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2022 Vol. 29, No. 5
Published: 2022-10-25
 
 
321 Investigation on medical record information construction of hospitals in Guangdong Province from 2018 to 2020
Lin Zhuochen, Xin Ziyi, Xiong Ying
DOI: 10.3969/j.issn.1006-5253.2022.05.001
Guide:: 

Objective To understand the current situation and existing problems of hospitals medical record information construction in secondary hospitals and above in Guangdong Province.Methods The data of 179 hospitals at or above the second level were collected from the national medical quality data sampling survey column from 2018 to 2020. The medical record archiving, CA signature, medical record storage and special quality control method on the front page of medical records were collected. The data was organized by Excel 2010 and analyzed by SPSS 25.0.Results
The use of paperless medical record archiving in Guangdong Province increased from 49.72% in 2018 to 56.42% in 2020 (P＞0.05). In 2019, the paperless archiving rate of tertiary hospitals was higher than that of secondary hospitals (P=0.004). The proportion of partial or full CA signatures increased from 34.64% in 2018 to 43.02% in 2020 in Guangdong Province, and the rate increased significantly in public tertiary hospitals. The proportion of paperless or paper-based medical records and electronic/scanning combined in hospital medical records storage increased from 39.66% in 2018 to 53.07% in 2020, showing an overall upward trend (P=0.011). The informationization rate of special quality control on the home page of medical records in Guangdong Province increased from 17.88% in 2018 to 26.26% in 2020 (P＞0.05).Conclusion The personnel training of medical record coding personnel with information related major still needs to be strengthened. The construction of electronic medical record system has developed in recent three years, but the electronic medical record archiving system, CA signature technology and paperless storage technology still need to be further promoted, and the proportion of special quality control on the front page of medical records using informationbased methods is still low.
2022 Vol. 29 (5): 321-324 [Abstract] ( 45 ) HTML (1 KB)  PDF (3464 KB)  ( 59 )
325  Trend of treatment quality of invasive breast cancer based on joinpoint regression
Guo Ruize, Wang Chao, Li Jingkun, Wei Li, Hou Shuang, Liu Meina
DOI: 10.3969/j.issn.1006-5253.2022.05.002
Guide:: 
Objective To analyze the trend of treatment quality of invasive breast cancer using joinpoint regression, and provide reference for standardizing medical practice behavior and formulating improvement measures for breast cancer treatment quality.Methods Data of invasive breast cancer patients were collected. The utilization rate of each indicator was calculated based on the evaluation indicators of treatment quality of invasive breast cancer, and the denominator-based weight was used to obtain the comprehensive score. Joinpoint regression was used to analyze the trend of hospitallevel treatment quality of invasive breast cancer.Results Data of 2 349 patients from 6 hospitals from 2011 to 2013 were collected. The top three indicators with high utilization rate related to diagnostic examination of axillary lymph node dissection were preoperative molybdenum target or ultrasound (99.16%), no postoperative complications (98.38%), tumor diameter recorded in the pathology report (98.28%), and the lowest rate of the utilization of postmastectomy radiotherapy (33.33%). Hospital E has the highest composite score (0.94) and hospital F has the lowest score (0.77). Results of trend analysis showed that the trend of quality of care for invasive breast cancer has increased slowly (MPC=0.12, P=0.003), and trends of different hospitals varied, among which the quality of care of hospital C increased monthly (MPC=0.10, P=0.031), hospital D increased before November 2012(MPC=0.91, P=0.001), and hospital E declined before October 2011(MPC=-2.05, P=0.004).Conclusion Compared with the conventional regression methods, joinpoint regression could be used to evaluate the trend of quality of care for invasive breast cancer over different time periods in more detail and find the key nodes of the decrease of the treatment quality. Combined with the utilization rate of indicators and the composite score of hospitals, joinpoint regression could be used to analyze the reasons for the adverse trend of quality of care, and provide a theoretical basis for standardizing the behavior of medical practice and improving the quality of care.
