RESUMEN
With the continuous development of internet information computing, the continuous improvement of medical and health systems, and the continuous increase of medical big data, traditional operating room care also needs to be further optimized. Medical big data is a forum data set for medical industry healthcare, electronic medical record information, clinical case record information, medical financial data, remote patient monitoring data, clinical decision support data, medical insurance data set, online consulting platform, and so on. Gastrointestinal tumors are currently one of the largest malignant tumors. Compared with ordinary patients, the presence of fear, depression, irritability, and other unhealthy emotions in patients with gastrointestinal tumors will reduce the therapeutic effect. Without careful care, the use of chemotherapy and other treatments makes patients vulnerable to various side effects. This article aims to study the use of medical big data intelligent algorithms to perform detailed care for patients during gastrointestinal tumor surgery and analyze the effects of care. This paper proposes an improved DNN algorithm; the DNN algorithm is to use several weight coefficient matrices and bias vectors to perform a series of linear operations and activation operations with the input value vector, starting from the input layer, backward calculation layer by layer, until the operation reaches the output layer, and the output result is obtained. This algorithm is used to study the theory, use mathematical formulas for method calculation and model design, and use the model to carry out detailed nursing experiments in the relevant operating room. The results of the experiment show that patients who have performed detailed care have a 27.2% improvement in treatment and rehabilitation effects than those who have not, and the level of detailed care has an obvious positive relationship with the rate of condition conversion. In the end, the hospital's detailed care quality evaluation index, which is QEI, increases by 1 point, which can increase the rate of condition conversion by 0.4.
Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas , Neoplasias Gastrointestinales , Algoritmos , Macrodatos , Neoplasias Gastrointestinales/cirugía , Humanos , QuirófanosRESUMEN
AIM: To evaluate the outcomes of patients with medium-sized hepatocellular carcinoma (HCC) who underwent percutaneous microwave ablation (MWA). METHODS: We retrospectively reviewed all patients with a single medium-sized HCC who underwent percutaneous MWA from January 2010 to January 2013. Technical success, technical effectiveness and complications were subsequently observed. Survival curves were constructed using the Kaplan-Meier method. The Cox proportional hazards model was fitted to each variable. The relative prognostic significance of the variables for predicting overall survival rate, recurrence-free survival rate and local tumor recurrence(s) was assessed using univariate analysis. All variables with a P value < 0.20 were subjected to multivariate analysis. RESULTS: The study included 182 patients (mean age, 58 years; age range: 22-86 years) with a single HCC (mean size, 3.72 ± 0.54 cm; range: 3.02-5.00 cm). The estimated technical effectiveness rate was 93% in 182 patients. The major complication rate was 2.7% (5/182), including liver abscess in 4 cases, and abdominal bleeding at the puncture site in 1 case. Thirty-day mortality rate was 0.5% (1/182). One patient died due to liver abscess-related septicemia. Cumulative recurrence-free survival and overall survival (OS) rates were 51%, 36%, 27% and 89%, 74%, 60% at 1, 2, and 3 years, respectively. Age (P = 0.017) and tumor diameter (P = 0.029) were independent factors associated with local tumor recurrence. None of the factors had a statistically significant impact on recurrence-free survival. Serum albumin level (P = 0.009) and new lesion(s) (P = 0.029) were independently associated with OS. CONCLUSION: Percutaneous MWA is a relatively safe and effective treatment for patients with medium-sized HCC.
Asunto(s)
Técnicas de Ablación , Carcinoma Hepatocelular/cirugía , Neoplasias Hepáticas/cirugía , Microondas/uso terapéutico , Técnicas de Ablación/efectos adversos , Técnicas de Ablación/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Imagen por Resonancia Magnética , Masculino , Microondas/efectos adversos , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Carga Tumoral , Adulto JovenRESUMEN
BACKGROUND: Repeated hepatic resection (HR) and thermal ablation therapy (TAT) are increasingly being used to treat recurrent intrahepatic cholangiocarcinoma (RICC). This study compared the efficacy and safety of these procedures for RICC treatment. METHODS: Patients were studied retrospectively after curative resection of RICCs by repeated HR (n = 32) or TAT (n = 77). Treatment effectiveness and prognosis were compared between the two treatment groups. RESULTS: The repeated HR and TAT groups did not differ in their overall survival (OS; p = 0.996) or disease-free survival (DFS; p = 0.692) rates. However, among patients with recurrent tumors >3 cm in diameter, patients in the repeated HR group had a higher OS rate than patients in the TAT group (p = 0.037). The number of recurrent tumors and the recurrence interval were significant prognostic factors for OS. The major complications incidence rate was greater in the repeated HR group than in the TAT group (p < 0.001). CONCLUSIONS: Repeated HR and TAT are both effective treatments for RICC with similar overall efficacies. TAT should be preferred in any cases when the RICC is ≤3 cm in diameter and technically feasible. However, for large tumors (>3 cm), repeated HR may be a better choice.