论著

非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果探讨

Identification of the constitution of the elderly with nonalcoholic fatty liver disease and discussion on the therapeutic effect of preventing disease before arising

:63-69
 
       目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象,根据患者就诊顺序分配为两组。对照组35例,接受常规干预;观察组35例,其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果,以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%,高于对照组的68.57%,差异有统计学意义(P<0.05)。治疗前,两组各项血脂水平、肝功能、慢性肝病问卷(CLDQ)评分比较,差异无统计学意义(P>0.05);治疗后,两组各项血脂水平优于治疗前,各项肝功能低于治疗前,CLDQ评分高于治疗前,差异有统计学意义(P<0.05);治疗后,观察组的各项血脂水平优于对照组,各项肝功能低于对照组,CLDQ评分高于对照组,差异有统计学意义(P<0.05)。结论   对非酒精性脂肪性肝病老年患者而言,中医“治未病”理念下体质辨识干预服务能够提高其治疗效果,调节血脂水平的异常,改善肝功能及生存质量,值得应用。
       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising.Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects.Patients were assigned to two groups,control group(35 cases)received  routine intervention,observation group(35 cases)received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally.The effect of intervention and the changes of blood lipid levels,liver function and quality of life before and after intervention were compared between the two groups.Results  The total effective rate of the observation group was 91.43%,higher than that of the control group(68.57%),the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in blood lipid levels,liver function and CLDQ scores between the two groups(P>0.05).After treatment,the levels of blood lipids were better than those before treatment,liver function was lower than that before treatment,CLDQ score was higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,the blood lipid levels of the observation group was better than that of the control group,the liver function was lower than that of the control group,and the CLDQ score was higher than that of the control group,with statistical significance(P<0.05).Conclusions  For elderly patients with nonalcoholic fatty liver disease,the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect,regulate the abnormal blood lipid levels,improve liver function and quality of life,which is worthy of application.
论著

认知行为疗法联合治疗性沟通对 ESD 术后患者心理及治疗依从性的效果

Effect of cognitive behavioral therapy combined with therapeutic communication on psychological health and therapy compliance of ESD patients

:1730-1735
 
       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离(ESD)术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象,采用随机数字表法将患者分为A、B组,B组56例患者采取治疗性沟通干预,A组66例患者采用认知行为疗法联合治疗性沟通干预,两组均连续干预2个月。比较两组患者干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、心理弹性量表(CD-RISC)评分、Herth希望指数量表(HHI)评分差异,对比两组干预依从性。结果   干预后,两组SAS、SDS评分均下降且A组低于B组(t分别为12.096、10.326,P<0.05);干预后,两组CD-RISC量表各项评分均提高且A组高于B组(t分别为18.483、12.060、13.622,P<0.05);干预后,两组HHI量表各项评分均上升且A组高于B组(t分别为1.289、11.568、12.527、13.794,P<0.05);A组患者总依从率96.97%(64/66)高于B组80.36%(45/56)(χ 2 =8.782,P<0.05)。论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想,能够明显改善患者负性情绪,提高心理弹性及对疾病康复的希望水平,有效提升依从性。
       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection(ESD).Methods  Prospectively,122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects.These patients were randomly divided into Group A and Group B using the random number table method,and 56 patients in group B were treated with therapeutic communication,66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication,and both groups were continuously intervened for 2 months.The  scores of Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Connor-Davidson Resilience Scale(CD-RISC)and Herth Hope Index(HHI)were compared between the two groups before and after treatment.Therapy compliance between the two groups was compared.Results  After treatment,the SAS and SDS scores of the two groups were decreased,and the scores of group A was lower than that of group B(t=12.096,10.326,P<0.05)after the intervention,the scores of the CD-RISC scale of the two groups were improved,and the score of group A was higher than that of group B(t=18.483,12.060,13.622,P<0.05).After intervention,the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup Bt=11.289,11.568,12.527,13.794,P<0.05).The total compliance rate of patients in group A was 96.97%(64/66),which was significantly higher than 80.36%(45/56)in group B(χ 2 =8.782,P<0.05).Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients,which can significantly improve patients’ negative emotions,psychological resilience and hope for disease recovery,and also therapy compliance.
论著

