简介:摘要目的探讨急性胰腺炎(acute pancreatitis,AP)患者发生急性肾损伤(acute kidney injury,AKI)的尿量阈值,指导早期液体治疗。方法提取美国重症监护医学信息数据库Ⅳ(medical information mart for intensive care Ⅳ,MIMIC-Ⅳ)中AP患者的临床资料,计算24 h尿率[24 hour urine output·kg-1·24 hour-1, 24-UR mL/(kg·h)]和48 h尿率[48 hour urine output·kg-1·48 hour-1, 48-UR mL/(kg·h)],根据患者7 d内是否发生急性肾损伤(AKI within 7 days,7-AKI)分为7-AKI组和非7-AKI组,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评估24-UR和48-UR对AP患者7-AKI发生的预测价值,根据ROC曲线得出的最佳截断值分别对24-UR与48-UR分组,采用逻辑回归分析7-AKI的危险因素,绘制Kaplan-Meier(KM)生存曲线分析24-UR和48-UR对AP患者住院病死率的影响。结果共纳入713例AP患者,ROC曲线分析结果显示,24-UR预测AP患者7-AKI的ROC曲线下面积(area under the ROC curve,AUC)为0.76,依据最大约登指数计算出的24-UR截断值为0.795 mL/(kg·h),48-UR的AUC为0.78,48-UR截断值为0.975 mL/(kg·h)。逻辑回归分析结果显示,与24-UR>0.795 mL/(kg·h)相比,24-UR≤0.795 mL/(kg·h)的是7-AKI的独立危险因素(OR:4.22,95%CI:1.5~11.85,P=0.006),同样,与48-UR>0.975 mL/(kg·h)相比,48-UR≤0.975 mL/(kg·h)的是7-AKI的独立危险因素(OR:3.75,95%CI:1.45~9.72,P=0.007);KM生存曲线显示高24-UR组住院生存率高于低24-UR组。结论24-UR可用于指导AP患者早期液体治疗。
简介:【 摘要 】 :目的: 本次 实验将 在 防治糖尿病性眼底病中 实施 健康教育 护理模式并探讨其效果和作用。 方法:实验选取了 201 8 年 1 月~ 2019 年
简介: [摘要 ] 目的 探析临床护理路径( CNP)在 2型糖尿病胰岛素注射护理中的应用效果。方法 将 2018年 6—12月于该院接收胰岛素注射治疗的 46例 2型糖尿病患者作为该研究的基础组,予以其常规护理,再将 2019年 1—6月接收的 46例作为路径组,予以其 CNP护理。比较两组空腹血糖( FPG)、餐后 2 h血糖( 2 hPG)、糖化血红蛋白( HbA1c)水平及胰岛素注射知识评分。 结果 护理后,路径组 FPG、 2 hPG、 HbA1c水平均较基础组低 ;同时,路径组胰岛素注射知识评分高于基础组( P<0.05)。 结论 将 CNP用于 2型糖尿病胰岛素注射护理中,可有效降低患者血糖水平,增强其对胰岛素注射的认知。 [关键词 ] 胰岛素注射 ;2型糖尿病 ;临床护理路径 ;护理效果 [Abstract] Objective To explore the application effect of clinical nursing pathway (CNP) in insulin injection nursing of type 2 diabetes mellitus. Methods 46 patients with type 2 diabetes who received insulin injection treatment in our hospital from June to December 2018 were selected as the basic group of the study, and they were given routine nursing care, and then 46 patients received from January to June 2019 as the pathway group were given CNP nursing. Fasting blood glucose (FPG), 2 h postprandial blood glucose (2 HPG), glycosylated hemoglobin (HbA1c) and insulin injection knowledge score were compared between the two groups. Results after nursing, the levels of FPG, 2 HPG and HbA1c in the pathway group were lower than those in the basic group; meanwhile, the score of insulin injection knowledge in the pathway group was higher than that in the basic group (P < 0.05). Conclusion CNP can effectively reduce blood glucose level and enhance the cognition of insulin injection in patients with type 2 diabetes mellitus.