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        west china medical publishers
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        find Author "周愚" 5 results
        • 氣管切開術后遲發性出血致死亡一例及文獻回顧

          Release date:2016-08-30 11:53 Export PDF Favorites Scan
        • 創傷性凝血病:低纖維蛋白原血癥

          Release date:2019-01-23 10:50 Export PDF Favorites Scan
        • 侵襲性肺曲霉菌感染診治進展

          隨著社會老齡化, 抗腫瘤藥物、免疫抑制劑和器官移植等治療的廣泛開展, 在危重患者中廣譜抗生素藥物的長期應用, 與之伴隨的是真菌感染發生的逐年增多, 其中侵襲性曲霉菌感染因其感染隱匿, 難以診治和高死亡率等特點被臨床醫生所重視。按我國醫院感染監控網分析, 醫院真菌感染率從1993 ~1996 年的13. 9% 上升至1998 ~1999 年的17. 1% 、1999 ~2000 年的24. 4% 。侵襲曲霉菌病特別是肺部曲霉菌感染多發生在有嚴重基礎疾病的患者,預后差, 病死率達50% ~100% [ 1 ] 。本文回顧相關研究文獻中關于侵襲性肺曲霉菌診治進展, 高危人群, 目前診斷檢測技術的臨床價值, 抗曲霉菌藥物特點和治療現狀。

          Release date:2016-08-30 11:56 Export PDF Favorites Scan
        • The value of platelet volume indices in early period as prognostic indicators of sepsis

          ObjectiveTo investigate the prognostic value of platelet volume indices [mean platelet volume (MPV) and platelet distribution width (PDW)] in early period for patients with sepsis .MethodsThis retrospective study was conducted in a general ICU at a University Hospital from January 2015 to January 2017. Patients with sepsis were divided into a survival group and a death group according to 28-day prognosis. The demographic and clinical data were recorded and analyzed, including platelet indices, Charlson comorbidity index, Glasgow Coma Scale (GCS) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score. Multivariable COX proportional hazard ratio model was used to evaluate the 28-day mortality risk, and receiver operating characteristic (ROC) curve were used to evaluate the value of platelet volume indices.ResultsA total of 209 patients were enrolled in this study. Mean arterial pressure, pH, platelet count, serum creatinine, bilirubin, troponin I, prothrombin time, GCS score and platelet volume indices showed significant differences between the survival group (n=137) and the death group (n=72) (all P<0.05). Multivariable COX regression analysis revealed that the PDW was independently associated with 28-day mortality in sepsis (HR=1.068, 95%CI 1.002-1.139, P=0.043). The area under the ROC curve of PDW was 0.762 (95%CI 0.694 - 0.831), with a sensitivity of 86% and a specificity of 63% at a cut-off value of 18.65%.ConclusionPDW can be used as a powerful prognostic indicator in patients with sepsis following 28-day.

          Release date:2019-07-19 02:21 Export PDF Favorites Scan
        • The Risk Factors and Prognosis of Postintubation Hypotension in Critically Ill Patients

          ObjectiveTo identify the incidence of postintubation hypotension (PIH) in critically ill patients and evaluate the responsive risk factors and prognosis. MethodsThe data of intubation patients with normal blood pressure before intubation were collected and analyzed in Intensive Care Unit (ICU) in the latest two years and divided into two groups. One contained PIH patients and the other one contained patients with no change in blood pressure after intubation. The primary outcome measure was 28-day mortality and secondary outcome measure was length of stay (LOS) in ICU and hospital. ResultsThere were 25(31.65%) PIH patients in included 79 patients. The patients in PIH group had significantly higher 28-day mortality (40.00% vs 14.81%, P=0.01) and there were no difference in LOS in ICU and hospital. Risk factors were age (OR:1.1, 95% CI:1.00-1.12), chronic respiratory diseases (OR:3.0, 95% CI:1.13-8.07) and complication with over two chronic diseases (OR:3.6, 95% CI:1.18-11.03). ConclusionPIH is more common in old patients complicated with chronic diseases and results in higher 28-day mortality.

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