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Objective:To investigate the effect of liver cirrhosis complicated with thrombocytopenia on perioperative period.Methods:The retrospective and descriptive study was conducted. The clinical data of 75 cirrhosis patients complicated with thrombocytopenia who were admitted to the Fuyang City Second People's Hospital from July 2020 to February 2022 were collec-ted. There were 56 males and 19 females, aged (58±11)years. Observation indicators: (1) preoperative conditions; (2) intraoperative and postoperative conditions. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the one way ANOVA. Pairwise comparison was conducted using the LSD- t test. Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Results:(1) Preoperative conditions. Of 75 cirrhosis patients complicated with thrombocytopenia, there were significant differences in the preoperative Child-Pugh grading and platelet count between patients with mild, moderate, and severe thrombocytopenia ( P<0.05). Results of further analysis showed that compared with patients with mild thrombocytopenia, patients with moderate and severe thrombocytopenia had significantly lower preoperative platelet count ( P<0.05). Compared with patients with moderate thrombocytopenia, patients with severe thrombocytopenia had significantly lower preoperative platelet count ( P<0.05). (2) Intraoperative and postoperative conditions. Of 75 cirrhosis patients complicated with thrombocytopenia, there were significant differences in the surgical anesthesia methods, operation time, postoperative bleeding, duration of hospital stay between patients with mild, moderate, and severe thrombocytopenia ( P<0.05). Results of further analysis showed that compared with patients with mild or moderate thrombocytopenia, patients with severe thrombocytopenia had a higher proportion of general anesthesia during surgery ( P<0.05) and compared with patients with mild thrombocytopenia, patients with severe thrombocytopenia significantly increased operation time and duration of hospital stay ( P<0.05). Of the 6 patients with severe thrombocytopenia, 3 of 5 cases with intraoperative platelet transfusion and 1 case without intraoperative platelet transfusion experienced postoperative bleeding, respectively, showing no significant difference between them ( P>0.05). Four patients with postoperative bleeding were successfully stopped bleeding after treatment and there was no death in the 75 patients. Conclusions:Patients with severe thrombocytopenia have longer operation time and duration of hospital stay, and higher proportion of general anesthesia than those with mild or moderate thrombocytopenia. Perioperative platelet transfusion cannot reduce the risk of postoperative bleeding.
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In 2020, the European Society of Paediatric and Neonatal Intensive Care first issued the international point-of-care ultrasound(POCUS) guideline for the critically ill newborns and children, which provided an evidence-based foundation to standardize the use of POCUS in the critically ill neonates and children.It has been widely recognized by neonatology and pediatric critical physicians worldwide.In order to keep our domestic colleagues updated and promote the POCUS application based on this international standard, the guideline was summarized and interpreted in this review.
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Objective To evaluate the effectiveness of low-dose erythromycin for the treatment of feeding intolerance in preterm infants in China.Methods In this study,random clinical trials on the treatment of feeding intolerance in preterm infants with intravenous low-dose erythromycin published were searched at Chinese Journal Full-text Database,Chongqing Weipu Database and Wanfang database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The publishing deadline for the literatures reviewed in this study was August 2012.Statistical analysis of clinical data was performed by using RevMan 4.2 software provided by the Cochrane Collaboration.Results A total of 9 studies were included.The results showed that compared with the group of comprehensive therapy,the group of low-dose erythromycin was superior in the following aspects with significant differences(P ＜ 0.05):the average length of hospital stay,time of parenteral nutrition,time to full feeding,the incidence rate of feeding intolerance (Z =3.44,P =0.000 6 ; Z =6.78,P ＜0.000 01 ; Z =3.96,P ＜ 0.000 1 ; Z =2.51,P =0.01).Conclusion Low-dose erythromycin therapy for feeding intolerance in preterm infants is superior to the comprehensive therapy.It provides a prospective therapeutic method for feeding intolerance in preterm infants.However,large scale,multicenter and well-designed clinical trials should be adopted to confirm the conclusions.