2022 Vol. 29 (5): 325-330 [Abstract] ( 67 ) HTML (1 KB)  PDF (4204 KB)  ( 107 )
331 Clinical efficacy of Huangkui capsule combined with losartan potassium in the treatment of diabetic kidney disease stage Ⅲ by using repeated measurement analysis of variance
Wang Wenwen, Lin Yongqiang, Wang Chaochao, Jiang Yi
DOI: 10.3969/j.issn.1006-5253.2022.05.003
Guide:: 
Objective To explore the clinical effect of Huangkui capsule combined with losartan potassium in the treatment of diabetic kidney disease stage Ⅲ by using repeated measurement analysis of variance (ANOVA).Methods Patients with stage Ⅲ diabetic kidney disease were divided into the experimental group (n=43) and the control group (n=43) by random number table method. All patients received the same basic treatment, the control group was given losartan potassium treatment, and the experimental group was treated with Huangkui capsule besides the treatment in the control group. The 24-hour urinary protein(Upro), urinary kidney injury molecule-1 (Ukim-1), and Urinary β-2-microglobulin (Uβ-2-MG) were measured before the treatment, 4 weeks after the treatment, 8 weeks after the treatment, and 12 weeks after the treatment in both groups, and the difference of TCM clinical syndrome scores between the two groups was evaluated before the treatment and 12 weeks after the treatment.Results The results of repeated measurement ANOVA showed that the time effect, inter group effect and interaction effect of Upro and Uβ-2-MG in the two groups were statistically significant (P<0.05), and only the time effect of Ukim-1 in the two groups was statistically significant (P<0.05). The results of one-way repeated measurement ANOVA showed that the levels of Upro and Uβ-2-MG in the experimental group and the control group had different trends with the treatment time. The results of multivariate analysis of variance showed that the level of Upro in the experimental group was lower than that in the control group at 4 weeks, 8 weeks and 12 weeks after the treatment (P<0.05). The level of Uβ-2-MG in the experimental group at 8 weeks and 12 weeks after the treatment was lower than that in the control group (P<0.05). After 12 weeks of the treatment, the TCM clinical syndrome score in the experimental group was significantly lower than that in the control group (P<0.05).Conclusion Huangkui capsule combined with losartan potassium is superior to losartan potassium alone in the treatment of stage Ⅲ diabetic kidney disease.
2022 Vol. 29 (5): 331-336 [Abstract] ( 43 ) HTML (1 KB)  PDF (4028 KB)  ( 192 )
337  Incidence and influencing factors of intraoperative hypothermia in patients undergoing thoracoscopic surgery
Lü Jianmin, Zhou Liuyin
DOI: 10.3969/j.issn.1006-5253.2022.05.004
Guide:: 
 Objective To investigate the risk of intraoperative hypothermia in patients undergoing thoracoscopic surgery and analyze its influencing factors.Methods The convenience sampling method was used to select 286 patients undergoing thoracoscopic surgery in our hospital from January to December 2021 as the study subjects. The intraoperative nasopharyngeal temperature of patients was detected and recorded, and relevant clinical treatment was collected. Logistic regression analysis was used to investigate the factors influencing the incidence of intraoperative hypothermia in patients undergoing thoracoscopic surgery.Results Intraoperative hypothermia occurred in 179 cases (62.59%) of 286 patients undergoing thoracoscopic surgery.  There were significant differences in the incidence of intraoperative hypothermia among patients with different gender, age, body mass index and infusion volume (P<0.05).  Age (OR=11.650, 95%CI:5.138-26.417), body mass index ＜18.5 (OR=12.865, 95%CI:3.438-48.139), body mass index 24-＜28 (OR=6.407, 95%CI:2.088-19.665) and gender (OR=0.491, 95%CI: 0.260-0.930) were the main influencing factors for the occurrence of intraoperative hypothermia in patients undergoing thoracoscopic surgery (P<0.05).Conclusion The incidence of intraoperative hypothermia is high in patients undergoing thoracoscopic surgery. So it is necessary to focus on patients over 60 years old, underweight or overweight, male patients undergoing thoracoscopic surgery, and take appropriate measures to reduce the risk of intraoperative hypothermia. 
