《广州医药》
点击关注官方服务号追踪稿件状态

【重要服务提醒】《广州医药》杂志服务号已上线稿件查询功能

各位作者、审稿专家:
本刊官方微信服务号新增稿件状态查询服务,无需反复登录投稿系统,微信即可随时查看审稿进度、修回通知、录用结果,稿件更新实时推送提醒,同步接收期刊征稿、学术资讯。

操作方式

微信搜索关注广州医药杂志服务号 → 点击菜单栏「绑定账号」→ 输入投稿邮箱完成账号关联;请关闭微信消息免打扰,避免遗漏稿件通知。

《广州医药》编辑部

广州医药杂志服务号
论著

支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况分析

Analysis of the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia treated with bronchoscopy combined with nebulized inhalation of medication

:377-381
 
        目的   探究支气管镜联合雾化吸入药物对肺炎支原体肺炎患儿症状持续时间及肺部影像学好转情况。方法   选取94例肺炎支原体肺炎患儿为研究对象,以随机数字表法分为A组、B组,各47例,分别实施布地奈德雾化吸入治疗、支气管镜肺泡灌洗联合布地奈德雾化吸入治疗,比较两组症状持续时间、治疗后肺部影像改善情况、炎症指标水平及不良反应发生率。结果  B组体温恢复时间(2.73±0.51)d、咳嗽消失时间(5.98±1.24)d、住院时间(10.96±3.36)d,A组分别为(3.14±0.83)(7.06±2.33)(13.27±3.18)d,B组较A组短(t=2.885、2.809、3.423,均P<0.05);治疗后B组40.43%阴影完全消失、34.04%阴影显著缩小、23.40%阴影有所缩小、2.13%阴影改善不明显,A组分别为21.28%、36.17%、25.53%、17.02%,B组肺部阴影改善情况优于A组(Z=8.311,P<0.05);治疗前B组白细胞计数(WBC)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平与A组相近(P>0.05);治疗后B组WBC(7.71±1.94)×109 /L、hs-CRP(4.96±1.44)mg/L、PCT(84.32±21.40)pg/mL,A组分别为(9.05±2.48)×109 /L、(6.17±1.85)mg/L、(105.46±34.02)pg/mL,B组水平较A组低(t=2.918、3.538、3.606,均P<0.05);B组不良反应发生率为8.52%,A组为4.26%,B与A组相近(χ 2 =0.178,P>0.05)。结论   对肺炎支原体肺炎患儿实施支气管镜联合雾化吸入药物治疗,可缩短康复时间,促进肺部阴影消退,降低其炎症指标水平,且未增加不良反应发生率。
     Objective  To investigate the effect of bronchoscopy combined with nebulized inhalation of medication on the duration of symptoms and pulmonary imaging conversion in children with Mycoplasma pneumoniae pneumonia(MPP).Methods  A total of 94 children with MPP were selected as the research subjects and randomly divided into Group A and Group B using a random number table,with 47 cases in each group.They were treated with budesonide nebulization inhalation therapy and bronchoalveolar lavage combined with budesonide nebulization inhalation therapy,respectively.The duration of symptoms,improvement of lung imaging before and after treatment,levels of inflammatory indicators,and incidence of adverse  reactions were compared between the two groups.The results showed that the temperature recovery time was(2.73±0.51)days,cough disappearance time was(5.98±1.24)days,and hospitalization time was(10.96±3.36)days in Group B,(3.14±0.83)days,(7.06±2.33)days,and(13.27±3.18)days in Group A,respectively.Durpation in Group B was shorter than Group A(t=2.885,2.809,3.423,all P<0.05). After treatment,40.43% of the shadows in Group B completely disappeared,34.04% of the shadows significantly reduced,23.40% of the shadows reduced,and 2.13% of the shadows showed no significant improvement,better than 21.28%,36.17%,25.53%,and 17.02% in Group A(Z=8.311,P<0.05). Before treatment,the white blood cell count(WBC),high-sensitivity C-reactive protein(hs CRP),and procalcitonin(PCT)levels in group B were similar to those in Group A(P>0.05).After treatment,the WBC(7.71±1.94)×109 /L,hs CRP(4.96±1.44)mg/L,and PCT(84.32±21.40)pg/mL in Group B were lower than those in Group A(9.05±2.48)×109 /L,(6.17±1.85)mg/L,and(105.46±34.02)pg/mL,respectivelyt=2.918,3.538,3.606,all P<0.05).The incidence of adverse reactions in Group B was 8.52%,while in Group A it was 4.26%.The incidence of adverse reactions in group B was similar to that in group A(χ 2 =0.178,P>0.05).Conclusions  Bronchoscopy combined with nebulized inhalation therapy for children with MPP can shorten the recovery time,promote the disappearance of lung shadows,reduce their inflammatory index levels,and without increasing the incidence of adverse reactions.
论著

