ABSTRACT
Objective To investigate the relationship between enteral nutrient albumin supply and prognosis in patients with mechanical ventilation. Methods The clinical data of 418 mechanically ventilated patients receiving enteral nutrition support treatment in intensive care unit (ICU) of the First Hospital of Jiaxing from January 2016 to June 2019 were retrospectively analyzed. According to whether the daily albumin supply was up to standard, the patients were divided into the standard group (albumin supply was ≥1.2 g·kg-1·d-1) and the non-standard group (albumin supply was < 1.2 g·kg-1·d-1). Prealbumin, transferrin levels before and after treatment, 28-day mortality, mechanical ventilation time and the length of ICU stay were compared between the two groups. Results A total of 418 patients were included, including 225 in the standard group and 193 in the non-standard group. There were no significant differences in gender, age and disease composition between the two groups, and the baseline data were comparable. There was no significant difference in daily calories between the standard group and the non-standard group (kJ/d: 119.73±31.55 vs. 110.05±28.98, P > 0.05), but the daily albumin supply of the standard group was significantly higher than that of the non-qualified group (g·kg-1·d-1: 1.38±0.83 vs. 0.95±0.75, P < 0.05). There was no significant difference in the levels of prealbumin, transferrin between the two groups before treatment. The levels of prealbumin, transferrin in standard group and non-standard group were significantly higher after treatment than before [prealbumin (mg/L): 188.53±69.25 vs. 119.44±57.62, 145.18±56.92 vs. 108.81±69.50; transferrin (g/L): 2.99±0.87 vs. 1.85±0.76, 2.09±0.81 vs. 1.52±0.76, all P < 0.05]. Moreover, prealbumin and transferring in the standard group were further improved than the non-standard group [prealbumin (mg/L): 188.53±69.25 vs. 145.18±56.92, transferrin (g/L): 2.99±0.87 vs. 2.09±0.81, both P < 0.05]. In addition, mechanical ventilation time, the length of ICU stay of the standard group were significantly shorter than those of the non-standard group (hours: 147.2±7.5 vs. 216.6±8.2, 198.8±9.5 vs. 295.4±8.9, both P < 0.05), but there was no statistically significant difference in 28-day mortality [11.56％ (26/225) vs. 15.03％ (29/193), P > 0.05]. Conclusion Under the condition of standard enteral nutritional calories, increased ofthe albumin supply can improve the clinical nutritional status of patients with mechanical ventilation, shorten mechanical ventilation time and hospital stay.
ABSTRACT
Objective@#To investigate the relationship between enteral nutrient albumin supply and prognosis in patients with mechanical ventilation.@*Methods@#The clinical data of 418 mechanically ventilated patients receiving enteral nutrition support treatment in intensive care unit (ICU) of the First Hospital of Jiaxing from January 2016 to June 2019 were retrospectively analyzed. According to whether the daily albumin supply was up to standard, the patients were divided into the standard group (albumin supply was ≥1.2 g·kg-1·d-1) and the non-standard group (albumin supply was < 1.2 g·kg-1·d-1). Prealbumin, transferrin levels before and after treatment, 28-day mortality, mechanical ventilation time and the length of ICU stay were compared between the two groups.@*Results@#A total of 418 patients were included, including 225 in the standard group and 193 in the non-standard group. There were no significant differences in gender, age and disease composition between the two groups, and the baseline data were comparable. There was no significant difference in daily calories between the standard group and the non-standard group (kJ/d: 119.73±31.55 vs. 110.05±28.98, P > 0.05), but the daily albumin supply of the standard group was significantly higher than that of the non-qualified group (g·kg-1·d-1: 1.38±0.83 vs. 0.95±0.75, P < 0.05). There was no significant difference in the levels of prealbumin, transferrin between the two groups before treatment. The levels of prealbumin, transferrin in standard group and non-standard group were significantly higher after treatment than before [prealbumin (mg/L): 188.53±69.25 vs. 119.44±57.62, 145.18±56.92 vs. 108.81±69.50; transferrin (g/L): 2.99±0.87 vs. 1.85±0.76, 2.09±0.81 vs. 1.52±0.76, all P < 0.05]. Moreover, prealbumin and transferring in the standard group were further improved than the non-standard group [prealbumin (mg/L): 188.53±69.25 vs. 145.18±56.92, transferrin (g/L): 2.99±0.87 vs. 2.09±0.81, both P < 0.05]. In addition, mechanical ventilation time, the length of ICU stay of the standard group were significantly shorter than those of the non-standard group (hours: 147.2±7.5 vs. 216.6±8.2, 198.8±9.5 vs. 295.4±8.9, both P < 0.05), but there was no statistically significant difference in 28-day mortality [11.56% (26/225) vs. 15.03% (29/193), P > 0.05].@*Conclusion@#Under the condition of standard enteral nutritional calories, increased of the albumin supply can improve the clinical nutritional status of patients with mechanical ventilation, shorten mechanical ventilation time and hospital stay.
ABSTRACT
A prospective study was conducted for 91 cases of fever patients after neurosurgical procedures during the period of January-December 2013.They were divided into non-infection (n =42) and infection (n =49) groups according to whether there was infection complication.And another 51 nonsurgical hospitalized patients without fever or infection were selected as control group.The levels of procalcitonin (PCT),C-reactive protein (CRP) and white blood cell (WBC) were detected respectively.Statistical analysis showed that the level of PCT had no significant difference between non-infection and control groups (P ＞ 0.05).However,it was markedly elevated in infection group than non-infection group (P ＜ 0.01).The level of CRP was significantly different between non-infection and control groups (P ＜ 0.01).And it was the same between infection and non-infection groups.The level of WBC had significant difference between non-infection and control groups (P ＜ 0.05) and infection and non-infection groups (P ＜ 0.01).The receiver operating characteristic (ROC) curve showed that either sensitivity or specificity of PCT was the highest.Compared with CRP and WBC,PCT may identify more accurately the causes of fever after neurosurgical procedures.
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Objective To evaluate the surgical effect of the surgical removal of both medial temporal lobe lesion and hippocampus amygdala for treating epilepsy. Methods Retrospectively analyzed 18 cases of epilepsy induced by the medial temporal lobe lesion and their hippocampal epileptic discharge was recorded by the deep electrode. Removed both medial temporal lobe lesion and hippocampus amygdala through medial temporal gyrus by modified pterional approach. The lesion had been totally removed in all of these 18 cases in naked eye. Evaluated the effect of surgery for epilepsy by Engel grading scale. Results These cases were followed up for average 2.8 years. Engel Ⅰ for 13 cases, Engel Ⅱ for 4 cases, Engel Ⅲ for 1 cases, Engel Ⅳ for none after operation. But there were lateral 1/4 quadrantanopsia in 2 cases, recent memory decreasing in 3 cases and none of death or any other complication. Conclusion Surgical removal of both medial temporal lobe lesion and hippocampus amygdala is a safe and effective method for treating epilepsy with less complication.