论著

预防性风险管理对肌层浸润性膀胱癌根治术后的应用效果及术后生活质量影响

Effect of preventive risk management after surgery and quality of life of myometrial invasive bladder cancer patients

:494-499
 
       目的   探讨预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果及对术后生活质量影响。方法   选取2020年6月—2023年10月安阳市肿瘤医院收治的66例肌层浸润性膀胱癌患者,应用抽签法分为观察组(n=33)与对照组n=33)。所有患者均采取根治性全膀胱切除术与淋巴清扫术治疗,对照组患者术后实施常规护理,观察组在对照组基础上增加预防性风险管理。对比两组术后尿量、胃肠功能恢复时间、术后住院时间,干预前后病耻感及负面情绪、术后并发症发生率,最后对比两组干预前后生活质量变化。结果   两组患者术后尿量对比差异无统计学意义(P>0.05),观察组术后胃肠功能恢复时间为(5.27±0.82)d,术后住院时间为(18.31±3.27)d,短于对照组的(7.25±1.12)(23.27±4.18)d,对比差异有统计学意义(t分别为8.194、5.369,P<0.05);干预后两组患者病耻感量表(SSCI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分均降低,观察组分别为(35.67±7.45)(40.02±2.43)(45.36±4.17)分,低于对照组的(48.27±10.69)(54.54±3.54)(51.37±4.38)分,对比差异有统计学意义(t分别为5.555、19.426、5.709,P<0.05);观察组术后并发症发生率为9.09%,低于对照组的30.30%(χ 2 =4.690,P=0.030);干预后两组膀胱癌特异性模块、功能状况、精神状况、家庭/社会状况及躯体状况相关维度膀胱癌患者生活质量量表(FACT-BL)评分均升高,观察组分别为(34.27±3.26)(25.11±4.23)(21.51±4.23)(25.02±4.43)(20.56±3.11)分,高于对照组的(27.00±4.34)(21.11±3.24)(16.12±2.12)(21.54±5.54)(15.87±4.13)分,对比差异有统计学意义(t分别为7.694、4.313、6.544、2.818、5.211,P<0.05)。结论   预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果显著,可缩短患者术后胃肠功能恢复时间及住院时间,改善患者负面情绪,有助减少术后并发症,提升患者生活质量。
       Objective  To explore the effect of preventive risk management on postoperative application and quality of life of myometrial invasive bladder cancer patients after radical surgery.Methods  A total of 66 patients with myometrial invasive bladder cancer admitted to Anyang Cancer Hospital from June 2020 to October 2023 were selected as research objects,and were divided into observation group(n=33)and control group(n=33)by lot drawing.All patients were treated with  radical total cystectomy and lymph node dissection.The control group received routine nursing care after surgery,while the observation group received preventive risk management in addition to the control group.The postoperative urine output,recovery time of gastrointestinal function,and hospitalization time between two groups were compared,as well as the shame and negative emotions before and after intervention,the incidence of postoperative complications,and the changes in quality of life between the two groups before and after intervention.Results  There was no significant difference in postoperative urine volume between the two groups of patients(P>0.05),and the postoperative gastrointestinal function recovery time(5.27±0.82)d,postoperative hospitalization time(18.31±3.27)d were shorter than the control group[(7.25±1.12)d,(23.27±4.18)d],with statistical significantce(t=8.194,5.369,P<0.05).After intervention,the Stigma Scale of Chronic Illness(SSCI),Self Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)in both groups of patients decreased,and the observation group[(35.67±7.45),(40.02±2.43),(45.36±4.17)]scored lower than the control group[(48.27±10.69),(54.54±3.54),(51.37±4.38)],statistically significantt=5.555,19.426,5.709,P<0.05).The incidence of postoperative complications in the observation group was significantly lower at 9.09% compared to the control group at 30.30%(χ 2 =4.690,P=0.030,P<0.05).After intervention,the scores of bladder cancer specific module,functional status,mental status,family/social status and physical status  related dimensions of bladder cancer patients’ quality of life scale for bladder cancer patients(FACT-BL)in both groups increased,and the observation group[(34.27±3.26),(25.11±4.23),(21.51±4.23),(25.02±4.43),(20.56±3.11)] scored higher than the control group[(27.00±4.34),(21.11±3.24),(16.12±2.12),(21.54±5.54),(15.87±4.13)],the comparison was statistically significant(t=7.694,4.313,6.544,2.818,5.211,P<0.05).Conclusions  Preventive  risk management has a significant effect on the application of myometrial invasive bladder cancer after radical surgery,which can shorten the recovery time of gastrointestinal function and hospital stay,improve patients’ negative emotions,assist in preventing postoperative complications,and improve patients’ quality of life.
论著