串联质谱技术筛查高危新生儿遗传代谢性疾病的价值分析

Value analysis of tandem mass spectrometry in screening genetic metabolic diseases in high-risk neonates

:372-376
 
       目的   分析串联质谱技术筛查高危新生儿遗传代谢性疾病的价值。方法   于2023年1月—2024年3月,选择入住本院新生儿科的995例高危新生儿作为研究对象,采用串联质谱技术进行筛查,对筛查结果进行分析。结果   本研究期内995例新生儿初筛查阳性83例,最终确诊5例,假阳性78例,真阴性912例,阳性率8.34%(83/995),真阳性率6.02%(5/83)。确诊病例包括尿素循环障碍及高氨血症4例(其中2例经全外显子组核心家系测序分析确诊鸟氨酸氨甲酰转移酶缺乏症,基因变异来源为新发),枫糖尿症1例(基因确诊,变异来源为父亲及母亲)。结论   在高危新生儿遗传代谢疾病的筛查中,运用串联质谱技术进行筛查,及时有效进行专项检查,早期诊断遗传代谢性疾病,及时控制病情进展,降低死亡率和致残率,从而提高人口素质及生存质量,同时,对遗传代谢病的高危家庭开展咨询,指导优生优育。
       Objective  To analyze the value of tandem mass spectrometry in screening genetic metabolic diseases in high-
risk neonates.Methods  From January 2023 to March 2024,a total of 995 high-risk neonates admitted to the neonatal department of our hospital were selected as the research subjects,tandem mass spectrometry was used for screening,and the screening results were analyzed.Results  During the study period,83 of the 995 neonates were positive in the initial screening,5 cases were finally confirmed,78 cases were false positives,and 912 cases were true negatives,with a positive rate of 8.34%(83/995)and a true positive rate of 6.02%(5/83).The confirmed cases included 4 cases of urea cycle disorder and hyperammonemia(2 cases were confirmed with ornithine carbamyltransferase deficiency by whole exome core family sequencing analysis,and the source of the gene variant was de novo),and 1 case of maple syrup urine disease(genetic diagnosis,the source of the mutation was father and mother).Conclusions  In the screening of genetic metabolic diseases in high-risk neonates,the use of special examinations in tandem mass spectrometry can timely and effectively diagnosis genetic metabolic diseases,therefore timely control the progression of disease and reduce mortality and disability rates,consequently improve the quality of population and life.At the same time,we can provide guidance for good birth and good parenting by carrying out consultation to high-risk genetic metabolic diseases families.
论著

D-HyCoSy 配合宫腔水造影对不孕症患者 IUA 诊断灵敏度、特异度分析

The analysis of sensitivity and specificity of D-HyCoSy combined with uterine hydrography in the diagnosis of IUA in infertile patients

:346-349
 
       目的   探析子宫输卵管超声造影(D-HyCoSy)配合宫腔水造影对不孕症患者宫腔粘连(IUA)诊断灵敏度、特异度情况。方法   选取2021年1月—2023年2月南华大学附属长沙中心医院的110例不孕症者为研究对象,均予以宫腔水造影、D-HyCoSy,以宫腔镜病理结果为金标准,分析不同诊断方法应用的效果。结果   在110例不孕症患者中,经宫腔镜病理检查发现,宫腔粘连患者占比47.27%(52/110)。D-HyCoSy的诊断准确率为76.36%、宫腔水造影的为79.09%,均低于联合诊断的93.63%(P<0.05)。D-HyCoSy的诊断灵敏度为73.08%,宫腔水造影的为80.77%,均低于联合诊断的94.23%,差异具有统计学意义(P<0.05)。D-HyCoSy的诊断特异度为79.31%,宫腔水造影的为77.59%,与联合诊断的93.10%相比,差异无统计学意义(P>0.05)。结论   对于不孕症患者,予以宫腔水造影联合D-HyCoSy诊断,其诊断效能高于单一诊断检查率,能更准确地判定宫腔粘连,效能高。
医院管理

