ABSTRACT
【Objective】 To study the effect of perioperative allogeneic blood transfusion on patients with oral squamous cell carcinoma (OSCC) after first-stage free flap transplantation. 【Methods】 A total of 306 OSCC patients who accepted primary repair and reconstruction using free flap admitted to our affiliation from January 2010 to January 2019 were selected as the research objects and retrospectively analyzed. According to their clinical data, they were divided into three groups: no transfusion group (n=98), 1-2 U transfusion group (n=131) and 3 + U transfusion group (n=77), respectively. The incidence of complications including flap infection, blood circulation disorder and hematoma in the three groups were compared. The five-year survival rate of the three groups was calculated by Kaplan-Meier analysis, and the relative risk of death was analyzed by Cox regression. 【Results】 There was no statistically significant difference among the three groups of patients (P>0.05) regarding such baseline data as embracing gender, age, primary location, degree of differentiation, adjuvant radiotherapy and chemotherapy. The complication rate of patients with 3 + U transfusion (25.97%) was significantly higher than that of no transfusion (6.12%) and 1-2 U transfusion (10.86%) (P<0.05); and the five-year survival rate of patients with 3 + U transfusion (51.95%) was significantly lower than that of no transfusion (69.38%) and 1-2 U transfusion (62.60%) (P<0.05). The results of univariate analysis showed that age, adjuvant radiotherapy, degree of tissue differentiation, collateral infiltration, vascular invasion and blood transfusion were all factors influencing the quality of prognosis after repair and reconstruction of first-stage free flap transplantation treating OSCC (P<0.05). The results of multivariate analysis showed that adjuvant chemoradiotherapy was an independent protective factor for the prognosis and survival quality of postoperative OSCC patients (P<0.01); the degree of differentiation, vascular invasion and blood transfusion were independent risk factors for the prognosis and survival quality of postoperative OSCC patients (P<0.05). 【Conclusion】 Perioperative allogeneic transfusion in OSCC patients can increase the risk of postoperative complications and directly affect their prognostic quality. It can be regarded as an important risk factor for OSCC patients.
ABSTRACT
Objective:To study the clinical efficacy and prognostic quality of neurointervention combined with alteplase in the treatment of acute ischemic stroke.Methods:Ninety-two patients with acute ischemic stroke admitted to the First People's Hospital of Bijie City from February 2019 to December 2020 were selected and divided into the control group and the observation group using the random number method, with 46 cases in each group. Patients in both groups received conventional treatment with intravenous thrombolytic therapy with alteplase, and on this basis, patients in the observation group received neurointerventional treatment. The overall efficiency, national institutes of health stroke scale (NIHSS) score, modified Thrombolysis in cerebral infarction classification (mTICI) score, modified rankin scale (mRS) score, complication rate, and prognostic indexes of patients in both groups were compared after the treatment.Results:The total treatment efficiency of patients in the observation group was 93.48%, which was significantly higher than that of 76.09% in the control group ( P<0.05). The NIHSS scores of both groups were significantly lower than those of the same period before treatment at 1 and 7 days and 1 and 3 months after the treatment (all P<0.05), and the NIHSS scores of the observation group were significantly lower than those of the control group at the same period ( P<0.01). The proportions of mTICI grades < grade 2 and mRS scores in the observation group were significantly lower than those in the control group after treatment(all P<0.05). The overall complication rate of patients in the observation group was significantly lower than that of the control group( P<0.05), and the re-infarction rate of patients in the observation group was significantly lower than that of the control group ( P<0.05). Conclusions:For acute ischemic stroke, neurointervention combined with alteplase is effective, can reduce the risk of complications, and improve the quality of the patient's prognosis, and therefore deserves to be promoted in clinical practice.