目的:评估和比较血红蛋白–白蛋白–淋巴细胞–血小板(Hemoglobin, Albumin, Lymphocyte and Platelet, HALP)评分与改良HALP (modified HALP, mHALP)评分对ICU脓毒性休克患者28天生存率的预测能力。方法:研究对2022年8月至2024年8月在...
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目的:评估和比较血红蛋白–白蛋白–淋巴细胞–血小板(Hemoglobin, Albumin, Lymphocyte and Platelet, HALP)评分与改良HALP (modified HALP, mHALP)评分对ICU脓毒性休克患者28天生存率的预测能力。方法:研究对2022年8月至2024年8月在济宁市第一人民医院ICU确诊为脓毒症休克的328例患者进行回顾性分析。收集患者的一般资料、实验室数据及各类评分,28天生存情况作为结局指标。通过单因素和多因素Logistic回归分析筛选生存的独立预测因素,并用ROC曲线比较两种评分的预测效果,同时绘制Kaplan-Meier曲线分析不同mHALP分组的生存差异。结果:328例患者中,178例在28天内死亡,150例存活超过28天,生存率为45.7%。生存组的白蛋白、淋巴细胞计数、血小板计数、HALP评分和mHALP评分显著高于死亡组,死亡组的APACHE II评分、SOFA评分、降钙素、乳酸和C反应蛋白明显高于生存组,差异具有统计学意义(P χ2 = 74.44,P Objective: To assess and compare the predictive ability of the hemoglobin, albumin, lymphocyte, platelet (HALP) score with the modified HALP (mHALP) score for 28-day survival in patients with septic shock in the ICU. Methods: The study retrospectively analyzed 328 patients diagnosed with septic shock from August 2022 to August 2024 in the ICU of the First People’s Hospital of Jining City. General data, laboratory data and various scores of patients were collected, and 28-day survival was used as an outcome indicator. Independent predictors of survival were screened by univariate and multivariate logistic regression analyses, and ROC curves were used to compare the predictive effects of the two scores, while Kaplan-Meier curves were plotted to analyze the differences in survival between different mHALP subgroups. Results: Of the 328 patients, 178 died within 28 days and 150 survived more than 28 days, resulting in a survival rate of 45.7%. Albumin, lymphocyte count, platelet count, HALP score, and mHALP score were significantly higher in the survival group than in the death group, and APACHE II score, SOFA score, calcitonin, lactate, and C-reactive protein were significantly higher in the death group than in the survival group, with statistically significant differences (P χ2 = 74.44, P < 0.001). Conclusion: The mHALP score is better than the traditional HALP score in predicting 28-day survival in ICU septic shock patients and is suitable for clinical prognostic assessment.
急性肾损伤(acute kidney injury, AKI)在重症监护病房(intensive care unit, ICU)中是一种常见的疾病,大多患者预后不良。早期的诊断和及时治疗对于患者来说非常重要。近期有大量的研究已经表明,相对于传统的实验室指标如尿量的减少以...
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急性肾损伤(acute kidney injury, AKI)在重症监护病房(intensive care unit, ICU)中是一种常见的疾病,大多患者预后不良。早期的诊断和及时治疗对于患者来说非常重要。近期有大量的研究已经表明,相对于传统的实验室指标如尿量的减少以及血肌酐值的上升来说,有很多的生物学标记物对于AKI的早期诊断具有一定的意义,本文将对这些生物学标记物的研究进展进行一篇综述,旨在对AKI的早期诊断和护理有一定的作用。Acute kidney injury (AKI) is a common disease in the intensive care unit (ICU), and most patients have a poor prognosis. Early diagnosis and timely treatment are very important for patients. A large number of recent studies have shown that compared with traditional laboratory indicators such as reduced urine volume and increased serum creatinine value, there are many biological markers that have certain significance for the early diagnosis of AKI. This article will review the research progress of these biological markers, aiming to have a certain role in the early diagnosis and care of AKI.
目的探讨微信支持下个案管理模式对慢性肾炎患者自我护理能力和病情状态的影响。方法采用便利抽样法,选取2020年1月—2022年2月于济宁医学院附属医院肾内科实施治疗的110例慢性肾炎患者,根据所住病区不同进行分组,对照组为在一病区住院患者,研究组为在二病区住院患者,每组55例。对照组采取常规延续护理指导,研究组在对照组的基础上采取微信支持下个案管理模式,比较两组的自我护理能力、负性情绪及肾功能水平。结果护理前,两组的自我护理能力量表(ESCA)评分、广泛焦虑量表(GAD-7)评分、患者健康问卷抑郁量表(PHQ-9)评分及各项肾功能指标[血肌酐(Scr)、血尿素氮(BUN)、24 h尿蛋白(24 h UP)]比较,差异无统计学意义(P>0.05);护理后,两组的健康知识水平、自我护理技能、自护责任感、自我概念等ESCA评分均高于护理前,且研究组高于对照组,差异均有统计学意义(t值分别为4.650、2.250、3.052、3.434,P均<0.05);两组护理后的GAD-7评分、PHQ-9评分均低于护理前,且研究组低于对照组,差异均有统计学意义(t值分别为8.207、3.464,P均<0.05);两组护理后的Scr、BUN、24 h UP等肾功能指标水平低于护理前,且研究组低于对照组,差异均有统计学意义(t值分别为2.831、2.797、2.228,P均<0.05)。结论在慢性肾炎患者中应用微信支持下个案管理模式能够提升患者的自我护理能力,减轻其负性情绪,促进病情改善。
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