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1.
Chinese Critical Care Medicine ; (12): 648-653, 2021.
Article in Chinese | WPRIM | ID: wpr-909377

ABSTRACT

Objective:To explore the risk factors of intensive care unit acquired weakness (ICUAW) in patients with sepsis, and to evaluate the predictive value of each risk factor for ICUAW.Methods:A case control study was conducted, 60 septic patients admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from October 20, 2020 to February 20, 2021 were enrolled. The patients were divided into two groups: sepsis ICUAW group and sepsis non-ICUAW group. The data of gender, age, body mass index (BMI), acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, complications, mechanical ventilation, duration of ICUAW, length of stay in ICU, fasting blood glucose, blood lactic acid (Lac), procalcitonin (PCT), C-reactive protein (CRP), sequential organ failure assessment (SOFA) score, outcome, antimicrobial agent, glucocorticoid, sedatives and analgesics drugs and vasoactive drugs were collected. Risk factors were screened by univariate Logistic regression analysis, and odds ratio ( OR) was adjusted by multivariate binary logistic regression, P < 0.05 was considered as independent risk factors. Finally, the receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of independent risk factors. Results:The APACHEⅡ score of the sepsis ICUAW group was significantly higher than that of the sepsis non-ICUAW group (23.05±8.17 vs. 15.33±4.89, P < 0.05), the total length of stay in the ICU was significantly longer than that of the sepsis non-ICUAW group (days: 15.1±9.2 vs. 8.5±3.4, P < 0.05), the improvement rate of patients was significantly lower than that of the sepsis non-ICUAW group [45.0% (9/20) vs. 95.0% (38/40), P < 0.05]. After univariate Logistic regression and multicollinearity test analysis, 7 factors including APACHEⅡ score, average SOFA score, blood lactic acid, proportion of mechanical ventilation, sedatives and analgesics drugs, type of antibiotics and type of vasoactive drugs were included in the binary Logistic regression model [ OR: 1.21, 2.05, 2.26, 0.21, 1.54, 2.07, 1.38, 95% confidence interval (95% CI): 1.09-1.35, 1.42-2.94, 1.12-4.57, 0.05-0.66, 1.03-2.29, 1.27-3.37, 0.96-2.00, all P < 0.05]. Hosmer-Lemchaw test P = 0.901, and the correct percentage of prediction was 85%, indicating good model fit. Multivariate binary Logistic regression analysis showed that APACHEⅡ score and average SOFA score were independent risk factors for the occurrence of ICUAW in septic patients (APACHEⅡscore: OR = 1.17, 95% CI was 1.004-1.376, P = 0.044; average SOFA score: OR = 1.86, 95% CI was 1.157-2.981, P = 0.01). ROC curve analysis showed that the mean value of APACHEⅡ score, average SOFA score and their combined detection had a certain predictive value for the occurrence of ICUAW in sepsis patients, areas under ROC curve (AUC) were 0.787, 0.881, 0.905, 95% CI was 0.646-0.928, 0.791-0.972, 0.828-0.982, all P < 0.05. When the cut-off value was 19.500, 6.225, 0.375, the sensitivity was 75%, 90%, 90%, and the specificity were 80%, 80%, 85%, respectively. Conclusion:APACHEⅡ score and average SOFA score can be used as independent risk factors for the occurrence of ICUAW in sepsis, and their combined predictive value is better than that of individual index.