2022 Vol. 29 (5): 337-339 [Abstract] ( 42 ) HTML (1 KB)  PDF (2732 KB)  ( 85 )
340  Analysis of influencing factors of hospitalization expenses in patients with chronic rhinosinusitis surgery based on clinical pathway
Guo Shunping, Ye Shiyue, Zheng Zhenquan, Li Yueping
DOI: 10.3969/j.issn.1006-5253.2022.05.005
Guide:: 
 Objective To explore the composition and influencing factors of hospitalization expenses in patients with chronic rhinosinusitis surgery, and to provide reference for the control of disease expenses in medical institutions and the formulation of disease payment standards by medical insurance.Methods The medical records of patients with chronic rhinosinusitis admitted to a tertiary hospital in Fujian Province from January 1, 2018 to December 31, 2020 were collected, and descriptive analysis and multiple linear regression analysis were used to analyze the structure of hospitalization expenses and its influencing factors.Results In terms of the structure of hospitalization expenses, operation cost, consumables cost, and drug cost ranked the top three; the multiple linear regression results showed that anesthesia method was the primary factor affecting hospitalization cost, followed by the number and location of sinus surgery, and then the length of hospitalization, complications, age and year.Conclusion The hospitalization expenses of patients with chronic rhinosinusitis can be effectively reduced by selecting appropriate anesthesia methods, jointly controlling expenses by multiple departments, improving clinical pathways, and reasonably shortening the hospital stay.
2022 Vol. 29 (5): 340-344 [Abstract] ( 59 ) HTML (1 KB)  PDF (3199 KB)  ( 190 )
345  External cause analysis of inpatients with injury and poisoning in a tertiary hospital in Ningbo from 2019 to 2021
Yi Wei, Huang Zhenyu, Niu Yadan, Xie Mengtian, Huang Ling, Zhou Yuqin
DOI: 10.3969/j.issn.1006-5253.2022.05.006
Guide:: 
 Objective To understand the external causes of injury and poisoning and the location of injury and poisoning and the distribution of injury types of inpatients admitted to a hospital, so as to provide preventive strategies and theoretical basis for the occurrence of injury and poisoning.Methods The medical record management platform of the hospital was used to obtain the hospitalization information of injured and poisoned patients, and to analyze the distribution characteristics of the external causes of injury and poisoning, and the location and the type of injury in patients of different genders and age groups.Results From 2019 to 2021, 73 125 patients were admitted to this hospital due to injury and poisoning, of which 63.6% were male and 69.4% were 40 years old and above. The main parts of injury and poisoning were shoulders, upper limbs (56.0%) and lower limbs (28.9%). The proportion of males with "shoulder and upper limb injuries" (59.3%) was higher than that of females (50.1%), and the proportion of males with "lower limb injuries" (28.1%) %) than females (30.3%). The top three external causes of injury and poisoning were "smashing, crushing, glass and knife stab wounds, and mechanical accidents" (35.2%), "falling" (31.0%) and "traffic accident" (19.1%). The top three types in terms of injury type were "fracture" (43 647 cases), "muscle and tendon injury" (7 743 cases) and "disconnection injury" (7 683 cases).Conclusion In recent years, the number of patients admitted to this hospital due to injury and poisoning has increased year by year. It is necessary to strengthen the prevention of external injuries in men, young and middle-aged people, the coping ability of the elderly to traffic accidents and the prevention of falls in women. At the same time, medical resources should be reasonably allocated and effective coping measures should be formulated.
