Objective To investigate the causes for mental state abnormality in post liver transplantation patients during ICU. Methods The clinical and laboratory data of 35 patients following liver transplantation during ICU we...Objective To investigate the causes for mental state abnormality in post liver transplantation patients during ICU. Methods The clinical and laboratory data of 35 patients following liver transplantation during ICU were collected. By using Sedation Agitation Scale the patients were divided into agitation group and control group, and the data in the two groups were compared. Results There was no significant difference between the agitation group and the control group in age, sex, postoperative liver and renal function and the blood concentration of cyclosporin A. In the agitation group the duration of intravenous cyclosporin A was significantly longer ( P < 0.05 ), the number of catheter in vivo ( P < 0.01 ), the case proportion needing critical monitoring blood glucose concentration ( P < 0.05 ), the case proportion using tienam+ganciclovir+fluconazole ( P < 0.05 ) and the time staying in the ICU ( P < 0.05 ) was significantly increased as compare with those in the control group. Mean heart rate, respiratory rate and artery pressure in the agitation group were higher than in the control group. Conclusions Mental state abnormality in the patients following liver transplantation during ICU was contributed to the comprehensive causes.展开更多
目的评价重组人血小板生成素（recombinant human thromobopoietin，rhTPO）对脓毒症相关血小板减少症的疗效和安全性。方法前瞻、对照方法观察2009年1月至2009年11月入住天津市第一中心医院ICU的脓毒症并发生血小板减少的患者，外周血...目的评价重组人血小板生成素（recombinant human thromobopoietin，rhTPO）对脓毒症相关血小板减少症的疗效和安全性。方法前瞻、对照方法观察2009年1月至2009年11月入住天津市第一中心医院ICU的脓毒症并发生血小板减少的患者，外周血血小板计数≤40×10^9L^-1且主治及以上医师认为有必要升高血小板治疗的脓毒症患者为研究对象，排除恶性肿瘤、6个月内接受过免疫调节剂治疗、年龄〈14岁或〉75岁、心肺复苏后、入院24h内转出或死亡者及终末期肝或肾功能衰竭者。将入选43例患者根据“不平衡指数最小的分配原则”随机分为特比奥（rhTPO）组（21例）和静脉注射用人免疫球蛋白（Intravenous Immunoglobulin，IVIG）组（22例），rhTPO组在综合治疗的基础上加用特比奥300U·kg^-1·d^-1，2～8d，IVIG组则在综合治疗的基础上加用静脉注射用人免疫球蛋白400mg·kg^-1·d^-1，连用5d。观察比较两组患者治疗后第1，2，3，5，7天外周静脉血血小板计数以及凝血指标、肝肾功能、出血及血制品输注情况、ICU住院时间、治疗费用等指标，随访并比较28d病死率等预后情况。两组间参数的比较采用独立样本t检验，计数资料进行，检验。结果rhTPO组治疗后血小板恢复最高值明显高于IVIG组（t=2．21，P=0．032）；rhTPO组血小板最低值和最高值的差值明显大于WIG组（t=7．40，P〈0．001）。治疗前两组血小板计数差异无统计学意义（t=0．458，P〉0．05），用药第2天、第3天rhTPO组血小板计数升高明显高于IVIG组（t=2．166和t=2．132，P=0．036和P=0．041），两组存活病例用药第3天rhTPO组血小板计数明显高于IVIG组（t=2．28，P=0．032），两组出血发生率差异无统计学意义（X^2=0．720，P〉0．05），但rhTPO组血小板及血浆输注量明显少于IVIG组（t=2．038和f=2．252，P=0．048和P=0．030）。两组ICU住院时间及病死率差展开更多
文摘Objective To investigate the causes for mental state abnormality in post liver transplantation patients during ICU. Methods The clinical and laboratory data of 35 patients following liver transplantation during ICU were collected. By using Sedation Agitation Scale the patients were divided into agitation group and control group, and the data in the two groups were compared. Results There was no significant difference between the agitation group and the control group in age, sex, postoperative liver and renal function and the blood concentration of cyclosporin A. In the agitation group the duration of intravenous cyclosporin A was significantly longer ( P < 0.05 ), the number of catheter in vivo ( P < 0.01 ), the case proportion needing critical monitoring blood glucose concentration ( P < 0.05 ), the case proportion using tienam+ganciclovir+fluconazole ( P < 0.05 ) and the time staying in the ICU ( P < 0.05 ) was significantly increased as compare with those in the control group. Mean heart rate, respiratory rate and artery pressure in the agitation group were higher than in the control group. Conclusions Mental state abnormality in the patients following liver transplantation during ICU was contributed to the comprehensive causes.
文摘目的使用降阶梯方案治疗重症监护病房(ICU)重症获得性肺炎,评价其疗效. 方法选取2002年4月1日～2003年3月31日,我院ICU重症获得性肺炎患者62例(CPIS>6分),随机分成传统治疗组和降阶梯治疗组,比较两组患者的初始治疗恰当率、感染控制率和感染控制所需时间等指标. 结果降阶梯治疗组和传统治疗组的初始治疗恰当率为83.87% vs 45.16%, P<0.01, 治疗有效率90.32% vs 64.52%, P<0.05, 感染控制所需天数7.5±2.6 vs 16.7±4.7, P<0.05. 结论对于ICU重症获得性肺炎使用降阶梯治疗可获得良好疗效.
文摘目的评价重组人血小板生成素（recombinant human thromobopoietin，rhTPO）对脓毒症相关血小板减少症的疗效和安全性。方法前瞻、对照方法观察2009年1月至2009年11月入住天津市第一中心医院ICU的脓毒症并发生血小板减少的患者，外周血血小板计数≤40×10^9L^-1且主治及以上医师认为有必要升高血小板治疗的脓毒症患者为研究对象，排除恶性肿瘤、6个月内接受过免疫调节剂治疗、年龄〈14岁或〉75岁、心肺复苏后、入院24h内转出或死亡者及终末期肝或肾功能衰竭者。将入选43例患者根据“不平衡指数最小的分配原则”随机分为特比奥（rhTPO）组（21例）和静脉注射用人免疫球蛋白（Intravenous Immunoglobulin，IVIG）组（22例），rhTPO组在综合治疗的基础上加用特比奥300U·kg^-1·d^-1，2～8d，IVIG组则在综合治疗的基础上加用静脉注射用人免疫球蛋白400mg·kg^-1·d^-1，连用5d。观察比较两组患者治疗后第1，2，3，5，7天外周静脉血血小板计数以及凝血指标、肝肾功能、出血及血制品输注情况、ICU住院时间、治疗费用等指标，随访并比较28d病死率等预后情况。两组间参数的比较采用独立样本t检验，计数资料进行，检验。结果rhTPO组治疗后血小板恢复最高值明显高于IVIG组（t=2．21，P=0．032）；rhTPO组血小板最低值和最高值的差值明显大于WIG组（t=7．40，P〈0．001）。治疗前两组血小板计数差异无统计学意义（t=0．458，P〉0．05），用药第2天、第3天rhTPO组血小板计数升高明显高于IVIG组（t=2．166和t=2．132，P=0．036和P=0．041），两组存活病例用药第3天rhTPO组血小板计数明显高于IVIG组（t=2．28，P=0．032），两组出血发生率差异无统计学意义（X^2=0．720，P〉0．05），但rhTPO组血小板及血浆输注量明显少于IVIG组（t=2．038和f=2．252，P=0．048和P=0．030）。两组ICU住院时间及病死率差