经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析

Analysis of the influencing factors of adverse psychological health status in patients with kinesiophobia after percutaneous coronary intervention

:1712-1723
 
       目的   识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果  271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
       Objective  To identify the risk factors associated with depression,anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods  In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results  Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
论著

急性 DVT 患者 CDT 治疗中血管导管相关感染危险因素及病原菌分析

Risk factors and pathogens analysis of vessel catheter associated infection in acute DVT patients undergoing CDT treatment

:1705-1711
 
       目的   通过对急性深静脉血栓形成(DVT)患者经导管接触性溶栓治疗(CDT)中,影响血管导管相关感染(VCAI)危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法   收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果   本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示:溶栓频率>3次/天[OR=3.49(95%CI:1.86~6.45)]、导管留置时间>7 dOR=3.86(95%CI:1.26~10.18)]和有导管回送[OR=8.67(95%CI:4.83~12.65)]是患者发生VCAI的危险因素(P<0.05)。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论   导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。
        Objective  By analyzing the risk factors and pathogens of vessel catheter associated infection(VCAI)in patients with acute deep vein thrombosis(DVT)undergoing catheter directed thrombolysis(CDT),to provide  reasonable and effective measures for the prevention and treatment of VCAI .Methods  Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed.Results  This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰.The  results of multiple Logistic  regression analysis show that thrombolysis frequency>3 times/day(OR=3.49[95%CI:1.86-6.45]),catheter retention days>7 daysOR=3.86[95%CI:1.26-10.18]),and the presence of catheter return(OR=8.67[95%CI:4.83-12.65]) were risk factors for the occurrence of VCAI in patients.Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discoveredin blood culture,and 3 patients developed composite pathogen infections.Among them,Gram  positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%.Conclusions  The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment.The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen.
论著

基于思维导图的绿色通道急救干预对急性心梗患者介入治疗的效果

The effect of green channel emergency nursing based on mind mapping on PCI of acute myocardial infarction patients

:1677-1683
 
       目的   探讨基于思维导图的绿色通道急救干预对急性心肌梗死患者介入治疗的效果。方法   对天津市人民医院2022年1月—2024年12月收治的80例AMI患者进行研究,依照收治时间进行分组,将2022年1月—2023年6月采取常规急救流程干预的40例患者分为常规组,将2023年7月—2024年12月的采取基于思维导图的绿色通道急救干预的40例患者分为思维导图组。比较两组患者急救效率、急救前后生命体征(心率、舒张压、收缩压)、心肌损伤指标[磷酸肌酸激酶(CK-MB)及肌钙蛋白Ⅰ(cTnI)],最后比较两组患者干预满意度。结果   对比急救效率发现,思维导图组的预检时间、会诊时间、导管室激活时间、急诊送至PCI手术时间均短于常规组(P<0.05);对比急救前后生命体征发现,与急救前对比,急救后两组的心率、舒张压、收缩压均降低(P<0.05),急救前后两组心率、舒张压、收缩压比较差异无统计学意义(P>0.05);对比急救前后心肌损伤指标发现,急救前两组CK-MB、cTnI比较差异无统计学意义(P>0.05),急救后,思维导图组CK-MB、cTnI低于常规组与急救前(P<0.05);对比干预满意度发现,思维导图组干预满意度为100.00%,高于常规组的85.00%(P<0.05)。结论  基于思维导图的绿色通道急救干预可提升AMI患者的急救效率,稳定患者生命体征,减轻心肌损伤的同时,提升患者干预满意度。
       Objective  To explore the effect of green channel emergency nursing based on mind mapping on percutaneous coronary intervention(PCI) of patients with acute myocardial infarction(AMI).Methods  A study was conducted on 80 AMI patients admitted to Tianjin People’s Hospital from January 2022 to December 2024.The patients were divided into two groups based on their admission time.The 40 patients who received routine emergency nursing interventions from January 2021 to June 2023 were assigned to the conventional group,while the 40 patients who  received green channel emergency nursing based on mind mapping from July 2023 to November 2024 were assigned to the mind mapping group.The emergency treatment efficacy,vital signs(heart rate,diastolic blood pressure,systolic bloodpressure),myocardial injury indicators(phosphocreatine kinase[CK-MB],and troponin I[cTn1])between two groups of patients before and after emergency treatment were compared.Results  The pre-examination time,consultation time,catheterization room activation time and emergency room to PCI operation time of mind mapping group were all shorter than those of conventional group(P<0.05).Compared with the vital signs before and after emergency treatment,we found that the heart rate,diastolic pressure and systolic blood pressure of the two groups decreased after emergency treatment(P<0.05),and there was no significant difference between the heart rate,diastolic pressure and systolic blood pressure of the two groups before and after emergency treatment(P>0.05).Comparing the myocardial injury indicators before and after emergency treatment,there was no significant difference in CK-MB and cTn1 between the two groups before emergency treatmentP>0.05).After emergency treatment,CK-MB and cTn1 in the mind map group were lower than those in the conventional group and before emergency treatment(P<0.05).Comparing the intervention satisfaction,it was found that the mind mapping group of 100.00% was higher than the conventional group of 85.00%(P<0.05).Conclusions  Green channel emergency nursing based on mind mapping can improve the efficiency of emergency treatment for AMI patients,stabilize their vital signs,reduce myocardial injury,improve patient intervention satisfaction.
论著