2022 Vol. 29 (5): 345-349 [Abstract] ( 54 ) HTML (1 KB)  PDF (3949 KB)  ( 65 )
350  Path analysis of hospitalization expenses and its influencing factors in 376 skin cancer patients
Lin Jinxiong, Chen Xin, Liao Yuehua, Shen Shuqun
DOI: 10.3969/j.issn.1006-5253.2022.05.007
Guide:: 
 Objective To study the main influencing factors of inpatient costs of skin cancer, and to provide scientific basis for reducing the economic burden of inpatient costs of skin cancer and restraining the rapid growth of medical cost.Methods Medical record data of 376 inpatients were collected from a large tertiary dermatology hospital in Guangdong Province. Descriptive statistics, t-test, path analysis and other methods were used to analyze the direct and indirect factors affecting the hospitalization costs of skin cancer patients.Results The results of path analysis showed that the length of stay was the primary factor that directly affected the hospitalization costs of skin cancer patients; the Bootstrap test of the mediating effect showed that the use of antibiotics, surgery, and comorbidities indirectly affected the hospitalization costs by affecting the length of stay.Conclusion It is helpful for restraining the rapid increase of hospitalization costs and reducing the economic burden of patients and society to shorten the average length of stay as a breakthrough, and to take comprehensive and effective measures to control the controllable factors of the hospitalization cost of skin cancer patients.
2022 Vol. 29 (5): 350-353 [Abstract] ( 51 ) HTML (1 KB)  PDF (2762 KB)  ( 108 )
354 Disease characteristics of inpatients in a hospital of southern Xinjiang from 2017 to 2021
Ma Xin, Wang Ronghua，Yang Haixia, Pang Rizhao, Gao Liang, Wang Yuan, Yan Yongli, Pei Haifeng
DOI: 10.3969/j.issn.1006-5253.2022.05.008
Guide:: 
Objective To analyze the trends and characteristics of inpatient admissions in a secondary hospital in southern Xinjiang, and to provide a basis for the rational allocation of medical resources in hospitals in this area.Methods The information of inpatients in this hospital from 2017 to 2021 was collected. According to the international Classification of Diseases (ICD-10), the characteristics were retrospectively analyzed including disease type ratio, ethnicity ratio, gender ratio and age ratio.Results During the five years, 54 119 patients were admitted to the hospital, with more males (53.80%) than females (46.20%); the top 5 diseases were coronary heart disease, lumbar disc herniation, hypertension III, cerebral infarction and pulmonary tuberculosis; the patients belonged to 12 ethnic groups, and the top 3 were Uygur (73.97%), Han (23.55%) and Hui (0.78%); in terms of age group, the majority of patients were young adults (15-64 years old) (76.33%), followed by elderly patients aged sixty-five years old and above (19.73%) and pediatric patients aged fourteen years old and below (3.94%).Conclusion The inpatients in the hospital are mainly young and middle-aged and male patients, and the Uyghur 
population is the majority. It is necessary for the hospital to strengthen the material and personnel reserve of the departments with more inpatients, appropriately support the corresponding departments of surgery, and promote the coordinated development of internal and surgical departments.
2022 Vol. 29 (5): 354-357 [Abstract] ( 53 ) HTML (1 KB)  PDF (3332 KB)  ( 112 )
358 Analysis of errors in disease coding using computer software system and error correction paths
Jiang Jun, Ge Linlin, Zhang Yao, Huai Jingyang, Dai Hui
DOI: 10.3969/j.issn.1006-5253.2022.05.009
Guide:: 
Objective To aim at the frequent errors in disease coding using computer software systems, to analyze the causes of those coding errors, and to propose correction paths to improve the quality of disease coding.Methods Combined with practical work, the causes of errors in disease coding by computer software systems were discussed by case study. With further inductive analysis, paths to correct the errors were found out.Results There are two main reasons for the errors of disease coding by using computers. One is that coders, unfamiliar with ICD-10 codes and diseases, rely too much on the computer software system, and mechanically draw upon the electronic coding base. Second, there is also room for optimization in the computer software system.Conclusion Coders should keep learning medical knowledge and improve the coding accuracy. Large hospitals can divide the coding staff according to clinical departments, so that every coder can have a more specialized understanding of some chapters of ICD-10 and related diseases, so as to improve work efficiency and reduce errors. When the conditions are ripe, the computer software system can be upgraded.