广东省高水平中医院建设背景下的青年中医人才岗位胜任力现状调查分析

Investigation and analysis of the job competence status of young TCM talents under the background of high level TCM hospital construction in Guangdong Province

:273-281
 
      目的   旨在通过实证了解广东省青年中医人才岗位胜任力现状,探讨青年中医人才岗位胜任力素质特征,为青年中医人才培养提供策略。方法   通过专家咨询制定《青年中医人才岗位胜任力评价框架》并开展问卷调查,采用SPSS 26.0进行数据分析。结果   构建了包含8个一级指标、76个二级指标的《青年中医人才岗位胜任力评价框架》;广东省青年中医人才岗位胜任力自评总分整体处于及格以上水平。女性在职业价值和职业素养、临床技能、交流与沟通技能、管理能力和团队合作、批判性思维与学术科研能力的评分高于男性;不同职称在其他附加维度的评分比较具有统计学差异(P<0.05)。结论   构建的评价框架能够有效评估青年中医人才岗位胜任力;广东省青年中医人才岗位胜任力整体处于及格水平,需重视补强短板;女性青年中医人才岗位胜任力多个维度的得分优于男性,着重提升各人群的弱项维度岗位胜任力;进一步建立健全职称评聘制度,以破五唯为导向构建符合不同级别职称的青年中医人才评价机制。
      Objective  To understand the current job competence status of young TCM talents in Guangdong Province through empirical research,to explore the characteristics of job competence and quality of young TCM talents,providing strategy for cultivating young talents in TCM.Methods The “Competency Evaluation Framework for Young TCM Talents” was developed through expert consultation and a questionnaire survey was conducted.SPSS 26.0 was used for data analysis.Results  “Job Competency Evaluation Framework for Young TCM Talents” was constructed,which included 8 primary indicator items and 76 secondary indicator items.The overall self-evaluation score of the overall job competence of young TCM talents in this study was above the passing level.Female score was higher than male in terms of professional value and professional ethics,clinical skills,communication and interpersonal skills,management ability and teamwork,critical thinking and academic research ability.There were statistically significant differences in the scores of different job titles in other additional dimensions(P<0.05).Conclusions  The constructed evaluation framework can effectively assess the job competence of young TCM talents.The overall competence of young TCM talents in Guangdong Province is at a passing level,and attention  should paid to  strengthening their weaknesses.Female young TCM talents have better multidimensional scores in job competence than males,and efforts should be made to focus on improving the weak dimensional job competence of various groups of people.The professional title evaluation and appointment system needs to be established and improved.A talent evaluation mechanism should be built for young TCM talents that meets different levels of professional titles,guided by the principle of breaking the five criteria.
中医研究

