1.Risk prevention in subtotal thyroidectomy for hyperthyroidism accompanied with cardiothyrotoxicosis
Jie SUN ; Dingming LI ; Shanghui JIANG ; Shenhui LI ;
Chinese Journal of General Surgery 1997;0(06):-
Objective To investigate the feasible safty of the subtotal thyroidectomy on the condition that hyperthroidism is accompanied with cardiothyotoxicosis. Methods In 138 hyperthroidism cases accompanied with cardiothrotoxicosis, the operation tolerance was evaluated preoperatively with a dagrous index of hyperthroidism accompanied cardiothrotoxicosis for operation. These patients were monitored and the dangerous factors were treated preoperatively, to make the operation safely. Results The cure rate that hyperthyroidism with subtotal thyroidectomy was 100%. The cardiothrotoxicosis cure rate was 89.2%. The cardiac insufficiency and operative complication didn't occur in any patient. Conclusions Hyperthroidism accompanied with caridiothrotoxicosis isn't of intraindaction to subtotal thyroidectomy. The operation is safe and effective after controlled the dangerous index.
2.Assessment of malnutrition diagnosed with GLIM criteria in liver cirrhosis patients and its influencing factors
Shenhui LUO ; Lini WEI ; Qun XIANG ; Xiaofeng SHI ; Juan WANG ; Xuefeng LI
Chinese Journal of Clinical Nutrition 2024;32(4):232-238
Objective:To evaluate the incidence of malnutrition in hospitalized patients with liver cirrhosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and to identify the risk factors of malnutrition.Methods:A total of 305 inpatients with liver cirrhosis were included from the Department of Gastroenterology of the People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture between January 1, 2023 to September 30, 2023. The patient characteristics, clinical indicators, complications, unplanned readmission within 90 days and death outcomes were collected. Malnutrition was diagnosed according to the GLIM criteria, the differences in various indicators were compared between the malnutrition group and the well-nourished group, and the influencing factors of malnutrition were analyzed. The relationship between malnutrition and short-term prognosis was also discussed.Results:Among the enrolled patients, 188 (61.6%) were diagnosed with malnutrition per GLIM criteria, of whom 18 were with Child-Turcotte-Pugh (CTP) Grade A liver function, 108 Grade B, and 62 Grade C. Compared with the well-nourished group, the malnutrition group showed prolonged length of hospital stay ( P<0.001), lower body mass index P=0.003), lower levels of red blood cell count, hemoglobin, serum albumin, serum albumin/globulin ratio, and serum calcium ( P<0.001), higher level of aspartate aminotransferase ( P=0.025), and increased levels of C-reactive protein, total bilirubin, international normalized ratio, plasma prothrombin time and model for end-stage liver disease score ( P<0.001). The proportion of patients with ascites, esophageal gastric varices, upper gastrointestinal bleeding, hepatic encephalopathy and unplanned readmission within 90 days were significantly increased ( P<0.001) in malnutrition group, and the mortality within 90 days was also higher ( P=0.042). Logistic regression analysis identified lower body mass index level ( OR=0.910, P=0.038), ascites ( OR=0.065, P<0.001) and upper gastrointestinal bleeding ( OR=0.184, P=0.001) as the influencing factors of malnutrition in liver cirrhosis patients. Conclusions:The prevalent malnutrition in patients with liver cirrhosis may affect the short-term prognosis. Lower body mass index, ascites and upper gastrointestinal bleeding are influencing factors for malnutrition in liver cirrhosis patients. Therefore, patients with liver cirrhosis should be screened for malnutrition to allow timely nutritional intervention measures.