2022 Vol. 29 (5): 358-361 [Abstract] ( 55 ) HTML (1 KB)  PDF (2634 KB)  ( 142 )
362 Effect analysis of continual quality control of main diagnosis and operation codes on the front page of inpatient medical records
He Meiling，Zeng Lingxia
DOI: 10.3969/j.issn.1006-5253.2022.05.010
Guide:: 
Objective To improve the accuracy of the main diagnosis and the coding of the main operations by summarizing and analyzing the main diagnosis and the coding of the main operations in the first page of the medical record of a general tertiary hospital.Methods Stratified sampling was used to select the first page of medical records of discharged patients in 10 specialties in the medical record management system of a tertiary hospital from April 2021 to April 2022, with surgery accounting for more than 30% of the total. The same cli-nicians and coders carried out the quality control of main diagnosis and surgical coding, and the linear trend chi-square test was used to analyze the change trend of the error rates of main diagnosis and main surgical procedures on the front page of medical records before and after quality control.Results Totally 1 400 medical records were collected and analyzed, of which 885 included operation. After one year of quality control for the main diagnosis and main surgical procedures, the error rate of the writing of the main diagnosis by clinicians reduced from 23.5% to 3.0%, and the error rate of the writing of the main diagnosis by coders reduced from 16.0% to 2.0%. The coding error rate of major surgical procedures reduced from 40.5% to 10.4%, with 19.0% decrease in the error rate of clinicians and 11.1% decrease in the error rate of coders.Conclusion The error rate of filling in and coding in the main diagnosis and main operations on the front page of the medical records is high, and the clinicians and the coders are the main responsible persons. It is necessary to strengthen the training and assessment of clinicians and coders, increase the verification of main diagnosis and surgical procedures in the information system, form a daily quality control plan and process, continue to promote the home page quality control work, and take the main diagnosis and main surgical procedures as the key quality control content.
2022 Vol. 29 (5): 362-366 [Abstract] ( 54 ) HTML (1 KB)  PDF (3849 KB)  ( 251 )
367 Analysis on the influence and countermeasures of ventilator operation errors in DRGs payment
Gu Xiaomin，Zhao Qing
DOI: 10.3969/j.issn.1006-5253.2022.05.011
Guide:: 
Objective To analyze the influence of incorrect filling of ventilator operation name on DRGs enrollment, improve the accuracy of operation name coding, and provide effective data support for the performance appraisal of tertiary public hospitals and medical insurance DRGs payment.Methods Based on HIS charging system, 936 medical records of patients discharged from a hospital using ventilators from July 1, 2021 to December 31, 2021 were retrieved. The contents related to ventilator operation in the first page of medical records were quality-controlled, the actual clinical writing and the coding of medical records were checked, and the wrong cases were corrected after summary and analysis. DRGs was simulated again and analyzed and compared.Results There were 936 medical records of patients discharged from the hospital using ventilators, and there were 17 with problems, including 8 with missing ventilator-related operation names, accounting for 47.06% with the defect rate 0.85%, 5 with writing errors in ventilator use time, accounting for 29.41% with the defect rate 0.53%, 2 with errors in writing/coding of ventilator types, accounting for 11.76% with the defect rate 0.21%, and 2 with coding of medical insurance, accounted for 11.76% with the defect rate 0.21%. After correction and with the simulation of DRGs, the filling error led to a big difference in the DRGs enrollment, the weight was reduced, and the hospital lost 892 378.87 yuan.Conclusion The errors in ventilator operation were mainly caused by the omission of operation name or the error of operation time by doctors and the coding errors of coders. It is necessary to establish an information monitoring system for the first page of medical records, strengthen the training of standardized filling in the first page of medical records, set up a threelevel quality control management team, and improve the accuracy of DRGs inclusion.
