1.
Hepatic and renal functions and blood cell counts in brain tumor patients during the perioperative period.
Zhang, F, Guo, X, Xing, B, Yang, Y, Xu, Z
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2019;:190-197
Abstract
We aimed to investigate the correlations between biochemical and hematological markers and the clinical conditions of brain tumor patients before and after craniotomy. A retrospective study was conducted in 90 brain tumor patients. Age, gender, underlying diseases, tumor size and intraoperative blood loss were recorded. Red blood cell counts and hepatic and renal markers were analyzed preoperatively and postoperatively. Albumin decreased by 5.6 g/L after surgery (p < 0.001). Older patients (>52 years) and females had lower albumin levels than younger patients and males did. Red blood cell counts and hemoglobin levels decreased significantly on the 1st and increased on the 3rd postoperative day. The blood glucose level increased on the 1st postoperative day and then decreased. Older patients had higher blood glucose levels than younger patients did (p < 0.05). The postoperative serum sodium, potassium and calcium levels were within the normal ranges; 37 patients had hypocalcemia (41.1%) and patients with hypokalemia and hyponatremia increased postoperatively. Albumin and hemoglobin levels were linearly correlated (correlation coefficient 0.559, p < 0.001). Intraoperative blood loss was correlated with tumor size (p < 0.05) but did not affect the decrease in hematological markers. In brain tumor patients, red blood cell counts and hemoglobin and serum albumin levels were significantly decreased after craniotomy; these effects were influenced by gender and age instead of intraoperative blood loss. The postoperative blood glucose level peaked and then decreased; it was affected by age and diabetes mellitus. Electrolytes remained relatively stable. These findings have implications for patient management and postoperative complication prevention.
2.
Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome: A systematic review and meta-analysis.
Song, T, Rössle, M, He, F, Liu, F, Guo, X, Qi, X
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 2018;(4):323-330
Abstract
BACKGROUND Hepatorenal syndrome is a severe complication of advanced liver diseases with a dismal prognosis. AIMS This systematic review and meta-analysis aims to explore the efficacy and safety of transjugular intrahepatic portosystemic shunt for the treatment of hepatorenal syndrome. METHOD Publications were searched via PubMed and EMBASE databases. The pooled proportion and mean difference were calculated by using a random-effect model. RESULTS Nine publications were included, in which 128 patients with hepatorenal syndrome were treated with transjugular intrahepatic portosystemic shunt. The pooled short-term and 1-year survival rates were 72% and 47% in type 1 hepatorenal syndrome and 86% and 64% in type 2 hepatorenal syndrome. No lethal procedure-related complications were observed. The pooled rate of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt was 49%. The pooled rate of renal function improvement after transjugular intrahepatic portosystemic shunt was 93% in type 1 hepatorenal syndrome and 83% in any type of hepatorenal syndrome. After transjugular intrahepatic portosystemic shunt, serum creatinine, blood urea nitrogen, serum sodium, sodium excretion, and urine volume were significantly improved; by comparison, serum bilirubin slightly increased, but the difference was not statistically significant. CONCLUSION Limited evidence suggested a potential survival benefit of transjugular intrahepatic portosystemic shunt in patients with hepatorenal syndrome but with a high incidence of hepatic encephalopathy.
3.
Goal-directed fluid therapy versus conventional fluid therapy in colorectal surgery: A meta analysis of randomized controlled trials.
Xu, C, Peng, J, Liu, S, Huang, Y, Guo, X, Xiao, H, Qi, D
International journal of surgery (London, England). 2018;:264-273
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Abstract
OBJECTIVES This meta-analysis was conducted to compare the effects of goal-directed fluid therapy (GDFT) versus conventional fluid therapy (CFT) in colorectal surgery on patients' postoperative outcome and to detect whether the results differ between studies with the Enhanced Recovery After Surgery (ERAS) protocol and those without, between studies using different devices for GDFT, or between different surgical approaches (laparoscopy or laparotomy). METHODS The Cochrane Library, PubMed, Embase, Wanfang Data and ClinicalTrials.com were searched for studies from January,1990 to February, 2018. Randomized controlled trials (RCTs) comparing both two abovementioned fluid therapy protocols in colorectal surgery were included. The primary outcome was 30-day mortality after surgery. Secondary outcomes were length of hospital stay (LOS), complication rate, ICU admission and gastrointestinal indicators. RESULTS Eleven studies were included, including a total of 1281 patients: the GDFT group included 624 patients and the control group included 657 patients. No significant differences were found between groups in 30-day mortality (relative risk, RR 0.86,0.28 to 2.63, P = 0.79), LOS (weighted mean difference, WMD 0.22,-0.1 to 0.55, P = 0.18), and ICU admission (RR 0.42, 0.17 to 1.04, P = 0.06). However, the GDFT group had a lower complication rate (RR 0.84,0.71 to 0.99, P = 0.04). In subgroup analyses, time to first flatus and time to tolerate an oral diet were shorter in GDFT group than the control group in studies who did not use the ERAS protocol. No publication bias was identified according to Begg's test. CONCLUSION Compared with conventional fluid therapy, GDFT may not improve patients' postoperative outcome in colorectal surgery. However, the improvement of gastrointestinal function associated with GDFT over conventional fluid therapy was significant in the surgeries that did not use the ERAS protocol.