1.Clinical analysis of hyperlipidemic sever acute pancreatitis
Hongliang SHEN ; Jianbiao ZHANG ; Zhen LIU
Clinical Medicine of China 2009;25(7):741-743
Objective To investigate the clinical characteristics of sever acute pancreatitis (SAP) with high triglyceride(TG). Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group (n=26) and normal TG group (n=56) according to serum TG lev-els tested (high TG group≥1.7 mmoL/L;normal TG group<1.7 mmol/L on admission). Results 31.71% (26/82) SAP patients were discovered with high TG APACHE-Ⅱ grade of high TG group was higher than that of normal TG group on admission[(14.62±7.58) vs (10.68±5.21),P<0.01]. Within the onset of 72 hours,the incidence of cardiac,pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group (34.62%,34.62% and 19.23% vs 5.36%,3.57% and 1.79%,P<0.01),and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group(42.31% vs 7.14%,P<0.01). No emergency and early-stage surgical cases in high TG group but 13 cases(23.21%) in normal group. There were 2 cases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication,in this case nonsurgical intervention is the first choice.
2.Perioperative risk factors associated with prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy
Xiaodong WANG ; Yanchao PENG ; Limin ZHANG ; Baoxu ZHANG ; Lili YU ; Panpan SONG ; Xupeng WANG ; Chunxiao GUI ; Yongchang LIU ; Jianbiao ZHEN
Chinese Journal of Neuromedicine 2020;19(2):125-130
Objective To investigate the perioperative risk factors associated with prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy under general anesthesia.Methods The clinical data of 108 patients with acute ischemic stroke,admitted to and accepted mechanical thrombectomy under general anesthesia in our hospital from January l,2016 to October 31,2018,were collected.According to modified Rankin scale (mRS) scores 90 d after surgery,patients were divided into good prognosis group (mRS scores ≤2) and poor prognosis group (mRS scores ≥3).Univariate analysis was used to compare the general data (age,gender,body mass index,and underlying diseases) and perioperative conditions (immediate heart rate,systolic and diastolic blood pressures immediately after admission,operative time,and anesthesia time) between the two groups of patients.Multivariate Logistic regression analysis was used to identify the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy.Results Among the 108 patients,65 had good prognosis and 43 had poor prognosis.Univariate analysis showed that there was no significant difference in general data between the two groups (P>0.05),but there were significant differences in heart rate immediately after admission,National Institutes of Health Stroke Scale (NIHSS) scores immediately after admission and 3 d after operation,maximum hemoglobin and blood glucose values from immediately after admission to 3rd d of operation,and thrombolysis in myocardial infarction (TIMI) blood flow classification (P<0.05).Multivariate Logistic regression analysis showed that heartrate immediately after admission (OR=1.035,95%CI:1.002-1.067,P=0.037) and NIHSS scores 3 d after operation (OR=1.153,95%CI:1.016-1.272,P=0.030) were the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy.Conclusion For patients with acute ischemic stroke who have rapid heart rate immediately after admission and high NIHSS scores 3 d after mechanical thrombectomy,possibility of poor prognosis should be noticed.