运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响

The effect of exercise intervention combined with therapeutic listening on social communication function inchildren with autism spectrum disorder

:403-409
 
       目的   探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法   选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿,应用随机数字表法分为两组,各50例。对照组患儿实施常规护理,观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表(ATEC)、儿童感觉统合发展评定量表、格塞尔发育量表(GDS)及中国韦氏儿童智力量表(WISC-R)评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果   干预后两组患儿的ATEC各部分评分,包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低,观察组低于对照组(P<0.05);干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高,观察组高于对照组P<0.05);干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高,观察组高于对照组(P<0.05);干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高,观察组高于对照组(P<0.05)。  运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著,可提升其社会交往能力,促进感觉统合发展,进而促进其神经发育及智力水平提升。
       Objective  To  explore the  effect  of  exercise intervention  combined with therapeutic listening  on  social communication function in children with autism spectrum disorder.Methods  A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method,with 50 children each.The control group received routine care,while the observation group  received exercise intervention combined with therapeutic listening in addition to routine care.The Autism Treatment Evaluation Scale (ATEC),Children’s Sensory Integration Development Scale,Gesell Development Scale,and Wechsler Intelligence Scale for Children-Revised by China (WISC-R)were used before and 6 months after the intervention to evaluate the social communication ability,sensory integration development level,neural development level,and intellectual level changes of the two groups of children.Results  After intervention,the score of every dimension in ATEC including the health/physiology/behavior,perception/cognitive ability,social ability,language expression/communication ability,and total ATEC score of the two groups of children decreased,and the observation group was lower than the control group (P<0.05).After intervention,the total scores of the learning ability development insufficient,proprioceptive dysfunction,excessive tactile defense,vestibular dysfunction,and children’s sensory integration development assessment scale in both groups of children increased,with the observation group being higher than the control group (P<0.05).After intervention,the neurological development scores related to motor,adapt,language,and social ability in both groups of children increased,and the observation group was higher than the control group (P<0.05).After intervention,the WISC-R scores related to verbal intelligence,operational intelligence,and total intelligence in both groups of children increased,and the observation group was higher than the control group (P<0.05).Conclusions  The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder,which can enhance their social communication ability,promote sensory integration development,and ultimately promote their neural development and intellectual level improvement.
论著

无管化微创 PCNL 治疗嵌顿性输尿管上段结石的效果

The effect of tubeless minimally invasive PCNL in the treatment of incarcerated upper ureteral calculi

