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Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 207-210, 2019.
Artigo em Chinês | WPRIM | ID: wpr-754535

RESUMO

Objective To investigate the epidemiological characteristics of inpatients with acute cerebral hemorrhage, and to observe the different influencing factors on the outcome of the disease, so as to provide a reference for formulating prevention and treatment measures. Methods Four hundred in-patients with acute cerebral hemorrhage admitted to Haikou People's Hospital from May 2016 to May 2018 were enrolled, and their diagnoses were confirmed by magnetic resonance imaging (MRI), the CT, digital subtraction angiography (DSA). The patients' relevant information, including gender, age, occupation, life habits (drinking alcohol, smoking), onset season, hemorrhagic site, past medical history and complication (hypertension, cardiovascular disease, diabetes), blood glucose, first episode and recurrence, etc clinical data were collected from the self-designed case information table, the epidemiological characteristics of patients with acute cerebral hemorrhage were analyzed, and the indexes with statistical significance obtained from univariate analysis were included in the multivariate Logistics regression analysis, and the risk factors affecting the 28-day disease outcome of patients with cerebral hemorrhage were screened out. Results Among the 400 in-patients with acute cerebral hemorrhage, the patients with age ≥ 70 years old, being workers, winter onset, hemorrhage mainly in the cerebral lobe and having history of hypertension were the highest [35.00% (140/400), 36.00% (144/400), 36.75% (147/400), 27.00% (108/400), 58.75% (235/400)], and the proportion of males was significantly higher than that of females [68.25% (273/400) vs. 31.75% (127/400)]. Among the 400 inpatients, 88 died after admission, accounting for 22.00%, and 312 patients were discharged, accounting for 78.00%. Univariate analysis showed that workers [odds ratio (OR) = 2.416, 95% confidence interval (95%CI) = 0.258-6.859, P = 0.011], unhealthy living habits:smoking [OR = 1.792, 95%CI = 1.107-2.895, P = 0.015], drinking alcohol (OR = 1.664, 95%CI = 1.024-2.713, P = 0.040), hypertension (OR = 1.730, 95%CI = 0.701-4.266, P = 0.031), fasting blood glucose ≥ 7.0 mmol/L (OR = 8.112, 95%CI = 3.631-20.183, P = 0.000) could be the influencing factors of the cerebral hemorrhage;multivariate Logistic regression analysis showed: occupation being worker (OR = 3.427, 95%CI = 0.221-0.815, P = 0.010), hypertension (OR = 2.974, 95%CI = 1.182-7.489, P = 0.022), fasting blood glucose ≥ 7.0 mmol/L (OR = 8.974, 95%CI = 3.677-21.936, P = 0.000) were the main risk factors affecting the outcome of acute cerebral hemorrhage, effective first aid is a protective factor. Conclusion The age of patients with acute cerebral hemorrhage is mainly ≥ 70 years old, and the males are more than females; the incidence is high in winter, and the cerebral lobe is the main hemorrhagic site; from single and multiple factors analyses, workers, hypertension history, hyperglycemia and unhealthy habits (smoking, drinking) are the risk factors for the disease outcome, effective first aid is a protective factor.

2.
Chongqing Medicine ; (36): 5098-5100, 2017.
Artigo em Chinês | WPRIM | ID: wpr-665146

RESUMO

Objective To investigate the occurrence factors of duodenobiliary reflux (DBR) after endoscopic sphincterotomy (EST ) .Methods A total of 198 patients with choledocholithiasis hospitalized in the digestive department of the hospital from Sep-tember 2012 to February 2016 were selected and given duodenal papilla EST .The DBR occurrence was judged and the occurrence factors were investigated ,meanwhile the Oddi sphincter function was measured and long term complications were followed up .Re-sults All patients successfully completed EST ,the average common bile duct diameter in 198 cases was (2 .24 ± 0 .24)cm ,the aver-age common bile duct stones number was 3 .63 ± 1 .12 ;the maximum diameter of common bile duct stones was (1 .02 ± 0 .19)cm . There were 12 cases of DBR after EST ,the occurrence rate was 6 .1% ,the average radioactivity was (3 .39 ± 0 .89)MBq .The post-operative Oddi sphincter systolic peak and contraction frequency were (31 .49 ± 4 .22)mm Hg and (3 .78 ± 0 .53) times /min ,which were significantly lower than those before operation (P<0 .05);and the postoperative Oddi sphincter basic pressure and common bile duct pressure were (8 .23 ± 1 .03)mm Hg and (3 .32 ± 0 .45)mm Hg respectively ,which had no statistical difference compared with preoperation (P>0 .05) .The Logistic regression analysis showed that complicating gallbladder stone ,diameter of common bile duct ,frequency difference of Oddi sphincter contraction before and after operation ,number of stones and maximum diameter of stone were the main risk factors for postoperative DBR occurrence (P<0 .05) .All cases were followed up for 6 months ,18 cases developed long term complications ,the incidence rate was 9 .1% ,including 4 cases of reflux cholangitis ,6 cases of bile duct stric-ture ,4 cases of papillary stenosis and 4 cases of recurrence .Conclusion DBR after duodenal papilla EST is common ,which can re-sult in the Oddi sphincter function decrease and increase of long-term complications ,and needs to actively strengthen prevention and management .

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