新型穿戴式气压治疗仪预防深静脉血栓的非劣效性临床研究

Evaluation of new type of wearable pneumatic compression pump in prevention of deep vein thrombosis:A non-inferiority study

:1663-1668
 
       目的   评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法   将156例脑梗死患者随机分为对照组和试验组,各78例。试验组使用新型穿戴式气压治疗仪(邦普医疗/VW100)进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d,观察临床疗效及安全性,比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果   治疗10 d后,试验组与对照组深静脉血栓未发生率差值为1.2%,相应的95%置信区间为–5.3%~7.9%,下限高于–10%,医护人员和患者对试验组的评价优于对照组(P<0.001)。结论   新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪,治疗过程中未见明显不良反应,临床使用安全有效。
        Objective  To  evaluate the  effectiveness  and  safety  of  new wearable  pneumatic  compression  pump in preventing deep vein thrombosis.Methods  One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group.Study group was treated with the new wearable pneumatic compression pump(Bangpu Medical / VW100).Control group was treated with pneumatic compression pump(Wonjin-POWER).The course of both groups was 10 days,comparing the deep vein thrombosis  rate and useage satisfaction of patients and staffs between the two groups.Results  After 10 days of treatment,the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%.The corresponding 95% confidence interval was(-5.3%,7.9%),and the lower limit was greater than -10%.The appraisal from medical staffs and the patients of study group was better than that of the control group(P<0.001).Conclusions  The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump,which clinical practice experience is better.There is no obvious adverse reactions in the treatment process,and the clinical practice is also safe and effective.
专家述评

帕金森病细胞替代治疗的现状及进展

Current status and advances in cell replacement therapy for Parkinson’s disease

:1611-1620
 
       帕金森病是全球第二大神经退行性疾病,其根本病理特征为中脑黑质多巴胺能神经元的退变死亡。目前临床一线治疗主要采用左旋多巴替代疗法,然而疗效有限且副作用显著。以补充多巴胺能神经元为基础的细胞替代疗法,能够从根本上解决神经元丢失的问题,具有长远的临床意义。细胞替代治疗的细胞最早来自于胎儿腹侧中脑组织,随着重编程技术的不断发展,已逐步转向人类胚胎干细胞和诱导多能干细胞体外分化的前体细胞。同时,直接在体内重编程,将胶质细胞转分化为多巴胺能神经元,也是一种具有应用潜力的策略。本文系统总结了近年来帕金森病细胞替代疗法的进展和面临的挑战,旨在为该疾病治疗新策略的研究提供参考和启示。
       Parkinson’s disease(PD)is the second most prevalent neurodegenerative disorder worldwide,characterized by the progressive loss of dopaminergic neurons in the substantia nigra pars compacta.Traditional treatments,primarily involving levodopa for dopamine replacement,offer limited efficacy and associated with significant side effects.Cell  replacement therapies aimed at replenishing dopaminergic neurons provide a promising long-term solution to neuronal loss,with  substantial clinical significance.The initial successful cellular source for transplantation in PD research was fetal ventral mesencephalic tissue.Nevertheless,advancements in  reprogramming technologies have increasingly favored the use of human embryonic stem cells and induced pluripotent stem cells.Additionally,direct in vivo reprogramming,converting glial cells into dopaminergic neurons,has emerged as an alternative strategy for cell replacement therapy.This  review  systematically  summarizes the  recent advances and challenges in cell replacement therapies for PD,with the aim of providing insights and guidance for the development of novel therapeutic strategies for the PD.
医院管理

