J Gastroenterology:液体隔离参数能早期识别急性胰腺炎

2018-12-01 MedSci MedSci原创

临床工作中能否早期识别急性胰腺炎(AP)的严重程度对于改善预后至关重要。适用流体和流体输出计算的流体隔离(FS)是简单的预后参数,本项研究调查了其在预测AP严重程度中的作用。

背景及目的
临床工作中能否早期识别急性胰腺炎(AP)的严重程度对于改善预后至关重要。适用流体和流体输出计算的流体隔离(FS)是简单的预后参数,本项研究调查了其在预测AP严重程度中的作用。

方法
研究人员回顾性调查了2009年1月至2017年4月期间的AP患者,并比较了前24小时FS(FS24)与前48小时FS(FS48)和前24小时内给药液量(FV24)。使用ROC曲线评估用于预测重症监护病房(ICU)入院和持续器官衰竭(POF)的诊断率。

结果
共有400名AP患者纳入本项研究(中位年龄64岁;男性60%)。根据严重程度判断标准,158名患者(40%)被诊断为严重AP。死亡率,ICU入院率和POF分别为0.8%,4.5%和7.3%。与FS48相比,FS24显示出类似的预测准确性,并且在预测ICU入院和POF方面优于FV24。在多变量分析中,FS24≥1.6L,男性,全身炎症反应综合征和计算机断层扫描严重程度指数≥3的存在是AP中疾病进展的独立危险因素。

结论
FS24是一个简单且易于计算的参数,具有较高的预测准确性,可用于区分需要重症监护的患者。FS24≥1.6L的患者发生严重疾病的风险增加。

原始出处:

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    2018-12-29 许安
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    2018-12-02 txqjm

    谢谢了,学习

    0

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PAIN: 催眠可以降低急性烧伤患儿的疼痛及焦虑感,并加速伤口愈合

目前学界还没有一项随机对照试验研究催眠治疗在减轻疼痛和改善烧伤儿童伤口愈合中的效果。因此,本项随机对照试验旨在阐明催眠是否能减轻疼痛,焦虑和压力,并加速烧伤儿童的创面手术伤口愈合。

DDS: 血浆线粒体DNA分析有助于预测急性胰腺炎患者的胰腺坏死的发生风险

在治疗急性胰腺炎(AP)中常常需要特异性血浆生物标志物来预测胰腺坏死(PNec)的情况。本项研究的目的就是探讨血浆线粒体DNA(mtDNA)能否对AP患者出现PNec有预测作用。

BMC Gastroenterology:红细胞分布宽度与总血清钙比值是急性胰腺炎严重程度和死亡率的主要预测因子

急性胰腺炎(AP)有着很高的发病率和死亡率。红细胞分布宽度(RDW)是一个简单的常规参数,并且进步的炎症状态有关。本项研究的目的是评估RDW在AP严重程度和死亡率方面的诊断价值,并与其他预后评分系统相比较。

Clin Translational Gastroenterology:减肥手术的类型影响急性胰腺炎发生的风险

病态肥胖患者接受手术切除胃的治疗是解决肥胖的有效手段,而胃的切除方式分为垂直袖状胃切除术(VSG)和Roux-en-Y胃旁路手术(RYGB),这两种手术类型是否对急性胰腺炎(AP)的发生风险是否有不同的影响目前还没有研究报道。

GUT: MELD评分以及Child-Pugh 分级高的患者应早期行TIPS术

早期放置经颈静脉肝内门体分流术(TIPS)可提高肝硬化和急性静脉曲张出血(AVB)的高风险患者(Child-Pugh B加内镜下活动性出血或Child-Pugh C)的生存率。然而,早期TIPS标准可能会高估大部分患者的死亡风险,并且早期TIPS赋予此类患者的生存益处是否做够满意令人质疑。本项研究旨在探明何种患者适合TIPS手术。