目的系统评估综合重症监护病房(intensive care unit,ICU)内发生多重耐药菌感染的危险因素,为临床医护人员预防ICU患者发生多重耐药菌感染提供理论参考。方法计算机检索中国生物医学数据库、中国知网、万方、维普、PubMed、Web of Scie...目的系统评估综合重症监护病房(intensive care unit,ICU)内发生多重耐药菌感染的危险因素,为临床医护人员预防ICU患者发生多重耐药菌感染提供理论参考。方法计算机检索中国生物医学数据库、中国知网、万方、维普、PubMed、Web of Science、Cochrane Library、Embase数据库从2012年1月1日—2024年6月1日ICU多重耐药菌感染危险因素的相关文献,对符合纳排标准的文献经双人数据提取及质量评价无异后,应用Revman 5.4软件进行Meta分析。结果共纳入25篇文献,累计19280例患者,其中3945例多重耐药菌感染患者(20.5%)。对24个风险因素进行分析,其中19个因素差异有统计学意义(P<0.050)。多重耐药菌感染的危险因素包含:(1)一般因素(3个):住院时间、ICU住院时间、APACHEⅡ评分;(2)侵入性操作相关因素(7个):机械通气、机械通气时间、纤维支气管镜检查、动静脉插管、静脉置管时间、输尿管插管、导尿管留置时间;(3)抗生素相关因素(4个):入ICU前使用抗菌药物、联用抗菌药物、抗菌药物种类、抗菌药物使用时间;(4)基础疾病相关因素(5个):低蛋白血症、合并肺部疾病、合并基础疾病、合并基础疾病数量、混合感染。结论多种因素与综合ICU患者发生多重耐药菌感染有关,可为ICU医护人员早期筛查多重耐药菌感染高危患者提供依据。展开更多
Pterygium,a common ocular surface disorder characterized by the abnormal growth of conjunctival tissue onto the cornea,often necessitates surgical excision as its primary treatment.While effective,pterygium surgery is...Pterygium,a common ocular surface disorder characterized by the abnormal growth of conjunctival tissue onto the cornea,often necessitates surgical excision as its primary treatment.While effective,pterygium surgery is frequently associated with a spectrum of postoperative complications that significantly impact patient prognosis and quality of life.This comprehensive review systematically analyzes the classification,underlying pathophysiological mechanisms,and associated risk factors of these complications,with a particular focus on less commonly explored entities such as postoperative granuloma(PPG),corneal dellen,and scleral necrosis,alongside the more prevalent issue of recurrence.We delineate these complications based on their temporal presentation(early,intermediate,and late),and provide an in-depth analysis of general and specific contributing factors,including surgical trauma,individual patient characteristics,surgical technique,and perioperative management.Furthermore,this review synthesizes advancements in preventive strategies and therapeutic interventions,encompassing refined surgical techniques[e.g.,femtosecond laser-assisted pterygium surgery(FLAPS),pterygium extended removal followed by extended conjunctival transplant(P.E.R.F.E.C.T.)technique,Tissue Tuck technique],judicious application of adjuvant therapies[e.g.,mitomycin C(MMC),5-fluorouracil(5-FU),corticosteroids,anti-vascular endothelial growth factor(VEGF)agents],and optimized postoperative care protocols.By consolidating current evidence and identifying future research priorities,this review aims to provide ophthalmologists with a valuable theoretical foundation to guide individualized surgical planning,dynamic postoperative management,and ultimately minimize complications and improve patient satisfaction.展开更多
目的研究分析活髓切断术治疗深龋意外露髓患者的临床应用效果。方法回顾性分析2017年1月至2019年1月湛江市霞山区广东医科大学附属第二医院诊治的65例深龋意外露髓患者的临床资料,将其中实施生物陶瓷根管封闭糊剂(iroot Bp plus)行活髓...目的研究分析活髓切断术治疗深龋意外露髓患者的临床应用效果。方法回顾性分析2017年1月至2019年1月湛江市霞山区广东医科大学附属第二医院诊治的65例深龋意外露髓患者的临床资料,将其中实施生物陶瓷根管封闭糊剂(iroot Bp plus)行活髓切断术的33例患者作为观察组,实施iroot Bp plus直接盖髓术的32例患者作为对照组,将两组的治疗满意度、盖髓效果以及并发症情况作比较分析。结果观察组的治疗满意度(96.97%)明显高于对照组(81.25%),差异有统计学意义(P<0.05)。观察组治疗2、4、6月的盖髓成功率(分别为100.00%、96.97%、93.93%)明显高于对照组(分别为87.50%、81.25%、68.75%),差异有统计学意义(P<0.05)。观察组与对照组在治疗期间皆无并发症出现。结论活髓切断术治疗能增加深龋意外露髓患者的治疗效果,提高治疗满意度,安全性高,值得推广。展开更多
