Objective To assess the growth station, the upper respiratory infection frequency and consultation frequency of the geographically defined high risk neonatal population at 1-year-old based on both birthweight and gestational age. Methods All infants admitted in our hospital from May in 2008 to May in 2009 were divided into three groups according to gestational age and birth weight, that were, group 1: born lt;32 completed gestational weeks and weighing ≥1 500 g; group 2: born after 32 completed gestational weeks and weighing lt;1 500 g; and group 3: born lt;32 completed gestational weeks and weighing lt;1 500 g. Information at 12 months corrected age about growth, the upper respiratory infection frequency and consultation frequency was collected. Results The growth rate of weight and head circumference in group 3 were lower than that in group 1, and the length growth rate was lower than that in group 1 and group 2. Infants in group 3 suffered from more airway infections (median: 15.5) than in group 1 (12.5) and group 2 (8.5). Infants in group 3 needed more medical consultations (median: 27.5) than those in group 1(17.5) and group 2 (15.5). Conclusions This study gives estimates for growth outcome, airway infection and consultation frequency at 12 months corrected age for very low birthweight infants (lt;1 500 g) and for very preterm infants (lt;32 completed gestational weeks). Gestational age and birth weight are the same important for predicting infants’ outcome and should therefore be integrated into clinical statistics.
ObjectiveTo systematically review the effectiveness and safety of interventions which target to improve the rate of successful extubation in preterm infants.MethodsPubMed, Web of Science, Cochrane Library, Chongqing VIP database, China National Knowledge Infrastructure, and Wanfang Database were searched for articles published from the dates of establishment of databases to August 2020, which compared different noninvasive respiratory support models or different doses of caffeine to improve the rate of successful extubation in preterm infants in randomized controlled trials. The references of included articles were also retrieved. And then a meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 33 randomized controlled trials involving 4 536 preterm infants were included. Compared with nasal continuous positive airway pressure (NCPAP), high-flow nasal cannula (HFNC) reduced the nose injury rate [odds ratio (OR)=0.29, 95% confidence interval (CI) (0.15, 0.57), P=0.000 3] and the pneumothorax rate [OR=0.18, 95%CI (0.06, 0.55), P=0.003]; nasal intermittent positive pressure ventilation (NIPPV) reduced the extubation failure rate [OR=0.33, 95%CI (0.23, 0.48), P<0.000 01], the reintubation rate [OR=0.36, 95%CI (0.20, 0.65), P=0.000 7], the respiratory failure rate [OR=0.33, 95%CI (0.17, 0.64), P=0.000 9], and the pneumothorax rate [OR=0.29, 95%CI (0.12, 0.70), P=0.006]; and biphasic positive airway pressure (BiPAP) reduced the reintubation rate [OR=0.21, 95%CI (0.09, 0.46), P=0.000 1]. Compared with low-dose caffeine, high-dose caffeine reduced the extubation failure rate [OR=0.44, 95%CI (0.32, 0.60), P<0.000 01] and the bronchopulmonary dysplasia rate [OR=0.69, 95%CI (0.48, 0.99), P=0.04], but increased the rate of tachycardia [OR=1.99, 95%CI (1.22, 3.25), P=0.006].ConclusionAccording to the current evidence, compared with NCPAP, NIPPV and BiPAP could be used to improve the rate of successful extubation in preterm infants, HFNC could be used to decrease the risk of nose injury and pneumothorax; the optimal dose of caffeine should be chosen after evaluating the risk of adverse reactions such as tachycardia.
目的探讨晚期恶性梗阻性黄疸减黄、保肝的处理方式。方法回顾性分析我科2008年1月至2009年10月期间收治的80例恶性梗阻性黄疸患者，根据肿瘤部位、患者身体、经济条件等确定无法行根治性手术者，采用不同的减黄术式。结果本组80例患者中，9例行PTCD，42例行PTBS，29例行ERBD。并发症发生情况: PTBS组有15例，ERBD组6例，PTCD组2例。PTCD组的住院时间和住院费用明显低于PTBS组和ERBD组(Plt;0.05)。结论晚期恶性梗阻性黄疸，一经确诊，尽早处理，微创引流减黄是首选方式。
ObjectiveTo summarize the clinical progress of minimally invasive techniques in treatment of pilonidal disease.MethodThe relevant literatures about minimally invasive techniques in the treatment of pilonidal disease in recent years were reviewed.ResultsAbout hair removal and carbolic acid injection, they had less damage, fewer complications, higher recurrence rate compared to other surgery, and did not affect the second treatment. The fibrin injection could not clarify its role in the treatment of pilonidal disease due to some defects in the clinical design. Bascom Ⅰhad the advantages of fast recovery and no need for hospitalization, with a recurrence rate of 8%–16%. According to the results of some current clinical researches, it was a promising operation. Sinus resection required further clinical evaluation due to the limited results of current researches. A clinical study of more than 1 000 cases over 10 years showed that the recurrence rate in 10 years was 16%. Compared with frequently used pilonidal operations, the trephine technique was associated with a lower recurrence rate and a lower incidence of postoperative complication. Some short-term clinical researches showed that endoscopic pilonidal sinus treatment was a safe, minimally invasive, and less complication treatment.ConclusionsCompared with frequently used pilonidal operations, minimally invasive technique has the advantages of shortening the hospital stay, shortening the healing time, and reducing complications. It is worth of application.
ObjectiveTo explore the incidence, treatment and prognosis of neonatal respiratory failure (NRF). MethodsThe clinical data of 421 neonates with NRF treated between January 2011 and December 2013 were retrospectively analyzed. ResultsThe incidence and the mortality of NRF was 4.8% and 14.5%, respectively. The main primary disease of NRF was neonatal respiratory distress syndrome (36.1%) and aspiration pneumonia (29.0%). Mechanical ventilation was the main treatment for NRF (77.2%). Premature (χ2=12.216, P<0.001), low birth weight (χ2=8.932, P=0.003) and the neonatal asphyxia (χ2=6.199, P=0.013) were closely related to the prognosis of NRF, which were the risk factors of the death of NRF. ConclusionNRF is a disease with high incidence and high mortality; make effective prevention and treatment measures are important to improve the success rate of therapy for NRF.