型,以期为构建更高质量的IAPI风险预测模型提供参考。方法检索中国生物医学文献数据库,中国知网及PubMed,Web of Science等中英文数据库中有关IAPI风险预测模型的相关研究,语种限定为中文和英文,检索时限为建库至2022年11月4日。由2名研究者独立筛选文献和提取数据,并应用预测模型研究的偏倚风险评估工具分析纳入文献的偏倚风险和适用性。结果共纳入13项成人IAPI风险预测模型构建研究,涉及17个模型,手术时间、年龄、合并糖尿病、体质量指数、血清白蛋白水平是最常见的预测因子。17个模型中有14个模型的受试者工作特征曲线下面积(area under the curve,AUC)为0.616~0.984,另外3个模型没有报告AUC结果。13项研究中10项适用性较好,其余3项适用性不清楚。13项研究偏倚风险较高,偏倚主要是因为纳入研究为回顾性研究、基于单变量分析筛选预测因子及预测结局未采用指南或者标准化的定义等。结论现有成人IAPI风险预测模型适用性较好,但偏倚风险较高,构建尚不完善,需在后期的构建中关注对不同风险评估方法有效性的研究,以便得到更好高准确度的风险预测模型,为制订相关预防策略提供参考依据。
