目的 探讨数字智能化诊疗技术在多次胆道手术史肝胆管结石病诊疗中的应用价值。方法采用回顾性队列研究方法,纳入2017年1月至2024年12月南方医科大学珠江医院行胆道镜联合硬镜取石手术治疗的合并胆道手术史的肝胆管结石病患者,分为3DVT...目的 探讨数字智能化诊疗技术在多次胆道手术史肝胆管结石病诊疗中的应用价值。方法采用回顾性队列研究方法,纳入2017年1月至2024年12月南方医科大学珠江医院行胆道镜联合硬镜取石手术治疗的合并胆道手术史的肝胆管结石病患者,分为3DVT-FI组和常规手术组。收集、分析和比较两组临床数据。结果共纳入63例患者,其中3DVT-FI组33例,常规手术组30例。逆概率加权(inverse probability of treatment weighting,IPTW)后一般资料均差异无统计学意义(P>0.05)。3DVT-FI组的开腹率、术中出血量、术后并发症发生率以及3月内再次手术发生率显著低于常规手术组(均P<0.05)。单因素分析显示术后有和无并发症患者在是否合并肝外胆管结石、手术年份、以及手术方案存在差异(P<0.05)。多因素分析表明无肝外胆管结石(OR=0.105)为术后出现并发症的保护因素,而常规手术方式(OR=3.952)则为其危险因素(均P<0.05)。结论三维可视化联合ICG荧光成像技术运用在多次胆道手术史的肝胆管结石病诊疗中,可以提高手术的微创率和减少术后并发症发生率,该技术的应用提高了多次胆道手术史肝胆管结石病手术治疗的安全和有效性,具有重要的临床价值。展开更多
AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS...AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.展开更多
文摘目的 探讨数字智能化诊疗技术在多次胆道手术史肝胆管结石病诊疗中的应用价值。方法采用回顾性队列研究方法,纳入2017年1月至2024年12月南方医科大学珠江医院行胆道镜联合硬镜取石手术治疗的合并胆道手术史的肝胆管结石病患者,分为3DVT-FI组和常规手术组。收集、分析和比较两组临床数据。结果共纳入63例患者,其中3DVT-FI组33例,常规手术组30例。逆概率加权(inverse probability of treatment weighting,IPTW)后一般资料均差异无统计学意义(P>0.05)。3DVT-FI组的开腹率、术中出血量、术后并发症发生率以及3月内再次手术发生率显著低于常规手术组(均P<0.05)。单因素分析显示术后有和无并发症患者在是否合并肝外胆管结石、手术年份、以及手术方案存在差异(P<0.05)。多因素分析表明无肝外胆管结石(OR=0.105)为术后出现并发症的保护因素,而常规手术方式(OR=3.952)则为其危险因素(均P<0.05)。结论三维可视化联合ICG荧光成像技术运用在多次胆道手术史的肝胆管结石病诊疗中,可以提高手术的微创率和减少术后并发症发生率,该技术的应用提高了多次胆道手术史肝胆管结石病手术治疗的安全和有效性,具有重要的临床价值。
文摘AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.