基于压疮治疗方式的不同对 DRG 入组的特征与应用的研究

A study on the characteristics and application of DRG admission based on different treatment methods for pressure ulcers

:1599-1604
 
       目的   通过对压疮不同治疗方式的分析,探讨疾病诊断相关分组(DRG)组合的特征,提高核心疾病诊断相关组(ADRG)的入组率和提升相对权重值,从而提升医疗服务效率和水平。方法   使用医院DRGs分析评价系统以及EXCEL软件筛选出2023—2024年广州市第一人民医院主要诊断压疮疾病病例,分析ADRG组合的特征。结果   根据压疮疾病不同治疗方式,主要诊断为压疮(L89)的176病例进入相对的外科治疗组和内科治疗组,ADRG组分别为JD1组合、JJ1组合、JV1组合。JJ1组合治疗方案以创面封闭式负压引流为主;JD1组合的外科治疗方式均是以皮肤和皮下坏死组织的切除清创术+创面封闭式负压引流术(VSD)的手术治疗方案。JD13组、JD15组比JJ13组、JJ15组,相对权重分别高2.35和1.48。26例患者的住院时间均超过60 d,导致进入了QY组合。结论   利用好DRGs工具能有效地提高压疮的入组率,结合精细化的首页质量管理,提升DRGs的组合权重值及医疗服务效率和水平。
       Objective  To analyze  different treatment methods for  pressure  ulcers and explore the characteristics of Diagnosis-Related Groups(DRGs)to improve the admission rate of Adjacent DRGs(ADRGs)and enhance the  relative weight value,thereby improving the efficiency and level of medical services.Methods  Using the DRGs management system and EXCEL software,cases of pressure ulcer disease from Class A tertiary hospital in Guangzhou from 2023 to 2024 were selected,with pressure ulcers as the primary diagnosis,and analyzed the characteristics of ADRG combinations.Results  Based on different treatment methods for pressure ulcers,176 cases primarily diagnosed with pressure ulcers(L89)were categorized into  relative surgical and medical treatment groups,with ADRG groups being JD1,JJ1,and JV1 combinations.The JJ1 group’s treatment plan primarily focused on closed wound negative pressure drainage,the surgical treatment method for JD1 group involved skin and subcutaneous necrotic tissue excision and debridement surgery combined with closed wound negative pressure drainage(VSD).The  relative weights of JD13 and JD15 groups were 2.35 and 1.48,higher than those of JJ13 and JJ15 groups.Twenty-six cases had an average hospital stay exceeding 60 days,leading to their categorization into the QY group.Conclusions  Utilizing the DRG tool effectively improves the admission rate for pressure ulcer diseases.By combining it with refined quality management on the first page of medical records,the combination weight value of DRGs and the efficiency and level of medical services can be enhanced.
论著

急性缺血性脑卒中介入治疗优化护理路径的构建及应用

Development and application of an optimized nursing pathway for endovascular therapy in acute ischemic stroke