穴位贴敷疗法干预矮小症现代文献分析

Modern literature analysis of acupoint application therapy for short stature

:260-267
 
       目的   分析现代文献中穴位贴敷疗法干预矮小症研究现状,为临床治疗该病提供依据。方法   整理近2018年1月—2023年12月6年间国内医学期刊上公开发表的关于穴位贴敷疗法治疗矮小症的中文文献,对文献年代分布、发表期刊、研究内容、贴敷穴位、贴敷药物、贴敷的时间、频次、治疗时间、观察指标、中西医结合治疗矮小症、不良反应等进行统计分析。   最终纳入的文献共10篇,近6年间均有相关文献发表;发表期刊《中医儿科杂志》《新中医》《中国现代医生》《中医外治杂志》《中国中西医结合儿科学》;研究内容涉及矮小症分型、穴位贴敷联合重组人生长激素法、畲医法、中药内服法、拉伸操法、营养干预指导、推拿等方法治疗矮小症。结论   穴位贴敷疗法联合其他疗法在临床上对儿童矮小症的改善效果显著,不良反应轻微,相信随着矮小症成因的进一步明确,穴位贴敷疗法治疗矮小症的机制会更加清晰,为改善矮小症提供科学理论依据,同时,为矮小症等相关疾病的治疗提供新思路。
      Objective  To analyze the research status of acupoint application therapy in short stature from January 2018 to December 2023,and to provide basis for clinical treatment of the disease.Methods  To review the Chinese literature published in domestic medical journals in recent 6 years on the treatment of short stature by acupoint application therapy,including the distribution of time and journals,the research contents,the acupoint application,the drug application,the application time,the treatment frequency and duration,the observation index,treatment of short stature with integrated traditional,Chinese and Western medicine and adverse reactions were statistically analyzed.Results  There were 10 articles in this review,and all of them were published in the past 6 years,published journal were Pediatrics of Traditional Chinese medicine,new Traditional Chinese medicine,modern Chinese doctor,Journal of external treatment of traditional Chinese medicine,Pediatrics of integrated traditional Chinese and Western medicine in China.The research content involved the short stature classification,acupoint application combined with  recombinant human growth hormone therapy,the She medical therapy,traditional Chinese medicine,stretching manipulation,nutrition intervention guidance,massage and other methods.Conclusions  The combination of acupoint application therapy and other therapies has a significant clinical effect on the improvement of short stature in children,with slight adverse reactions.It is believed that with the further clarification of the causes of short stature,the mechanism of point application therapy for short stature will be more clear and provide scientific basis for improving short stature.At the same time,it may provide a new idea for the treatment of dwarfism and other related diseases.
论著

阴道分娩后尿失禁患者疾病应对方式及其相关影响因素分析

Analysis of disease coping strategies and related influencing factors in patients with urinary incontinence after vaginal delivery

:211-215
 
       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例,评估所有患者的应对方式,根据结果分为积极应对组与消极应对组,设计基线资料调查表,详细统计两组患者的基线资料并比较,重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估,78例阴道分娩后尿失禁患者疾病消极应对有40例,占比51.28%;积极应对组与消极应对组患者的产次(χ 2 =4.110,P=0.043)、文化水平(Z=2.094,P=0.036)、家庭关怀度(Z=2.069,P=0.040)与自我效能(Z=2.249,P=0.025)比较差异有统计学意义,组间年龄(t=0.096,P=0.924)、孕次(t=1.257,P=0.212)、体质指数(BMI)(t=0.125,P=0.901)、工作(χ 2 =0.778,P=0.378)、家庭月人均收入(χ 2 =0.044,P=0.834)、漏尿(χ 2 =0.040,P=0.842)比较差异无统计学意义;经回归分析发现,家庭关怀度低(OR=1.799,P=0.041)、自我效能低(OR=1.942,P=0.026)、经产妇(OR=2.554,P=0.045)及文化水平低(OR=1.837,P=0.038)均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高,可能与产次、文化水平、家庭关怀度及自我效能有关。
       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery.Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected.The coping strategies of all patients were evaluated,and they were divided into a positive coping group and a negative coping group based on the results.A baseline data questionnaire was designed,and the baseline data of the two groups of patients were compared in detail.The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery.Results After evaluation,40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies,accounting for 51.28%.The parity of patients in the positive and negative coping groups(χ 2 =4.110,P=0.043),educational level(Z=2.094,P=0.036),family care(Z=2.069,P=0.040),and self-efficacy(Z=2.249,P=0.025)among the groups were different.Age between groups(t=0.096,P=0.924),gestational age(t=1.257,P=0.212),body mass index(t=0.125,P=0.901),and work experience(χ 2 =0.778,P=0.378),monthly per capita income of households(χ 2 =0.044,P=0.834),urinary leakage(χ 2 =0.040,P=0.842)had no statistically significant difference in comparison.Through regression analysis,it was found that low family care(OR=1.799,P=0.041),low self-efficacy(OR=1.942,P=0.026),postpartum women(OR=2.554,P=0.045),and low educational level(OR=1.837,P=0.038)were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery.Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease,which may be related to parity,educational level,family care and self-efficacy.
论著