:398-402
 
       目的   探讨无管化微创PCNL(经皮肾镜取石术)治疗嵌顿性输尿管上段结石的效果。方法   将中山大学附属第一医院惠亚医院2019年12月—2021年12月收治的95例嵌顿性输尿管上段结石患者按照随机数字表法分组,给予对照组47例患者经尿道输尿管镜碎石术(TURL)治疗、观察组48例患者无管化微创PCNL治疗,观察两组手术一般状况、血清学指标、肾脏血流动力学以及并发症发生情况。结果   观察组手术时间、术后血尿以及住院时间均短于对照组,观察组术中出血量少于对照组,观察组结石清除率高于对照组(P<0.05);术后1 d观察组肾损伤分子-1(KIM-1)、中性粒细胞明胶相关脂脂质运载蛋白(NGAL)以及胱抑素C(Cys-C)水平低于对照组(P<0.05);两组肾动脉收缩期血流速度(Vs)以及舒张末期血流速度(Vd)对比差异无统计学意义(P>0.05);观察组并发症发生率(4.16%)低于对照组(19.15%)P<0.05)。结论   无管化微创PCNL可改善嵌顿性输尿管上段结石手术一般状况,减轻患者肾脏损伤,提高结石清除率,不影响肾脏血流,且并发症更少。
       Objective  To explore the effect of tubeless minimally invasive(percutaneous nephrolithotomy,PCNL)in the treatment of impacted upper ureteral stones.Methods  A total of 95 patients with impacted upper ureteral stones admitted to our hospital from December 2019 to December 2021 were grouped according to the random number table method.Control group of 47 cases were treated with transurethral ureteroscopy lithotripsy(TURL),48 patients in the observation group were given tubeless minimally invasive PCNL treatment.The general surgical conditions,serological indicators,renal hemodynamics and complications of the two groups were observed.Results  The operation time,postoperative hematuria and hospitalization time of the observation group were shorter than those of the control group,the intraoperative bleeding volume of the observation group was less than that of the control group,and the stone free rate of the observation group was higher than that of the control group(P<0.05).One day after surgery,the levels of kidney injury molecule-1(KIM-1),lipocalin(NGAL)and cystatin C(Cys-C)in the observation groupwere lower than those in the control group(P<0.05);the renal artery systolic blood flow velocity(Vs)and end-diastolic blood flow velocity(Vd)had no statistical significance(P>0.05);the incidence of complications in the observation group(4.16%)was lower than that in the control group(19.15%)(P<0.05).Conclusions  Tubeless minimally invasive PCNL can improve the general conditions of surgery,reduce kidney damage,increase stone free rate,does not affect renal blood flow,and has fewer complications.
论著

清醒镇静在急性缺血性脑卒中血管内治疗中的应用效果及预后

Effect of conscious sedation in the application of endovascular treatment and prognosis of acute ischemic stroke

:382-386
 
       目的   探讨清醒镇静应用在急性缺血性脑卒中血管内治疗中的效果。方法   选择2020年1月—2023年3月医院接收的急性缺血性脑卒中患者82例进行研究,按随机数表法分为2组,每组各41例,两组采取溶栓与取栓治疗,对照组采取全身麻醉方式,观察组采取清醒镇静方式,记录两组治疗相关参数,比较两组近期疗效、并发症发生情况及预后。结果   观察组入院到腹股沟穿刺时间(95.52±3.63)min、穿刺至血管再通时间(72.25±5.58)min低于对照组(112.25±4.18)min、(102.45±10.63)min(t=19.349,P<0.05);观察组ICU时间(7.81±2.63)d、住院时间(13.75±3.64)d,与对照组(8.05±2.81)d、(14.52±4.07)d比较差异无统计学意义(t分别为0.524、0.399、0.902,P分别为0.601、0.690、0.369)。观察组近期总有效39例(95.12%)与对照组37例(90.24%)比较差异无统计学意义χ 2 =0.719,P=0.396)。观察组症状性颅内出血3例(7.32%)与对照组6例(14.63%)比较差异无统计学意义(χ 2 =1.123,P=0.289);观察组脑水肿4例(9.76%)、坠积性肺炎12例(29.27%),低于对照组7例(17.07%)、18例(43.90%)(χ 2分别为4.969、6.962,P分别为0.025、0.008)。观察组预后良好21例(51.22%)高于对照组10例(24.39%)(χ 2 =6.275,P=0.012)。结论   急性缺血性脑卒中患者溶栓与取栓治疗中采取清醒镇静方式可获得与全身麻醉相近的疗效,而且可进一步缩短治疗时间,促进血管快速再通,减少相关并发症,使患者获得更好的预后。
       Objective  To investigate the conscious sedation effect of endovascular treatment in acute ischemic stroke.Methods  A total of 82 patients with acute ischemic stroke admitted to the hospital from January 2020 to March 2023 were selected and divided into two groups according to the random number table method,with 41 cases in each group.The two groups were treated with thrombolysis and thrombectomy,the control group was treated with general anesthesia,and the observation group was treated with conscious sedation.The short-term efficacy,complications and prognosis were compared between the two groups.Results  The time from admission to groin puncture [(95.52±3.63)min] and time from puncture to vascular  recanalization [(72.25±5.58)min] in the observation group were significantly lower than those in the control group [(112.25±4.18)min,(102.45±10.63)min](t=19.349,P<0.05).Observation group ICU time,length of hospital stay(7.81+2.63)d(13.75+3.64)d,and the control group(8.05+2.81)d,(14.52-4.07)d  had  no  statistically  significant  difference in comparison(t were 0.524,0.399,0.902,P were 0.601,0.690,0.369).Recent total effective cases observation in group was 39(95.12%)and control group was 37(90.24%),there was no statistically significant difference comparing(χ 2 =0.719,P=0.396).Observation group had symptomatic intracranial hemorrhage in three patients(7.32%)and control group had six cases(14.63%),there was no statistically significant difference(χ 2 =1.123,P=0.289).There were four cases(9.76%)of brain edema and 12 cases(29.27%)of hypostatic pneumonia in the observation group,which were significantly lower than seven cases(17.07%)and 18 cases(43.90%)in the control group(χ 2 =4.969,6.962,P=0.025,0.008).The number of patients with good prognosis in the observation group(21 cases,51.22%)was significantly higher than that in the control group(10 cases,24.39%)χ 2 =6.275,P=0.012).Conclusions In the treatment of acute ischemic stroke patients with thrombolysis and thrombectomy,conscious sedation can achieve the same efficacy as general anesthesia,and can further shorten the treatment time,promote  rapid recanalization of blood vessels and reduce related complications,so that patients can get a better prognosis.
论著