:1563-1568
 
       目的   探讨优化护理路径在急性缺血性脑卒中介入手术中的应用及效果。方法   采用随机对照研究,纳入2024年1月—2025年1月收治的112例急性缺血性脑卒中取栓患者,观察组(56例)实施优化介入护理路径,对照组(56例)采用常规护理。结果   观察组患者的满意度评分、医护满意度评分均优于对照组(P<0.05);观察组的术前等待时间、患者自进入介入室至股动脉穿刺时间、手术时间、住院费用、并发症发生率、差错事故发生率也优于对照组(P<0.05)。结论   通过标准化术前准备、术中多学科协作及术后康复衔接,优化护理路径可显著提升急性缺血性脑卒中治疗时效性(缩短急性脑卒中患者从进入医院到开始静脉溶栓给药的时间至黄金时间窗内),改善患者神经功能预后。
       Objective  To explore the application and efficacy of an optimized nursing pathway in endovascular therapy for acute ischemic stroke(AIS).Methods  A randomized controlled trial was conducted,enrolling 112 AIS patients undergoing mechanical thrombectomy from January 2024 to January 2025.Patients were randomly assigned to either the observation groupn=56),which received the optimized interventional nursing pathway,or the control group(n=56),which  received  routine nursing care.Results  Patient satisfaction score,medical staff satisfaction score,and postoperative favorable  recovery  rate in observation group were better than those of control group(P<0.05).Additionally,the observation group  showed  significant improvements in preoperative waiting time,time from entering the operation room to femoral artery puncture,surgical duration,hospitalization costs,complication incidence rate,and medical error incidence rate(P<0.05).Conclusions  By standardizing preoperative preparations,implementing intraoperative multidisciplinary collaboration,and enhancing postoperative  rehabilitation coordination,the optimized nursing pathway significantly improved the timeliness of thrombectomy treatment(shortening door-to-needle time to reach the golden time window)and enhanced neurological functional prognosis in AIS patients,demonstrating substantial clinical applicability.
论著

中医药治疗儿童哮喘随机对照试验结局指标现状

Current status of outcome indicators of randomized controlled trials of traditional Chinese medicine for the treatment of childhood asthma

:1531-1541
 
       目的   剖析中医药治疗儿童哮喘的随机对照试验(RCT)结局指标,为中医药治疗该病临床试验的核心指标集构建提供初步依据。方法   检索中国知网(CNKI)、万方(WanFang)、维普网(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane Library、EmBase、Web of Science。时间跨度为建库至2024年7月1日。此次检索全面覆盖了中医药疗法治疗儿童哮喘的临床随机对照研究,由两名研究者根据纳排标准独立完成文献筛选和资料提取,提取文献基本特征和结局指标。结果   初步检索出2 449篇文献,最终纳入165个RCT,包括205个结局指标,分为症状/体征、中医症状/证候、理化检查、生活质量评价、远期预后、安全性指标六域。结论   中医药治疗儿童哮喘尚存在中医证候诊断和疗效标准不完善、主要和次要结局指标界限不清等问题,应当构建统一规范且广为认可的核心指标集,以促进儿童哮喘核心指标集的完善。
        Objective  To analyze the outcome indicators of randomised controlled trials(RCTs)of traditional Chinese medicine(TCM)for the treatment of childhood asthma,and to provide a preliminary basis for the construction of a core set of indicators for clinical trials of TCM for the treatment of this disease.Methods  A database search was conducted on China Knowledge Network(CNKI),WanFang,VIP,SinoMed,PubMed,Cochrane Library,EmBase,and Web of Science,covering the period from the establishment of the database to 1 July 2024.The search comprehensively covered clinical randomised controlled studies of TCM therapies in the treatment of childhood asthma,and was completed independently by two investigators who screened the literature and extracted information according to the criteria,and extracted the basic characteristics of the literature and outcome indicators.Results  Initially,2 449 literatures were retrieved,and 165 RCTs were finally included,including 205 outcome indicators,which were classified into six domains:symptoms/signs,TCM symptoms/evidence,physical and chemical examination,quality of life evaluation,long-term prognosis,and safety indicators.Conclusions  Currently,there are problems such as imperfect diagnostic and efficacy criteria for TCM evidence,and unclear boundaries between primary and secondary outcome indicators in the treatment of childhood asthma with TCM.A unified,standardised and widely recognised core indicator set should be constructed to promote the improvement of the core indicator set for childhood asthma.
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