恶性中胚叶混合瘤临床病理特征分析

Analysis of clinicopathologic features of malignant mesodermal mixed tumor

:160-165
 
       目的   总结女性生殖系统中恶性中胚叶混合瘤(MMMT)的临床病理特征及预后,分析P53及错配修复蛋白与MMMT发病之间的关系。方法   收集大理大学第一附属医院2015年9月—2022年9月15例经手术切除病理诊断为MMMT的病例,总结临床病理特点、免疫表型(P53、错配修复蛋白等)、治疗方案并随访。结果  15例MMMT原发于子宫10例,卵巢5例。发病年龄范围49~76岁,平均年龄60岁,中位年龄58岁。临床表现为阴道流血或流液,伴或不伴腹痛或盆腔包块。镜下肿瘤均由不同比例的恶性上皮和间叶源性肿瘤构成,P53野生型12例,突变型3例;错配修复蛋白(MSH6、MSH2、MLH1、PMS2)检测存在缺失的有4例。15例患者中均行手术治疗,12例行盆腔淋巴结清扫术,术后辅以放化疗。随访失访2例,死亡4例,复发6例,3例术后无复发和转移。结论   恶性中胚叶混合瘤临床少见,恶性程度高,病理诊断上存在困难,需要辅以免疫组织化学染色,P53及错配修复蛋白缺失与MMMT的发生存在一定关系。治疗上需要手术切除,辅以放化疗。
    Objective  To summarize the clinical and pathological characteristics and prognosis of malignant mesodermal mixed tumor(MMMT)in the female reproductive system,and analyze the relationship between P53 and mismatch  repair proteins and the onset of MMMT.Methods  A total of 15 cases diagnosed with MMMT after surgical resection at the First Affiliated Hospital of Dali University from September 2015 to September 2022 were collected.The clinical and pathological characteristics,immune phenotype(P53,mismatch repair protein,etc. ),treatment plan were summarized.And the patients were followed-up.Results  Ten of 15 cases of MMMT were primary in the uterus and 5 of 10 in the ovaries.The age range of onset was 49 to 76 years old,with an average age of 60 and a median age of 58.Clinical manifestations included vaginal bleeding or fluid discharge,with or without abdominal pain or pelvic masses.Under the microscope,all tumors were composed of malignant epithelial and mesenchymal tumors in different proportions,with 12 cases of P53 wild-type and 3 cases of mutant type.There were 4 cases of missing mismatch repair proteins(MSH6,MSH2,MLH1,PMS2)detected.Among the 15 patients,all underwent surgical treatment,and 12 underwent pelvic lymph node dissection with postoperative adjuvant chemotherapy and radiotherapy.Two cases were lost to follow-up,four cases died,six cases recurred,and three cases had no recurrence or metastasis after surgery.Conclusions  MMMT are rare in clinical practice,with high malignancy and poor prognosis.Pathological diagnosis is difficult,and immunohistochemical staining is needed.The absence of P53 and mismatch repair protein is related to the occurrence of MMMT. Surgical  resection is required for treatment,supplemented by radiotherapy and chemotherapy.
医院管理

广州市越秀区 3 所综合医院 93 例医疗损害责任纠纷案件法院审理浅析

Analysis of the court trial of 93 cases of medical damage liability disputes in three general hospitals in Yuexiu District,Guangzhou

:131-138
 
       目的   对医疗损害责任纠纷案的法庭审理进行分析,探究医疗损害责任纠纷案件的处理现状,对此过程中医疗机构应当关注的问题进行分析总结,以期为医院应对医疗损害鉴定工作和法官审理医疗损害责任纠纷案提供参考。方法   对广州市三所综合医院2015—2021年共93例医疗损害责任纠纷案的判决书进行描述性分析。结果  93例案例中79例进行了医疗损害鉴定。79例进行医疗损害鉴定的案例中,71例鉴定结论被法院采信,采信率达90%。有29例案件鉴定人出庭(占比36.7%),其中有25例鉴定意见被法院采信,采信率为86.2%,仅有7例案例当事人申请了专家辅助证人出庭。医方大多数最终承担次要及以下责任占比为73.4%。鉴定结论为责任范围的,法院最后判决偏向于取最高值和中间值(43例出具责任范围的案例中,14例为最高值,13例为中间值)。结论   医疗机构要充分加强对医疗事故技术鉴定和医疗损害鉴定的认识,高度重视医疗损害鉴定工作,尤其加强尸体解剖告知及病历书写管理,充分利用好鉴定人和专家辅助证人出庭两种手段。
      Objective  To analyze the court trial of medical damage liability disputes,to explore the current situation of medical damage liability disputes,to analyze and summarize the problems encountered in dealing with medical damage disputes,so as to provide some references for hospitals to deal with medical damage disputes.Methods  Descriptive statistical analysis performed on the written judgment of 93 cases of medical damage liability disputes in three large comprehensive hospitals in Yuexiu District,Guangzhou from 2015 to 2021.Results  In 93 cases,79 cases had expertise of medical malpractice.In 79 expertise,71 of them were adopted,and the acceptance rate was 90%.Among the 29 cases in which the appraisers appeared in court,25 expert opinions were accepted by the court,the acceptance rate was 86.2%.In only 7 cases,the parties applied for expert witnesses to appear in court.In most cases,hospitals ultimately took secondary and lower responsibilities,accounting for 73.4%.If the appraisal conclusion falls within the scope of responsibility,the court’s final judgment tends to take the highest and middle values.Conclusions  Medical institutions should fully strengthen their understanding of technical identification of medical accidents and medical malpractice identification.Attach great importance to the identification of medical malpractice,especially strengthen the management of autopsy notification and medical record writing,make full use of two methods:appraisers and experts witnesses appearing in court.
论著