风险防范护理干预对控制冠状动脉造影术后患者血管并发症的影响

Effect of risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography

:356-360
 
      目的   探讨在冠状动脉造影术后患者中应用风险防范护理干预对血管并发症的控制效果。方法   选择2022年1月—2023年6月于我院接受治疗的85例冠状动脉造影术后患者。按照随机数字表法分组,其中对照组42例给予常规护理干预,观察组43例给予风险防范护理干预,比较两组干预前后的心理状态、治疗依从性、血管并发症。结果   干预后,观察组正性情绪(PA)评分高于对照组PA评分(t=3.821,P<0.001),观察组负性情绪(NA)评分低于对照组NA评分(t=5.380,P<0.001)。与对照组比,观察组治疗依从性更好(Z=2.268,P=0.023)。观察组血管并发症总发生率低于对照组(9.30% vs 30.95%,χ 2 =6.224,P=0.013)。结论   采用风险防范护理干预,能够改善冠状动脉造影术后患者的心理状态,提高治疗依从性,并降低血管并发症总发生率。
       Objective  To explore the effect of  risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography.Methods  Eighty-five patients after coronary angiography in our hospital were selected from January 2022 to June 2023.They were grouped according to the random number table.And 42 cases were divided into the control group for routine nursing intervention,and 43 cases in the observation group were given risk prevention nursing intervention.Psychological status,treatment compliance and vascular complications of the two groups were observed.Results  After the intervention,the postive affect score of the observation group was higher than that of the control group(t=3.821,P<0.001),and the negative affect score of the observation group(21.25±3.31)was lower than the score of the control group(25.35±3.70)t=5.380,P<0.001).Compared with the control group the compliance of observation group was higher(Z=2.268,P=0.023).The overall incidence of vascular complications in the observation group was lower than that in the control group(9.30% vs 30.95%,χ2=6.224,P=0.013).Conclusions  Risk prevention nursing intervention can improve the psychological status of patients after coronary angiography,improve treatment compliance,and reduce the overall incidence of vascular complications.
论著

