论著

基于机器学习的脓毒症谵妄患者死亡预测模型的构建与评估

Machine learning prediction model for sepsis-associated delirium mortality

:1501-1510
 
       目的   通过机器学习方法构建脓毒症谵妄患者30 d死亡的预测模型,并识别关键预测因子。方法   采用基于医疗信息集成重症监护数据库(Medical Information Mart for Intensive Care IV)的回顾性队列研究方法,boruta筛选重要特征,并通过决策树,K近邻,LightGBM,随机森林,支持向量机,XGBoost构建模型进行分析,通过ROC曲线下面积进行评估,利用F1分数、召回率、精确率、特异度、灵敏度和阳性预测值比较模型表现。结果  XGBoost模型在训练集和验证集中的ROC曲线下面积分别为0.906和0.762,表明该模型具有良好的预测能力,入院年龄、红细胞分布宽度和白细胞计数是最重要的预测因子。结论   基于机器学习的脓毒症谵妄患者预后预测模型展现出良好的预测效能,为临床早期干预提供了重要参考依据。
       Objective  To construct a  30-day mortality  prediction model for  patients with  sepsis-associated  delirium using machine learning methods and identify key predictive factors.Methods  A  retrospective cohort study was conducted based on the Medical Information Mart for Intensive Care IV database.Important features were selected using the Boruta algorithm,and models including Decision Tree,K-Nearest Neighbors,LightGBM,Random Forest,Support Vector Machine,and XGBoost were constructed and analyzed.Model performance was evaluated using the area under the reciver operater characteristic(ROC)curve(AUC),along with F1 score,recall,precision,specificity,sensitivity,and positive predictive value.Results  The XGBoost model demonstrated strong predictive performance,with AUC values of 0.906 in the training set and 0.762 in the test set.Key predictors identified included admission age,red blood cell distribution width,and white blood cell count.Conclusions  The machine learning-based prediction model for sepsis-associated delirium prognosis exhibits robust predictive efficacy,providing a valuable tool for early clinical intervention.
论著

基于孟德尔随机化以及 Meta 分析方法评估 CX3CL1 表达水平与系统性红斑狼疮的因果关系

Causal relationship between CX3CL1 expression levels and systemic lupus erythematosus based on Mendelian randomization and Meta-analysis

:1491-1500
 
      目的   采用两样本孟德尔随机化以及Meta分析研究趋化因子C-X3-C基序配体1(CX3CL1)表达水平与系统性红斑狼疮(SLE)发病风险的因果关系。方法   获取CX3CL1表达水平与SLE的全基因组关联研究(GWAS)数据,将单核苷酸多态性(SNP)作为工具变量并选择敏感的SNPs进行分析。通过逆方差加权法(IVW)、加权中位数法(WM)、MR-Egger回归法进行两样本MR分析,以OR值评估CX3CL1表达水平与SLE之间的因果关系,并对结果进行异质性和多效性检验。最后利用R软件Meta包进行Meta分析。利用coloc包进行共定位分析。结果   纳入9个SLE作为结局变量,其中4个变量ebi-a-GCST90018917(OR=2.14,95%CI:1.50~3.06),ebi-a-GCST003156(OR=2.25,95%CI:1.00~5.06),ebi-a-GCST90014238(OR=3.02,95%CI:1.54~5.94),finn-b-SLE_NOS(OR=1.81,95%CI:1.01~3.22)表明CX3CL1表达水平与SLE之间存在因果关系。关于 OR 95% CI 的森林图显示 SLE 患者的CX3CL1表达水平显著高于健康人群(OR=1.87,95%CI:1.53~2.29,P<0.001)。共定位分析结果提示CX3CL1表达水平和SLE表型之间有共享的遗传变异位点(rs170364)。结论  CX3CL1表达水平与SLE存在正向因果关系,CX3CL1表达水平的升高使得SLE的发病风险升高。
       Objective  To investigate the causal  relationship  between CX3CL1 levels and the  risk of  systemic lupus erythematosus(SLE)using two-sample Mendelian randomization and Meta-analysis methods.Methods  Genome-Wide Association Study(GWAS)data for CX3CL1 levels and SLE were obtained.Single nucleotide polymorphisms(SNPs)were used as instrumental variables,and sensitive SNPs were selected for analysis.Two-sample Mendelian  randomization was performed using the inverse variance weighted(IVW)method,weighted median(WM)method,and MR-Egger  regression to evaluate the causal relationship between CX3CL1 levels and SLE,with OR values assessing this relationship.Heterogeneity and pleiotropy tests were conducted on the results.Meta-analysis was performed using the Meta package in R software,and colocalization analysis was conducted using the coloc package.Results  Nine SLE outcomes were included as outcome variables,with four variables(ebi-a-GCST90018917[OR=2.14,95%CI:1.50-3.06],ebi-a-GCST003156[OR=2.25,95%CI:1.00-5.06],ebi-a-GCST90014238[OR=3.02,95%CI:1.54-5.94],finn-b-SLE_NOS[OR=1.81,95%CI:1.01-3.22])indicating a causal relationship between CX3CL1 expression levels and SLE.The forest plot for OR 95%CI showed that CX3CL1 expression levels in SLE patients were significantly higher than in healthy individuals(OR=1.87[95%CI:1.53-2.29],P<0.001).Colocalization analysis suggested that there was shared genetic variation sites(rs170364)between CX3CL1 expression levels and SLE phenotype.Conclusions  There is a positive causal relationship between CX3CL1 expression levels and SLE,with increased CX3CL1 levels elevating the risk of developing SLE.
论著