2022 Vol. 29 (5): 367-372 [Abstract] ( 50 ) HTML (1 KB)  PDF (3994 KB)  ( 202 )
373 Survey on the status of medical record practitioners in secondary and above general hospitals in Guangdong Province from 2018 to 2020
Pang Hui, Xin Ziyi, Xiong Ying
DOI: 10.3969/j.issn.1006-5253.2022.05.012
Guide:: 
 Objective To study the current situation and change trend of medical record practitioners in secondary and above general hospitals in Guangdong Province, and put forward suggestions for training and team construction of medical record practitioners.Methods The number, educational background and workload of medical record practitioners in Guangdong Province from 2018 to 2020 were obtained through the medical record management professional survey in the national medical quality data sampling survey, and the development trend of medical record practitioners was found by comparative analysis. Quartile and nonparametric tests were used to describe and analyze the data.Results In 2020, the average number of personnel in the medical record departments of sample institutions was 9.52, the number of personnel per 100 beds was 1.22, the number of staff per 10 000 discharged patients was 3.24, the number of medical record-related professional was 6.82, the number of undergraduate and above education personnel was 5.01, and the average annual number of medical records was 1.02 million copies/person-year, which remained stable compared to those in 2018.Conclusion With the continuous development of medical record professional team, the number of personnel has increased to a certain extent, but the workload of personnel is still heavy, and the imbalance of medical record team construction in different regions and different institutions is still prominent. We should continue to pay attention to the education of medical record professionals, including strengthening the undergraduate and postgraduate education of medical record informatics-related majors in higher education, especially continuously improving the construction of the post-graduation education system of medical record coders, so as to adapt to the new situation of the development of medical record disciplines and provide talent resources for medical record management.
2022 Vol. 29 (5): 373-376 [Abstract] ( 43 ) HTML (1 KB)  PDF (2587 KB)  ( 59 )
377 Impact of volume-based purchasing policy on the use of branded and generic cardiovascular drugs in a hospital
Li Qingtong，Wan Jun，Jiao Shuguang，Liu Guocheng，Zhao Shuang， Wang Xiangyu
DOI: 10.3969/j.issn.1006-5253.2022.05.013
Guide:: 
Objective To analyze the impact of volume-based purchasing policy on the use of branded and generic cardiovascular drugs in a tertiary hospital, and to provide reference for the further use of generic drugs and the implementation of drug-related policies.Methods Object drugs of the hospital were selected to analyze the number and proportion of branded and generic cardiovascular drugs, consumption sum and proportion, defined daily doses (DDDs), defined daily dose cost (DDDc), the substitution rate of generic drugs, and actual cost savings before and after the implementation of quantitative purchasing policy.Results After the implementation of volume-based purchasing policy, there is no impact on the unit price of branded cardiovascular drugs in the sample hospital, while the unit price of generic drugs show a downward trend. Compared to the pre-policy period, the overall use of branded cardiovascular drugs increased and accounted for a smaller share of the common use, while generics did the opposite. Overall sales of branded drugs declined but increased as a percentage of common sales, while overall sales of generics declined but decreased as a percentage of common sales. DDDs of the object drugs basically increased overall and DDDc of both decreased. The substitution rate of generic drugs rose, with actual savings of 3.075 6 million yuan.Conclusion After the implementation of volume-based purchasing policy in the sample hospital, the drug burden of some patients was effectively reduced and the drug cost was saved.
