Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Mar 2017
[Incidence and influencing factors of continuous positive airway pressure treatment-emergent central sleep apnea in the patients with obstructive sleep apnea syndrome at high altitude].
Objective: To investigate the incidence of treatment-emergent central sleep apnea (TE-CSA), the characteristics of demography and the influencing factors in patients with obstructive sleep apnea syndrome (OSAS) after initial continuous positive airway pressure (CPAP) titration at high altitude. Methods: Clinical data of 297 patients with OSAS which living in plateau areas (1 000 meters or more above sea level) were retrospectively analyzed in this study from January to December, 2015. All of these patients taken an overnight CPAP titration in the Sleep Medicine Center of First People's Hospital of Yunnan Province. ⋯ Among them, the increase of resident altitude and MAI were risk factors [OR=1.16(1.02, 1.32), 1.05(1.01, 1.09)]. The increase of FEV(1)/FVC and RV/TLC were protective factors [OR=0.94(0.89, 0.98), 0.94(0.88, 0.99)]. Conclusion: The incidence of TE-CSA is high at high altitude area, and the increase of resident altitude and MAI are the risk factors for TE-CSA.
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Zhonghua yi xue za zhi · Mar 2017
Randomized Controlled Trial[Effect of intravenous infusion with lidocaine on rapid recovery of laparoscopic cholecystectomy].
Objective: To investigate the effect of intravenous infusion with lidocaine on rapid recovery of laparoscopic cholecystectomy. Methods: This study was a prospective randomized controlled trial. From February to August 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 60 patients scheduled for laparoscopic cholecystectomy under general anesthesia were involved and randomly divided into control group (n=30) and lidocaine group (n=30). ⋯ The QoR-9 score in lidocaine group was 15.60±1.07, which was higher than that in control group(14.73±0.74, t=-3.649, P<0.05). There was no significant difference in the incidence of postoperative nausea/vomiting and the discharge time between two groups (all P>0.05). Conclusion: Intravenous infusion of lidocaine can effectively reduce the dosages of propofol and remifentanil, postoperative early VAS score, postoperative ambulation time and first intestine venting time which could improve the satisfaction of patients.
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Zhonghua yi xue za zhi · Mar 2017
[Predictors of in-hospital mortality in adult postcardiotomy cardiacgenic shock patients successfully weaned from venoarterial extracorporeal membrane oxygenation].
Objective: To assess the factors associated with outcome of patients undergoing extracorporeal membrane oxygenation (ECMO) in a large ECMO center. Methods: Patients aged >18 years who received ECMO support for postcardiotomy cardiogenic shock were identified between January 2011 and December 2015. One hundred and seventy-seven patients (64.8%) successfully weaned from ECMO. ⋯ Conclusions: Neurologic complications and lower extremity ischemia that occurred during ECMO, multi-organ function failure after weaned from ECMO had a significant impact on in-hospital mortality. Further studies are needed to prevent neurologic complications and lower extremity ischemia in these patients. Interventions that could reduce these complications may improve outcome.
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Zhonghua yi xue za zhi · Mar 2017
[Research on risk factors of short-term outcome in AIDS patients with pneumocystis pneumonia].
Objective: To investigate the prognostic risk factors of acquired immunodeficiency syndrome (AIDS) patients with pneumocystis pneumonia (PCP), and to establish risk models for predicting early outcome. Methods: The clinical data of 418 AIDS patients with PCP admitted to Department of Infectious Diseases, Beijing You'an Hospital, Capital Medical University from January 2008 to May 2016 were retrospectively analyzed. The patients were divided into death group and survival group according to clinical outcome during hospitalization. ⋯ The mortality rate increased with the increase of equation value. Conclusions: P(A-a)O(2, )ALB, LDH, N and CD4(+) T lymphocyte count are independent risk factors to predict short-term prognosis in these patients. The short-term prognostic model based on independent risk factors is useful in guiding clinical treatment.