脊髓损伤神经功能评估系统的优化和临床应用效果分析

Optimized design and clinical efficacy analysis of neural function evaluation system for spinal cord injury

:1415-1422
 
目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。
Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice.Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study.This led to the integration of a preliminary evaluation framework.Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project.Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals.This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023.Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application.Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%.Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process.Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors.This system holds considerable potential for widespread clinical adoption and application.
论著

64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值

The value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection intervention

:1409-1414
 
目的 探讨64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。方法 选择2023年7月—2024年5月在潜江市中心医院诊治的主动脉夹层疑似患者96例为研究对象,所有患者均进行64层螺旋CT三维重建技术检查, 记录成像参数。所有患者在64层螺旋CT三维重建后进行介入治疗, 以介入检查结果为金标准, 判断64层螺旋CT三维重建技术在主动脉夹层介入术前评估中的价值。结果 在96例患者中, 64层螺旋CT三维重建联合判断为主动脉夹层60例, 其中Ⅰ型32例、Ⅱ型20例、Ⅲ型8例,其中再现(VR)、最大密度投影(MIP)及多平面重建(MPR)分别判断为主动脉夹层56例、54例、56例。在96例患者中, 64层螺旋CT三维重建检查的破口层面主动脉平均直径(3.08±0.25)cm、破口至左锁骨下平均距离(4.05±0.26)cm, 与介入治疗检查(3.05±0.36)cm、(4.06±0.14)cm, 对比差异无统计学意义(t=0.671, P=0.503; t=0.332, P=0.740)。64层螺旋CT三维重建联合、VR、MIP、MPR对主动脉夹层的诊断灵敏度分别为98.33%、93.22%、89.83%、94.92%, 特异度分别为97.30%、97.30%、97.30%、100.00%, 准确率分别为98.96%、94.79%、92.71%、96.88%。结论 64层螺旋CT三维重建技术在主动脉夹层介入术前评估中具有很高的灵敏度、特异度与准确率。
Objective To explore and analyze the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection(AD)intervention.Methods From July 2023 to May 2024, 96 cases of patients suspected of aortic dissection treated in our hospital were selected as the research subjects.All patients underwent 64-slice spiral CT three-dimensional reconstruction technology examination, and imaging parameters were recorded.After the 64-slice spiral CT three-dimensional reconstruction, all patients were given interventional treatment, and the results of the interventional examination were used as the “gold standard” to evaluate the value of 64-slice spiral CT three-dimensional reconstruction technology in the preoperative assessment of aortic dissection intervention.Results Among the 96 patients,64-slice spiral CT three-dimensional reconstruction combined diagnosis identified 60 cases of aortic dissection,including 32 type I, 20 type II, and 8 type III cases.volume rendering(VR), maximum intensity projection(MIP), and muhiplanar reconstrudion(MPR) identified 56, 54, and 56 cases of aortic dissection,respectively.In 96 patients, the mean aortic diameter at the lacerated level and the mean distance from the lacerated to the left subclavicular level were(3.08±0.25)cm and(4.05±0.26)cm respectively in 64-slice spiral CT three-dimensional reconstruction examination, compared with(3.05±0.36)cm and(4.06±0.14)cm in interventional examination.There was no difference in comparison(t=0.671, P=0.503; t=0.332, P=0.740).The sensitivity, specificity, and accuracy of the 64-slice spiral CT three-dimensional reconstruction combined, VR, MIP, and MPR for the diagnosis of aortic dissection were 98.33%, 93.22%, 89.83%, 94.92%, specificity were 97.30%, 97.30%, 97.30%, 100%, accuracy were 98.96%, 94.79%, 92.71%, 96.88%.Conclusions Technology of 64-slice spiral CT three-dimensional reconstruction has high sensitivity, specificity, and accuracy in the preoperative assessment of aortic dissection intervention and is worth promoting and applying clinically.
论著