2022 Vol. 29 (5): 377-382 [Abstract] ( 56 ) HTML (1 KB)  PDF (4502 KB)  ( 159 )
383 Investigation of the current situation of social adaptability of medical students and its influencing factors
Yin Nana， Li Lixia，Meng Yu， Fang Xiaoqing， Liu Na， Liu Yaxin，Ding Xuemei，Zhang Xiaoli
DOI: 10.3969/j.issn.1006-5253.2022.05.014
Guide:: 
Objective To understand the current situation of the social adaptability of medical students, and analyze the influencing factors, so as to provide a reference for improving the social adaptability of medical students.Methods Stratified sampling method was used to select 1 388 undergraduate medical students in a medical school in Shandong Province, and a questionnaire was surveyed by the general data questionnaire and the social adaptation scale of college students.Results There were significant differences in the scores of social adaptation ability among medical students of different ages and grades, whether they had participated in community activities, whether they had served as class leaders, and how long they used mobile phones per day (P<0.05). The results of multiple linear regression showed that whether they had participated in club activities, whether they had served as class leaders, and the amount of time they used mobile phones every day were the main factors influencing the social adaptability of medical students (P<0.001).Conclusion The level of social adaptability of medical students is low, and colleges and universities can adopt strategies such as carrying out various school or club activities, rotating class cadres, increasing social practice activities, and reducing the time spent on mobile phones used by medical students to improve the social adaptability of medical students.
2022 Vol. 29 (5): 383-387 [Abstract] ( 59 ) HTML (1 KB)  PDF (3253 KB)  ( 88 )
388 Effectiveness of swallowing rehabilitation training in patients with laryngeal neoplasm: a meta-analysis
Wang Lili， Yan Wanhua， Chen Li′e
DOI: 10.3969/j.issn.1006-5253.2022.05.015
Guide:: 
Objective To evaluate the effectiveness of swallowing rehabilitation training among patients with laryngeal neoplasm with meta-analysis.Methods We searched databases including Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang, VIP and CBM from the inception of them to December 1, 2021 and included randomized controlled trials (RCTs) reporting the effectiveness of swallowing rehabilitation training in patients with laryngeal neoplasm. Meta-analysis was performed by RevMan 5.4 software after the quality evaluation.Results Fourteen RCTs with 1 210 patients were included in this meta-analysis. The meta-analysis results showed that swallowing rehabilitation training could reduce the score of Standardized Swallowing Assessment (SSA) scale (MD=-7.21, 95%CI:9.58~-4.85), and improve the normal rate of swallowing function (RR=1.46, 95%CI:1.29~1.64), shorten the indwelling time of gastric tube (MD=-4.92, 95%CI:-5.67--4.16),  reduced the reintubation rate of gastric tube (RR=0.18, 95%CI: 0.07~0.49), incidence of aspiration (RR=0.36, 95%CI:0.20~0.65) and the incidence of pneumonia (RR=0.17, 95%CI:0.05~0.65).Conclusion Swallowing rehabilitation training can effectively improve the swallowing function of patients with laryngeal neoplasm, accelerate the process of gastric tube removal, and reduce the rate of reintubation, aspiration and aspiration pneumonia.
2022 Vol. 29 (5): 388-396 [Abstract] ( 44 ) HTML (1 KB)  PDF (7410 KB)  ( 12 )
397 Prospective study of non-independent binary classification by Poisson regression
Wang Junping，Shen Lingzhi，Lu Zhaojun，Kou Shuo，Zheng Weijun
DOI: 10.3969/j.issn.1006-5253.2022.05.016
Guide:: 
Objective To analyze non-independent prospective data based on SAS software combined with modified Poisson regression.Methods The cluster data of observational studies were analyzed by comparing common methods and modified central effect Poisson regression analysis with SAS software.Results According to the standard of general Poisson regression, the OR-value obtained by logistic regression deviates from the real RR-value, and the modified central effect Poisson regression is more accurate.Conclusion Modified central effect Poisson regression model is more suitable for the treatment of common outcome events of non-independent prospective research data.
2022 Vol. 29 (5): 397-400 [Abstract] ( 37 ) HTML (1 KB)  PDF (2711 KB)  ( 146 )
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