AST、CHE、CA125、AFP 对肝硬化患者的诊断效果分析

Analysis of diagnostic efficacy of AST, CHE, CA125 and AFP in patients with liver cirrhosis

:113-116
 
     目的   分析谷草转氨酶(AST)、胆碱酯酶(CHE)、糖类抗原125(CA125)以及甲胎蛋白(AFP)对肝硬化患者的诊断效能。方法   选择70例肝硬化患者为观察组研究对象,另取70例同期健康体检者为对照组。两组研究对象均接受生化检验、肿瘤标志物检验。对比两组研究对象的AST、CHE、CA125、AFP检测结果,分析上述指标对肝硬化患者的诊断效能。结果   观察组肝硬化患者的CHE低于对照组,AST、CA125与AFP高于对照组(P<0.05);AST与CHE在肝硬化诊断中具有良好的灵敏度、特异度;CA125联合AFP的灵敏度、特异度、符合率均高于CA125或AFP单独检验(P<0.05)。结论  AST、CHE、CA125、AFP在肝硬化患者临床诊断中具有良好的应用表现,是反映患者肝硬化病情进展的重要参考指标。
     Objective  To analyze the diagnostic efficacy of aspartate aminotransferase(AST),cholinesterase(CHE),carbohydrate antigen 125(CA125),and alpha fetoprotein(AFP)in patients with liver cirrhosis.Methods  A total of 70 patients with liver cirrhosis were included in the observation group as the study subjects,and 70 healthy individuals who underwent physical examinations during the same period were selected as the control group.Both groups of  research subjects underwent biochemical testing and tumor marker testing.The AST,CHE,CA125,and AFP detection  results of two groups of research subjects were compared,and the diagnostic effect of the above indicators on patients with liver cirrhosis were analyzed.Results  The CHE test  results of patients with liver cirrhosis in the observation group were significantly lower than those of healthy individuals undergoing physical examination,and the AST,CA125,and AFP test results were higher(P<0.05).AST and CHE had good sensitivity and specificity in the diagnosis of liver cirrhosis.The sensitivity,specificity and coincidence  rate of CA125 combined with AFP were higher than those of CA125 or AFP alone.Conclusions  AST,CHE,CA125,and AFP have good clinical application performance in the diagnosis of liver cirrhosis patients,and are important reference indicators reflecting the progression of liver cirrhosis in patients.
论著

不同湿化方法对喉癌患者术后气道湿化效果的网状 Meta 分析

Effects of airway humidification for postoperative with laryngeal cancer:A network Meta-analysis

:89-98
 
       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR(95%CI)=537.70(4.18,124 511.88)、0(0,0.52),P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR(95%CI)=8.55(1.40,73.35),P<0.05];其余比较差异无统计学意义(P>0.05)。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。
       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer.Methods  PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively.Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation.The network Meta analysis was performed using ADDIS 1.16.5 softwares.Results  A total of 18 articles and 1596 patients were inciuded.The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR(95%CI)=537.70(4.18,124 511.88),0(0,0.52),P<0.05].In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR(95%CI)=8.55(1.40,73.35),P<0.05],the others were not statistically different(P0.05).Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness.Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients.
出版者信息








《广州医药》公众号