2.
Chinese Critical Care Medicine ; (12): 1368-1372, 2019.
Article in Chinese | WPRIM | ID: wpr-800903

ABSTRACT

Objective@#To explore the usability of regional saturation of cerebral oxygenation (rScO2) combined with percentage of α variability (PAV) in predicting brain function prognosis in patients with traumatic brain injury (TBI).@*Methods@#A retrospective analysis was conducted. The clinical data of patients with TBI who were monitored rScO2 and bedside quantitative electroencephalogram (qEEG) admitted to intensive care unit (ICU) of Henan Provincial People's Hospital from August 2018 to July 2019 were collected. The rScO2, PAV, and Glasgow coma scale (GCS) score were recorded within 72 hours after the TBI. The primary prognostic indicator was the 3-month Glasgow outcome score (GOS) score. The differences between the two groups of poor prognosis of brain function (GOS score 1-3) and good prognosis (GOS score 4-5) were compared. Binary multivariate Logistic regression analysis was used to analyze the correlation between rScO2, PAV, GCS score and the prognosis of brain function in patients with TBI. In addition, receiver operating characteristic (ROC) curve was plotted to analyze the predicting value of rScO2 and PAV only or combination for prognosis of brain function.@*Results@#A total of 42 patients with TBI were enrolled in the study, with rScO2≥0.60 (grade Ⅰ) in 14 patients, 0.50≤rScO2 < 0.60 (grade Ⅱ) in 16 patients, and rScO2 < 0.50 (grade Ⅲ) in 12 patients. PAV 3-4 scores (grade Ⅰ) were detected in 16 patients, 2 scores (grade Ⅱ) in 17 patients, and 1 score (grade Ⅲ) in 9 patients. GCS score 9-14 (grade Ⅰ) were observed in 13 patients, 4-8 (grade Ⅱ) in 23 patients, and 3 (grade Ⅲ) in 6 patients; 18 patients had poor prognosis and 24 had good one. The rScO2, PAV and GCS scores of the poor-prognosis group were significantly higher than those in the good-prognosis group [rScO2 with grade Ⅲ: 55.6% (10/18) vs. 8.3% (2/24), PAV with grade Ⅲ: 38.9% (7/18) vs. 8.4% (2/24), GCS score with grade Ⅲ: 27.7% (5/18) vs. 4.1% (1/24)] with significant differences (all P < 0.05). There was no significant difference in other general data including gender, age, total length of hospital stay or acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score between the two groups. Binary multivariate Logistic regression analysis showed that rScO2 and PAV were independent risk factors for prognosis of brain in patients with TBI [rScO2: odds ratio (OR) = 4.656, 95% confidence interval (95%CI) was 1.071-20.233, P = 0.040; PAV: OR = 3.525, 95%CI was 1.044-11.906, P = 0.042]. ROC curve analysis showed that both of rScO2 and PAV had predictive value for the prognosis of brain function in patients with TBI (AUC was 0.796 and 0.780, respectively, both P < 0.01), and rScO2 combined with PAV had higher predictive value with the AUC of 0.851 (P < 0.01) than rScO2 or PAV alone, the sensitivity was 94.4% and the specificity was 62.5%.@*Conclusions@#rScO2 and PAV were associated with early brain function prognosis in patients with TBI. The combination of two monitoring indicators can reliably assess the prognosis of brain function in patients with TBI.

3.
Chinese Critical Care Medicine ; (12): 1368-1372, 2019.
Article in Chinese | WPRIM | ID: wpr-824207

ABSTRACT

To explore the usability of regional saturation of cerebral oxygenation (rScO2) combined with percentage of α variability (PAV) in predicting brain function prognosis in patients with traumatic brain injury (TBI). Methods A retrospective analysis was conducted. The clinical data of patients with TBI who were monitored rScO2 and bedside quantitative electroencephalogram (qEEG) admitted to intensive care unit (ICU) of Henan Provincial People's Hospital from August 2018 to July 2019 were collected. The rScO2, PAV, and Glasgow coma scale (GCS) score were recorded within 72 hours after the TBI. The primary prognostic indicator was the 3-month Glasgow outcome score (GOS) score. The differences between the two groups of poor prognosis of brain function (GOS score 1-3) and good prognosis (GOS score 4-5) were compared. Binary multivariate Logistic regression analysis was used to analyze the correlation between rScO2, PAV, GCS score and the prognosis of brain function in patients with TBI. In addition, receiver operating characteristic (ROC) curve was plotted to analyze the predicting value of rScO2 and PAV only or combination for prognosis of brain function. Results A total of 42 patients with TBI were enrolled in the study, with rScO2≥0.60 (grade Ⅰ) in 14 patients, 0.50≤rScO2 < 0.60 (grade Ⅱ) in 16 patients,and rScO2 < 0.50 (grade Ⅲ) in 12 patients. PAV 3-4 scores (grade Ⅰ) were detected in 16 patients, 2 scores (grade Ⅱ) in 17 patients, and 1 score (grade Ⅲ) in 9 patients. GCS score 9-14 (grade Ⅰ) were observed in 13 patients,4-8 (grade Ⅱ) in 23 patients, and 3 (grade Ⅲ) in 6 patients; 18 patients had poor prognosis and 24 had good one. The rScO2, PAV and GCS scores of the poor-prognosis group were significantly higher than those in the good-prognosis group [rScO2 with grade Ⅲ: 55.6% (10/18) vs. 8.3% (2/24), PAV with grade Ⅲ: 38.9% (7/18) vs. 8.4% (2/24), GCS score with grade Ⅲ: 27.7% (5/18) vs. 4.1% (1/24)] with significant differences (all P < 0.05). There was no significant difference in other general data including gender, age, total length of hospital stay or acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score between the two groups. Binary multivariate Logistic regression analysis showed that rScO2 and PAV were independent risk factors for prognosis of brain in patients with TBI [rScO2: odds ratio (OR) = 4.656, 95% confidence interval (95%CI) was 1.071-20.233, P = 0.040; PAV: OR = 3.525, 95%CI was 1.044-11.906, P = 0.042]. ROC curve analysis showed that both of rScO2 and PAV had predictive value for the prognosis of brain function in patients with TBI (AUC was 0.796 and 0.780, respectively, both P < 0.01), and rScO2 combined with PAV had higher predictive value with the AUC of 0.851 (P < 0.01) than rScO2 or PAV alone, the sensitivity was 94.4% and the specificity was 62.5%. Conclusions rScO2 and PAV were associated with early brain function prognosis in patients with TBI. The combination of two monitoring indicators can reliably assess the prognosis of brain function in patients with TBI.