人工晶状体集中带量采购效果分析

Effect of centralized volume-based procurement policy of intraocular lens

:203-210
 
       目的 评价人工晶状体(IOL)集中带量采购政策对于白内障摘除术中人工晶状体选择的影响。 回顾性分析2020年6月—2022年5月在广州市第一人民医院眼科完成白内障超声乳化摘除联合IOL植入术的患者,根据医院开始集采的时间(2021年5月)将患者分为集采前组与集采后组。比较两组患者的一般资料、IOL类别、IOL价格、手术费用、国产IOL占比等。结果 集采前组(2020年6月—2021年5月)与集采后组(2021年6月—2022年5月)的白内障手术量分别为1 188例及1 099例(双眼手术者仅纳入一眼),两组患者的年龄及性别比例比较差异均无统计学意义(P0.05)。集采前IOL价格为3 770(3 162~7 950)元,高于集采后的1 613(1 079~4 994)元(P<0.001)。两组患者中非球面单焦点IOL所占比例均为最高,集采后多焦点及散光IOL的数量较集采前增加(集采前vs.集采后:多焦IOL:1.9% vs15.0%;散光IOL:0.2% vs 1.3%,均P<0.05),球面IOL的数量减少(集采前后:7.7% vs 0.6%,P<0.05)。集采后国产IOL的使用率由0.5%增加至3.5%(P<0.001)。并且集采后选择多焦点IOL的患者年龄更大[集采前(62.3±12.4)岁,集采后(66.1±10.5)岁,P=0.02]。结论  IOL集中带量采购政策减轻了白内障患者的经济负担,增加了高端IOL的使用量,同时减少了国家医疗保险的支出,并且促进国产医用耗材的使用。
     Objective  To evaluate the influence of intraocular lens(IOLs)purchasing policy in  a  centralized volume-based manner on patients’ selection of cataract extraction surgery.Methods The  patients who  completed  cataract phacoemulsification combined with IOLs implantation in the ophthalmology department of Guangzhou First People’s Hospital from June 2020 to May 2022 were retrospectively analyzed.According to the time of centralized  IOLs procurement policy implemented in our hospital(May 2021),the patients were divided into before centralized purchase group(from June 2020 to May 2021)and centralized purchase group(from June 2021 to May 2022).The demographics of study population,IOLs category,IOLs cost,operation cost and the proportion of Chinese-made IOLs were compared between the two groups.Results The total numbers of operations in the before centralized purchase group and centralized purchase group  were 1 188 and 1 099 eyes(only one eye was included in the binocular surgery),respectively.There was no significant difference in the age and sex between the two groups(P>0.05).The median cost of IOLs in the before centralized purchase group was 3 770(3 162,7 950),which was higher than that of centralized purchase group [1 613(1 079,4 994),P<0.001].The proportion of aspherical  IOLs was the highest in both groups.The number of multifocal and astigmatic  IOLs in the centralized purchase group increased significantly compared with those of before centralized purchase group(multifocal IOLs:1.9% and 15.0%;astigmatic IOLs:0.2% and 1.3%,all P<0.05).The number of spherical IOLs decreased significantly(7.7% and 0.6%,P<0.05).The utilization rate of domestic IOLs increased from 0.5% to 3.5%(P<0.001).The patients who chose multifocal IOLs in centralized purchase group were older than patients in before centralized purchase group [(62.3±12.4)vs(66.1±10.5),P=0.02].Conclusions The centralized volume-based procurement policy of IOLs reduces the economic burden of patients and increase the use of high-end IOLs.At the same time,it reduces the expenditure of national medical insurance and promotes the use of domestic medical consumables.
论著

安罗替尼联合不同 ALK 抑制剂治疗非小细胞肺癌的疗效比较

Comparion of the therapeutic effect of anlotinib combined with ALK inhibitors in treating non-small cell lung cancer