盆底磁刺激联合生物反馈治疗女性膀胱过度活动症的疗效评估

:903-906
 
目的 探讨盆底磁刺激联合生物反馈治疗女性膀胱过度活动症的疗效。方法 选择2022年8月—2023年7月福建医科大学附属福州市第一医院妇科接收的女性膀胱过度活动症患者90例为研究对象,以随机数字表法分为两组,每组各45例,对照组采取常规药物及康复治疗,观察组在此基础上给予盆底磁刺激联合生物反馈治疗,比较两组治疗效果、排尿功能、尿流动力学及生活质量。结果 观察组治疗有效率43例(95.56%)高于对照组36例(80.00%)(χ2=5.074,P=0.024)。治疗后观察组白天排尿次数(7.22±2.25)次、夜间排尿次数(2.05±0.44)次、尿急(1.54±0.48)次、急迫性尿失禁(1.22±0.25)次,低于对照组相应的(10.01±2.84)(3.32±0.84)(2.52±0.92)(2.24±0.39)次(t=5.165、8.984、6.335、14.770,P<0.05)。治疗后观察组初始尿意膀胱容量(188.45±24.43)mL、最大膀胱测压容积(320.42±25.49)mL,高于对照组的(155.54±20.06)(272.26±21.16)mL,膀胱顺应性(40.15±4.06)mL/cmH2O、残余尿量(82.25±8.45)mL,低于对照组的(50.05±5.54)mL/cmH2O、(125.44±12.26)mL(t=6.983、9.751、9.669、19.457,P<0.05)。治疗后观察组I-QOL(72.25±7.46)分,高于对照组(63.63±6.05)分(t=6.020,P<0.05)。结论 针对女性膀胱过度活动症患者采取盆底磁刺激联合生物反馈治疗可取得良好的治疗效果,减少患者排尿次数和残余尿量,改善尿急、尿失禁症状,恢复正常的尿流动力学,提高生活质量。
论著

血清胱抑素C、同型半胱氨酸及尿微量白蛋白在高血压患者肾损害早期评估中的应用价值

The application value of serum cystatin C,homocysteine and urinary microalbumin in early assessment of renal damage in hypertensive patients

