目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良...目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良将其分为发生组(n=24)和未发生组(n=68)。比较两组患者的洼田吞咽功能评分、荧光吞咽透视检查评分和临床特征,采用Logistic回归分析探讨影响神经性吞咽障碍患者发生营养不良的因素,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析洼田吞咽功能评分和荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的价值。结果随访1个月,共有24例患者发生营养不良,营养不良发生率26.09%。发生组患者的洼田吞咽功能评分高于未发生组,荧光吞咽透视检查评分低于未发生组(P<0.05)。发生组患者的体质量指数<18.5kg/m^(2)、饮食≤正常1/2、意识障碍患者的构成比及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均显著高于未发生组(P<0.05)。多因素Logistic回归分析结果显示,饮食状况、意识障碍、NIHSS评分、洼田吞咽功能评分和荧光吞咽透视检查评分均是影响神经性吞咽障碍患者发生营养不良的独立危险因素(P<0.05)。ROC曲线显示,洼田吞咽功能评分、荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的最佳截断值分别为2.73分、4.12分,敏感度分别为87.50%、79.17%,特异性分别为76.47%、85.29%,曲线下面积(area under the curve,AUC)分别为0.800,0.835,二者联合预测的AUC为0.851,敏感度和特异性分别为79.17%和97.06%。结论神经性吞咽障碍营养不良患者的洼田吞咽功能评分和荧光吞咽透视检查评分均发生异常变化,二者可作为预测神经性吞咽障碍患者发生营养不良的敏感指标。展开更多
Our purpose was to compare fluoroscopy time during endoscopic retrograde cholangiopancreatography(ERCP) between endoscopists with different levels of experience.We performed a cross-sectional analysis of 269 consecuti...Our purpose was to compare fluoroscopy time during endoscopic retrograde cholangiopancreatography(ERCP) between endoscopists with different levels of experience.We performed a cross-sectional analysis of 269 consecutive ERCPs at an academic hospital during 1 year.Median fluoroscopy time was significantly longer in more complex cases,such as in therapeutic(406.5 s [IQR,235.5-685]) compared to diagnostic(202 s [IQR,141-481];P = 0.002) procedures.The experience(number of prior ERCPs) of gastroenterology fellows involved in procedures was an independent predictor of shorter fluoroscopy time when controlling for patient and procedure characteristics(P < 0.0001) .Median fluoroscopy time was 2.73 min shorter after at least 50 procedures had been performed(P = 0.039) .Time for ERCPs involving fellows was not significantly longer than cases by attending physicians alone(P = 0.23) .Increased experience is associated with lower radiation exposure during ERCP training.Radiation reduction methods should be prospectively investigated and integrated into training programs.展开更多
文摘目的探讨洼田吞咽功能评分联合荧光吞咽透视检查评分在神经性吞咽障碍患者营养不良中的预测价值。方法回顾性分析2018年5月至2021年5月浙江中医药大学附属温州中医院收治的92例神经性吞咽障碍患者的临床资料,根据患者是否发生营养不良将其分为发生组(n=24)和未发生组(n=68)。比较两组患者的洼田吞咽功能评分、荧光吞咽透视检查评分和临床特征,采用Logistic回归分析探讨影响神经性吞咽障碍患者发生营养不良的因素,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析洼田吞咽功能评分和荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的价值。结果随访1个月,共有24例患者发生营养不良,营养不良发生率26.09%。发生组患者的洼田吞咽功能评分高于未发生组,荧光吞咽透视检查评分低于未发生组(P<0.05)。发生组患者的体质量指数<18.5kg/m^(2)、饮食≤正常1/2、意识障碍患者的构成比及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均显著高于未发生组(P<0.05)。多因素Logistic回归分析结果显示,饮食状况、意识障碍、NIHSS评分、洼田吞咽功能评分和荧光吞咽透视检查评分均是影响神经性吞咽障碍患者发生营养不良的独立危险因素(P<0.05)。ROC曲线显示,洼田吞咽功能评分、荧光吞咽透视检查评分预测神经性吞咽障碍患者发生营养不良的最佳截断值分别为2.73分、4.12分,敏感度分别为87.50%、79.17%,特异性分别为76.47%、85.29%,曲线下面积(area under the curve,AUC)分别为0.800,0.835,二者联合预测的AUC为0.851,敏感度和特异性分别为79.17%和97.06%。结论神经性吞咽障碍营养不良患者的洼田吞咽功能评分和荧光吞咽透视检查评分均发生异常变化,二者可作为预测神经性吞咽障碍患者发生营养不良的敏感指标。
文摘Our purpose was to compare fluoroscopy time during endoscopic retrograde cholangiopancreatography(ERCP) between endoscopists with different levels of experience.We performed a cross-sectional analysis of 269 consecutive ERCPs at an academic hospital during 1 year.Median fluoroscopy time was significantly longer in more complex cases,such as in therapeutic(406.5 s [IQR,235.5-685]) compared to diagnostic(202 s [IQR,141-481];P = 0.002) procedures.The experience(number of prior ERCPs) of gastroenterology fellows involved in procedures was an independent predictor of shorter fluoroscopy time when controlling for patient and procedure characteristics(P < 0.0001) .Median fluoroscopy time was 2.73 min shorter after at least 50 procedures had been performed(P = 0.039) .Time for ERCPs involving fellows was not significantly longer than cases by attending physicians alone(P = 0.23) .Increased experience is associated with lower radiation exposure during ERCP training.Radiation reduction methods should be prospectively investigated and integrated into training programs.