:171-178
 
       目的 评价不同间变性淋巴瘤激酶(ALK)抑制剂联合安罗替尼治疗非小细胞肺癌(NSCLC)的疗效。方法 收集ALK突变阳性NSCLC患者的临床资料,筛选服用ALK抑制剂疗效不佳再加用安罗替尼的病例。根据不同的用药方案分为阿来替尼+安罗替尼,塞瑞替尼+安罗替尼和克唑替尼+安罗替尼三个组别。记录患者联合用药前最近一次的影像学检查结果,并以此为基线按Recist1.1评价疗效,以病情进展、患者死亡、停药、改变治疗方案为终点计算各组患者的无事件生存期(EFS),收集肿瘤标志物、血常规和肝功、心功能、肾功能生化检测等指标数据,统计分析患者联合用药前后各项指标的变化。结果 经筛选,共纳入49例患者的临床数据。阿来替尼+安罗替尼组有23例,疾病控制率(DCR)为86.96%;平均EFS为(10.8±3.6)个月,中位EFS为8.3个月;塞瑞替尼+安罗替尼组有14例,DCR为71.43%;平均EFS为(6.5±2.9)个月,中位EFS为5.6个月;克唑替尼+安罗替尼组有12列,DCR为66.67%;平均EFS为(7.7±3.2)个月,中位EFS为7.2个月。阿来替尼+安罗替尼组的平均EFS长于另外两组(P<0.05)。各研究组肿瘤标志物仅有CyFra21-1在克唑替尼+安罗替尼组在联合用药后升高(P<0.05),生化检测和血常规指标在用药前后差异无统计学意义(P>0.05)。  ALK抑制剂与安罗替尼联用,疗效最好为阿来替尼,其次为塞瑞替尼,最后为克唑替尼。三种ALK抑制剂与安罗替尼联用后,均未导致心、肝、肾功能和血细胞损害。
      Objective  To evaluate the efficacy of different anaplastic lymphoma kinase(ALK)inhibitors combined with anlotinib in the treatment of non-small cell lung cancer(NSCLC).Methods  Clinical data of drug resistant NSCLC patients with ALK positive mutation was collected who were treated with ALK inhibitors and anlotinib synchronously.According to different regimens,three groups were set,alectinib+anlotinib,ceritinib+anlotinib,and crizotinib+anlotinib.The latest imageological examination  results of the patient before the synchronous therapy was set as the baseline to evaluate the therapeutic effect according to Recist1.1.The event free survival(EFS)of each group was calculated with disease progression,patient death,treatment discontinuation and changing regimen as endpoints.Data of tumor markers,hematology test,liver function,cardiac function,renal function biochemical examination was collected and analyzed statistically before and after the combination therapy,with P<0.05 as the statistically significant difference.Results  After screening,clinical data of 49 patients were collected.Twenty-three patients in the alectinib+anlotinib group,with a disease control rate(DCR) of 86.96%;mean EFS was(10.8±3.6)months,median EFS of 8.3 months;14 patients in the ceritinib+anlotinib group,with a DCR of 71.43%,mean EFS was(6.5±2.9)months,median EFS was 5.6 months;12 patients in the crizotinib+anlotinib group,with a DCR of 66.67%,mean EFS was(7.7±3.2)months,median EFS was 7.2 months.EFS of alectinib+anlotinib group was longer significantly than the other two groups(P<0.05).Only CyFra21-1,increased significantly after the combination of crizotinib and anlotinib(P<0.05).No statistically significant difference in biochemical test and hematology test before and after the treatment(P>0.05).Conclusions  The therapeutic effect of ALK inhibitors with anlotinib was ordered,alectinib being the most effective,followed by ceritinib and finally crizotinib.The combination of ALK inhibitors with anlotinib did not cause any abnormal results in the examination of heart,liver,kidney and blood cells.
论著

不同湿化方法对喉癌患者术后气道湿化效果的网状 Meta 分析

Effects of airway humidification for postoperative with laryngeal cancer:A network Meta-analysis

:89-98
 
       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR(95%CI)=537.70(4.18,124 511.88)、0(0,0.52),P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR(95%CI)=8.55(1.40,73.35),P<0.05];其余比较差异无统计学意义(P>0.05)。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。
       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer.Methods  PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively.Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation.The network Meta analysis was performed using ADDIS 1.16.5 softwares.Results  A total of 18 articles and 1596 patients were inciuded.The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR(95%CI)=537.70(4.18,124 511.88),0(0,0.52),P<0.05].In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR(95%CI)=8.55(1.40,73.35),P<0.05],the others were not statistically different(P0.05).Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness.Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients.
眼科专题:近视防控

户外活动对近视防控作用及其机制的研究进展

Research progress on prevention and control effect and mechanism of outdoor activities on myopia LI Shukui,LENG Yunxia

:4-10
 
       近几十年来,全球近视患病率不断上升,已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制,以期为近视防控提供新的思路。

     In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control. 
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