:875-880
 
目的 探讨血清胱抑素C(SCys-C)、同型半胱氨酸(Hcy)及尿微量白蛋白(UmAlb)在高血压患者肾损害早期评估中的应用价值。方法 选择2022年9月—2023年9月期间福建中医药大学附属第三人民医院接收的150例高血压患者作为观察组,另选择健康体检者150例为对照组,测定肾小球滤过率(GFR)、SCys-C、Hcy、UmAlb,比较不同血压程度及对照组的各指标水平,比较观察组各指标检测阳性率及诊断符合率,依据GFR值评估肾损害程度,比较不同肾损害程度患者的SCys-C、Hcy、UmAlb水平。结果 高血压2级、高血压3级患者SCys-C、Hcy、UmAlb水平高于高血压1级患者(t=5.255、10.976、21.578,P<0.05;t=7.378、18.012、23.708,P<0.05)及对照组患者(t=8.308、19.675、31.891,P<0.05;t=10.661、31.511、21.578,P<0.05),高血压3级患者高于高血压2级患者(t=2.776、12.725、7.779,P<0.05)。观察组肾损害患者SCys-C、Hcy、UmAlb的阳性率79.41%、73.53%、83.82%高于无肾损害患者的阳性率6.10%、4.88%、6.10%(χ2=83.733、76.040、92.613,P<0.05)。观察组中重度肾损害、轻度肾损害患者的SCys-C、Hcy、UmAlb水平高于无损害患者(t=7.567、24.214、30.836,P<0.05;t=5.783、16.054、25.164,P<0.05),中重度肾损害高于轻度肾损害患者(t=2.685、7.179、9.561,P<0.05)。结论 高血压分级越高患者的SCys-C、Hcy、UmAlb水平越高,各指标联合检测的阳性率高,而且SCys-C、Hcy、UmAlb水平越高,肾损害程度越严重。
Objective To explore the application value of serum cystatin C(SCys-C),homocysteine(Hcy) and urinary microalbumin(UmAlb)in early assessment of renal damage in hypertensive patients.Methods A total of 150 hypertensive patients admitted to the Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the observation group,and 150 healthy individuals were selected as the control group.Glomerular filtration rate(GFR),serum cystatin C(SCys-C),homocysteine(Hcy),and UmAlb were measured,and the levels of various indicators in different blood pressure levels and the control group were compared.The positive rate and diagnostic accuracy of each indicator in the observation group were compared,and the degree of renal damage was evaluated based on GFR values.The levels of SCys-C,Hcy and UmAlb in patients with different degrees of renal damage were compared.Results The levels of SCys-C,Hcy and UmAlb in patients with grade 2 and grade 3 hypertension were significantly higher than those in patients with grade 1 hypertension(t=5.255,10.976,21.578,P<0.05;t=7.378,18.012,23.708,P<0.05),as well as in the control group(t=8.308,19.675,31.891,P<0.05;t=10.661,31.511,21.578,P<0.05),patients with grade 3 hypertension were significantly higher than those with grade 2 hypertension(t=2.776,12.725,7.779,P<0.05).The positive rates of SCys-C,Hcy and UmAlb in patients with renal injury in the observation group were 79.41%,73.53% and 83.82%,which were significantly higher than the positive rates of 6.10%,4.88% and 6.10% in patients without renal injury(χ2=83.733,76.040,92.613,P<0.05).The levels of SCys-C,Hcy and UmAlb in patients with severe and mild kidney damage in the observation group were significantly higher than those in patients without damage(t=7.567,24.214,30.836,P<0.05;t=5.783,16.054,25.164,P<0.05),patients with moderate to severe kidney damage were significantly higher than those with mild kidney damage(t=2.685,7.179,9.561,P<0.05).Conclusions The higher the grading of hypertension,the higher the levels of SCys-C,Hcy and UmAlb in patients,and the higher the positive rate of combined detection of various indicators.Moreover,the higher the levels of SCys-C,Hcy and UmAlb,the more severe the renal damage.
论著

FRAX®评估广州社区中老年人群骨折风险的回顾性研究

A retrospective study of FRAX in predicting the fracture risk of senile people in Guangzhou community

