Abstract: Objective To investigate the application value of the Clinical Score developed by Cleveland University in predicting the occurrence ratio of acute renal failure in Chinese patients after cardiac surgery. Methods A total of 456 adult patients , 230 males and 226 females , with cardiac surgery during August 2008 to July 2009 were included in our study. Their age ranged from 18 to 88 years with an average age of 56.7 years. Before the surgery, Clinical Score was used to predict acute renal failure after cardiac surgery. Based on the score of ≤5, 610, or ≥11, the patients were divided into group Ⅰ (n=401), group Ⅱ (n=42) and group Ⅲ (n=13). The occurrence rate of acute kidney injury (AKI), continuous renal replacement therapy in hospital, multiple organ failure, mortality and other clinical indexes were compared among the 3 groups. Results Occurrence ratio of AKI of group Ⅰ, Ⅱ, Ⅲ was respectively 2.74%, 28.57% and 76.92% (χ2=73.004, P=0.000). Continuous renal replacement therapy rate was respectively 0.50%, 9.52%, and 38.46% (χ2=36.939, P=0.000). Multiple organ failure rate was respectively 0.50%, 4.76%, and 23.08% (χ2=19.694, P=0.000). Mortality rate was respectively 0.25%, 2.38%, and 15.38% (χ2=14.061, P=0.001). There were significant differences among the three groups. Conclusion The Clinical Score to Predict Acute Renal Failure developed by Cleveland University can effectively predict the occurrence rate of acute renal failure in the Chinese patients after cardiac surgery before the operation. Therefore, corresponding preventive methods can be taken for highrisk patients.
In order to detect the flow characteristics of blood samples in the capillary, this paper introduces a blood flow velocity measurement system based on field-programmable gate array (FPGA), linear charge-coupled devices (CCD) and personal computer (PC) software structure. Based on the analysis of the TCD1703C and AD9826 device data sheets, Verilog HDL hardware description language was used to design and simulate the driver. Image signal acquisition and the extraction of the real-time edge information of the blood sample were carried out synchronously in the FPGA. Then a series of discrete displacement were performed in a differential operation to scan each of the blood samples displacement, so that the sample flow rate could be obtained. Finally, the feasibility of the blood flow velocity detection system was verified by simulation and debugging. After drawing the flow velocity curve and analyzing the velocity characteristics, the significance of measuring blood flow velocity is analyzed. The results show that the measurement of the system is less time-consuming and less complex than other flow rate monitoring schemes.
【摘要】 目的 探討成人幕上低級別膠質瘤（WHO Ⅱ級）患者術后生活質量的影響因素。 方法 回顧性分析2008年10月—2010年5月經手術切除病變、術后病理證實為低級別膠質瘤的115例患者臨床資料，術后隨訪6~24個月。以患者年齡、性別、主要臨床癥狀、病變部位、病變大小及病理結果為自變量，以術后Karnofsky評分（KPS）改善為因變量，采用Logistic回歸分析研究相關影響因素。采用秩和檢驗比較不同組間KPS差異。 結果 隨訪至術后6個月，患者年齡、病變大小、病變部位、切除范圍以及是否有癲癇史在KPS比較中，其結果有統計學意義（Plt;0.05）。隨訪至術后12個月，切除范圍和癲癇史對KPS評分已無影響（Pgt;0.05）。病理類型、術前是否存在神經功能障礙與術后KPS改善在單因素和多因素比較中無統計學意義。 結論 患者年齡≤50歲、術前有癲癇史、腫瘤直徑≤4 cm、病變表淺、腫瘤全切除的患者術后KPS改善好于年齡gt;50歲、術前無癲癇史、腫瘤直徑gt;4 cm、病變深在、腫瘤次全切除的患者。患者術前是否存在神經功能障礙和病理類型與術后生活質量是否改善無明顯關系。復發也是影響患者術后KPS改善的因素。【Abstract】 Objective To assess the quality of life in adults with surgically managed cerebral supratentorial low grade glioma (WHO grade Ⅱ) and the relevant factors. Methods We retrospectively analyzed the clinical data of 115 patients with histologically proven supratentorial low grade glioma enrolled at West China Hosptial from October 2008 to May 2010. Follow-up lasted for 6 to 24 months after operation. Logisitc regression analysis is used to test the relevant factors with age, gender, main clinical manifestations, lesion location, lesion size and pathological results as the independent variables, and Kamofsky postoperative scale (KPS) scores as dependent variable. KPS scores of different groups were analyzed using the rank test. Results After 6 months of follow-up, we found that age, size, location, extent of surgical excision and eplispy history showed a statistical significance in KPS comparison (Plt;0.05). Till the 12th month in the follow-up, the extent of surgical excision and eplispy history were not statistically significant any more (Pgt;0.05). Histology type and neurological deficit had no relationship with KPS improvement in both single factor analysis and multivariate analysis. Conclusions Patients with an age older than 50 years, preoperative epilepsy history, the largest diameter of the tumor less than 4 cm, shallow lesions, and complete tumor resection have a better KPS improvement after operation than those with corresponding opposite conditions. There is no obvious relationship between histology type, neurologic deficits and KPS improvement after operation. Recurrence is also a factor influencing KPS improvement after operation.
目的 探討經胼胝體-穹窿間入路切除第三腦室腫瘤術后，近期下丘腦反應的發生情況及相關因素，為防治第三腦室腫瘤術后下丘腦反應提供參考。 方法 回顧分析2003年1月－2008年12月經胼胝體-穹窿間入路切除的78例第三腦室腫瘤患者手術后近期（1個月內）下丘腦反應的發生情況，并將其按照腫瘤部位、病理性質、大小、血供、手術切除程度進行分類統計，用SPSS 13.0軟件logistic 回歸分析影響這些并發癥的因素。 結果 78例術后下丘腦反應37例，發生率47.4%；死亡5例，下丘腦反應病死率為13.5%（5/37）。其中電解質糖代謝紊亂33例（42.3%），尿崩癥27例（34.6%），激素水平低下16例（20.5%），高熱6例（7.7%）。好轉痊愈率：激素水平低下43.7%，其余均＞70%。第三腦室前部顱咽管瘤術后最容易發生下丘腦反應（P＜0.05）。 結論 經胼胝體-穹窿間入路切除第三腦室腫瘤術后近期存在程度不同的下丘腦反應，其發生與腫瘤部位、病理性質有密切關系。經積極治療，大部分下丘腦反應能在術后1個月內好轉甚至痊愈。