盘点:2018年2月第2期BMJ研究精选

2018-02-13 zhangfan MedSci原创

BMJ

2018年2月第2期BMJ研究精选



【1】卡格列净可降低糖尿病患者心脏风险


近日研究人员考察了钠-葡萄糖协同转运蛋白2抑制剂卡格列净、DPP-4抑制剂、GLP-1受体激动剂、直接胰高血糖素样肽-1以及磺酰脲类药物等II型糖尿病药物的心血管风险差异。

2013-15年间,全美范围内服用上述抗糖尿病药患者参与研究。主要终点为心衰和复合心血管终点事件。

随访30个月,相对于DPP-4抑制剂,与卡格列净相关的心衰入院的风险比为0.70;与GLP-1受体激动剂相比为0.61;与磺酰脲相比为0.51。与DPP-4抑制剂相比,卡格列净相关的复合心血管终点的风险比为0.89;与GLP-1受体激动剂相比为1.03;与磺酰脲相比为0.86。

研究认为卡格列净可降低糖尿病患者心脏病住院风险。

【2】儿童肥胖家庭-学校干预--WAVES研究


近日研究人员考察了以学校和家庭为基础的健康生活方式干预对儿童肥胖的预防效果。

干预计划为期12个月,包括饮食及体育活动,主要内容为每天30分钟的体育活动时间、为期6周的足球课程、每六个月进行一次家庭社区体育活动大赛以及定期举行的健康烹饪技能培训。

研究发现,干预组与对照组在15个月以及30个月的体重指数变化差异不显著,其他人体机能、饮食、体力活动或心理健康方面组间也没有显著性差异。

【3】5-10分钟 Apgar 评分与新生儿脑瘫及癫痫风险成反比


近日研究人员考察了胎龄大于37周的新生儿出生5或10分钟 Apgar评分与脑瘫及癫痫风险之间的关系。

研究在瑞典开展,1213470名非畸形活胎新生儿参与研究,考察新生儿出生5或10分钟的Apgar评分。研究的主要终点是至16周岁时儿童脑瘫及癫痫。

1221名(0.1%)儿童诊断为脑瘫,3975名(0.3%)儿童诊断为癫痫。相对于5分钟 Apgar评分10分的新生儿,脑瘫风险随Apgar评分降低而增加:Apgar9分新生儿脑瘫风险为1.9,而0分新生儿风险高达277.7。。Apgar评分与癫痫之间的相关性降低,5分钟评分低于7分以及10分钟评分低于8的新生儿其癫痫风险增加。相对于5或10分钟均为9-10分的新生儿,5分钟评分7-8以及10分钟评分9-10的新生儿其脑瘫与癫痫风险增加。

【4】腹腔镜手术术后护理及注意事项


过去的30年间,腹腔镜手术为腹部手术带来了革命性的变化。全球每年约进行1500万例腹腔镜手术,其中英国占10%。腹腔镜手术因成像和特殊的仪器设计,使外科医生能够在不造成大腹部切口的情况下进行手术,因而深受全世界范围内医生和病人的欢迎。腹腔镜手术的优点包括术中可见性好、疤痕小、疼痛少、住院时间短以及恢复快。近日研究人员就腹腔镜手术后伤口护理,血栓预防和并发症处理等问题进行了探讨:

1、腹腔镜手术后的恢复时间取决于手术内容,一般可缩短至1-2周;

2、患者术后因避免驾驶机动车直至患者恢复至能够进行盲点观察以及紧急制动;

3、术后疼痛加重往往意味着潜在的腹部并发症,患者需要进行紧急评估;

4、大部分腹腔镜手术后伤口感染为浅表性,但部分伤口感染可能涉及较深的组织,特别假体材料植入患者。

【5】NICE胃食道癌治疗及诊断指南


胃食道癌是英国第四大常见肿瘤死亡因素,每年新增患者16000例,其发病率逐年上升 。近日NICE更新了胃食道癌的治疗和诊断指南:

1、对于接受胃食道癌治疗的患者,营养支持十分重要:应根据患者的临床情况制定个性化的营养支持方案;

2、通常不采用常规临床随访或放射影像的方法对患者疾病复发或进展进行监测,对于存在症状的食道癌病史患者应转诊到专业的医疗机构就诊;

3、食道癌患者和其他肿瘤患者一样,心理治疗以及来自家庭、亲属以及社会支持关爱对于疾病的治疗至关重要。

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    2018-08-18 gaoxiaoe
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    2018-02-26 惠映实验室

    学习.谢谢分享.

    0

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    2018-02-17 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-02-17 大爰

    学习了谢谢分享!!

    0

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    2018-02-15 虈亣靌

    好知识.值得学习!

    0

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    2018-02-14 周周人

    学习.

    0

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    2018-02-14 秀红

    学习了

    0

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    2018-02-13 131****1460

    学习了受益匪浅

    0

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