文摘目的系统评估综合重症监护病房(intensive care unit,ICU)内发生多重耐药菌感染的危险因素,为临床医护人员预防ICU患者发生多重耐药菌感染提供理论参考。方法计算机检索中国生物医学数据库、中国知网、万方、维普、PubMed、Web of Science、Cochrane Library、Embase数据库从2012年1月1日—2024年6月1日ICU多重耐药菌感染危险因素的相关文献,对符合纳排标准的文献经双人数据提取及质量评价无异后,应用Revman 5.4软件进行Meta分析。结果共纳入25篇文献,累计19280例患者,其中3945例多重耐药菌感染患者(20.5%)。对24个风险因素进行分析,其中19个因素差异有统计学意义(P<0.050)。多重耐药菌感染的危险因素包含:(1)一般因素(3个):住院时间、ICU住院时间、APACHEⅡ评分;(2)侵入性操作相关因素(7个):机械通气、机械通气时间、纤维支气管镜检查、动静脉插管、静脉置管时间、输尿管插管、导尿管留置时间;(3)抗生素相关因素(4个):入ICU前使用抗菌药物、联用抗菌药物、抗菌药物种类、抗菌药物使用时间;(4)基础疾病相关因素(5个):低蛋白血症、合并肺部疾病、合并基础疾病、合并基础疾病数量、混合感染。结论多种因素与综合ICU患者发生多重耐药菌感染有关,可为ICU医护人员早期筛查多重耐药菌感染高危患者提供依据。
文摘Pterygium,a common ocular surface disorder characterized by the abnormal growth of conjunctival tissue onto the cornea,often necessitates surgical excision as its primary treatment.While effective,pterygium surgery is frequently associated with a spectrum of postoperative complications that significantly impact patient prognosis and quality of life.This comprehensive review systematically analyzes the classification,underlying pathophysiological mechanisms,and associated risk factors of these complications,with a particular focus on less commonly explored entities such as postoperative granuloma(PPG),corneal dellen,and scleral necrosis,alongside the more prevalent issue of recurrence.We delineate these complications based on their temporal presentation(early,intermediate,and late),and provide an in-depth analysis of general and specific contributing factors,including surgical trauma,individual patient characteristics,surgical technique,and perioperative management.Furthermore,this review synthesizes advancements in preventive strategies and therapeutic interventions,encompassing refined surgical techniques[e.g.,femtosecond laser-assisted pterygium surgery(FLAPS),pterygium extended removal followed by extended conjunctival transplant(P.E.R.F.E.C.T.)technique,Tissue Tuck technique],judicious application of adjuvant therapies[e.g.,mitomycin C(MMC),5-fluorouracil(5-FU),corticosteroids,anti-vascular endothelial growth factor(VEGF)agents],and optimized postoperative care protocols.By consolidating current evidence and identifying future research priorities,this review aims to provide ophthalmologists with a valuable theoretical foundation to guide individualized surgical planning,dynamic postoperative management,and ultimately minimize complications and improve patient satisfaction.
文摘目的研究分析活髓切断术治疗深龋意外露髓患者的临床应用效果。方法回顾性分析2017年1月至2019年1月湛江市霞山区广东医科大学附属第二医院诊治的65例深龋意外露髓患者的临床资料,将其中实施生物陶瓷根管封闭糊剂(iroot Bp plus)行活髓切断术的33例患者作为观察组,实施iroot Bp plus直接盖髓术的32例患者作为对照组,将两组的治疗满意度、盖髓效果以及并发症情况作比较分析。结果观察组的治疗满意度(96.97%)明显高于对照组(81.25%),差异有统计学意义(P<0.05)。观察组治疗2、4、6月的盖髓成功率(分别为100.00%、96.97%、93.93%)明显高于对照组(分别为87.50%、81.25%、68.75%),差异有统计学意义(P<0.05)。观察组与对照组在治疗期间皆无并发症出现。结论活髓切断术治疗能增加深龋意外露髓患者的治疗效果,提高治疗满意度,安全性高,值得推广。