4.
Article in Chinese | WPRIM | ID: wpr-359535

ABSTRACT

Ultrasound diffraction tomography (UDT) possesses the characteristics of high resolution, sensitive to dense tissue, and has high application value in clinics. To suppress the artifact and improve the quality of reconstructed image, classical interpolation method needs to be improved by increasing the number of projections and channels, which will increase the scanning time and the complexity of the imaging system. In this study, we tried to accurately reconstruct the object from limited projection based on compressed sensing. Firstly, we illuminated the object from random angles with limited number of projections. Then we obtained spatial frequency samples through Fourier diffraction theory. Secondly, we formulated the inverse problem of UDT by exploring the sparsity of the object. Thirdly, we solved the inverse problem by conjugate gradient method to reconstruct the object. We accurately reconstructed the object using the proposed method. Not only can the proposed method save scanning time to reduce the distortion by respiratory movement, but also can reduce cost and complexity of the system. Compared to the interpolation method, our method can reduce the reconstruction error and improve the structural similarity.


Subject(s)
Algorithms , Artifacts , Image Processing, Computer-Assisted , Tomography , Ultrasonics
5.
Article in Chinese | WPRIM | ID: wpr-234485

ABSTRACT

A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.


Subject(s)
Biopsy, Needle , Humans , Imaging, Three-Dimensional , Male , Phantoms, Imaging , Prostate , Diagnostic Imaging , Rectum , Software , Ultrasonography
6.
Article in Chinese | WPRIM | ID: wpr-342962

ABSTRACT

A new scanning mode is proposed that the front-end of the probe is fixed, while the back-end makes fan-shaped, scanning movement. The new scanning mode avoided ribs drawbacks successfully. Based on the new scanning mode a 3D-Ultrasound Images System is accomplished to acquire 2D data of fetusfetus fetusfetus phantom and livers and kidneys, to demonstrates the effectiveness of the new scanning mode.


Subject(s)
Fetus , Humans , Imaging, Three-Dimensional , Kidney , Liver , Phantoms, Imaging , Ultrasonics , Methods
7.
Article in Chinese | WPRIM | ID: wpr-330488

ABSTRACT

This paper addressed the volume measurement of 3D ultrasound imaging system. Two different phantoms used in the measurement of volume of the 3D ultrasound imaging system were built, i.e., water phantom and agar phantom. The experiments demonstrated that as the increase of scan depth, the volume measurement accuracy is varied from 4% to 7% in water and 6% to 10% in agar. The phantoms and the volume measurement of the 3D ultrasound imaging system provides a basis for the establishment of testing standard and clinical application of 3D ultrasound imaging system.


Subject(s)
Imaging, Three-Dimensional , Phantoms, Imaging , Ultrasonography , Methods
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