:18-22
 
目的 应用FRAX®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX®工具进行骨折风险评估。
Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.
论著

老年慢性心力衰竭患者血清SCD-1和sVEGFR-2表达水平及其与预后的评估价值研究

Expression levels of serum SCD-1 and sVEGFR-2 in elderly patients with chronic heart failure and their prognostic value

:241-246
 
目的 探究血清多配体蛋白聚糖-1(SCD-1)与可溶性血管内皮生长因子受体-2(sVEGFR-2)表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法 选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果 Logistic回归分析显示,心功能分级(OR=3.433,95%CI:0.934~6.431)、B型脑钠肽升高(OR=2.462,95%CI:0.861~4.765)、血清SCD-1升高(OR=3.795,95%CI:0.972~6.894)、血清sVEGFR-2升高(OR=3.842,95%CI:0.942~6.912)为影响老年慢性心力衰竭患者预后不良的重要因素(P<0.05);联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高(P<0.05)。结论 经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。
Objective To investigate the prognostic value of serum syndecan-1(SCD-1)and soluble vascular endothelial growth factor receptor-2(sVEGFR-2)expression levels in elderly patients with chronic heart failure. Methods A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024.Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure.Multiple logistic regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure. Results According to logistic retrospective analysis,heart function grading(OR=3.433,95%CI:0.934-6.431),elevated B-type brain natriuretic peptide(OR=2.462,95%CI:0.861-4.765),elevated serum SCD-1(OR=3.795,95%CI:0.972-6.894),and elevated serum sVEGFR-2(OR=3.842,95%CI:0.942-6.912)were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05.The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05. Conclusions Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure.It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure.
论著

不同针具在治疗腰椎间盘突出症的有效性与安全性的系统评估和网状Meta分析

A systematic assessment and network meta-analysis of the efficacy and safety of different needles in the treatment of lumbar disc herniation

:469-485
 
目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI(中国知网)、万方数据库、VIP(维普)、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA(用于评估疗效的指标)=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。
Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation.Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied.Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined.Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected.Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%.According to the visual analogy score,the silver needle sucra=95%,ranking first.Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove.
论著

时机理论的护理干预在三叉神经痛微血管减压术中的应用效果评估

Evaluation of the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia

:1033-1037
 
目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组(n=43,予以常规护理)与观察组(n=42,实施常规护理基础上给予基于时机理论的护理干预),通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表(NRS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(2.13±0.57)(42.45±3.17)(42.45±3.17)分,低于对照组的(3.23±0.78)(52.34±4.45)(48.23±3.23)分(P<0.05);观察组术后1个月简明健康状况调查表(SF-36)生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为(38.12±8.27)(42.22±9.12)(52.34±8.23)(64.11±8.92)(70.12±9.03)(34.46±6.18)(71.34±8.17)(75.24±8.46)分,高于对照组的(35.23±8.13)(38.56±9.23)(45.03±8.11)(60.57±8.23)(65.23±8.78)(30.14±6.13)(66.23±8.08)(72.12±8.35)分(P<0.05)。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。
Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia.Methods The research period was from July 2020 to June 2023.The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery.They were divided into a control group(n=43,receiving routine care)and an observation group(n=42,receiving timing based nursing intervention on the basis of routine care)through odd and even number drawing.A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire.Results The scores of NRS,SDS and SAS in the observation group at discharge were(2.13±0.57),(42.45±3.17)and(42.45±3.17)respectively,which were significantly lower than those in the control group(3.23±0.78), (52.34±4.45)and(48.23±3.23).The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were(38.12±8.27),(42.22±9.12),(52.34±8.23), (64.11±8.92), (70.12±9.03), (34.46±6.18), (71.34±8.17) and(75.24±8.46), which were significantly higher than those of the control group(35.23±8.13), (38.56±9.23), (45.03±8.11), (60.57±8.23), (65.23±8.78), (30.14±6.13), (66.23±8.08)and(72.12±8.35)(P<0.05).Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life.
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