穴位按压腕带对缓解妇科术后患者胃肠道不适的Meta分析

目的 系统评价穴位按压腕带作用于内关穴对缓解成年女性妇科术后胃肠道不适的作用与效果。方法 计算机检索PubMed、Embase、Cochrane、Proquest、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普和万方数据库,收集国内外相关的临床随机对照试验（RCT）,检索时限为建库至2020 年12 月,采用RevMan 5.3 软件进行Meta 分析。结果 共纳入8 个RCT 910 例患者。Meta 分析结果显示,与安慰剂组相比,试验组穴位按压腕带作用于内关穴可以有效减少妇科术后呕吐的发生（OR=0.53,95%CI：0.30～0.95,P＜0.05）与止吐药使用率（OR=0.32,95%CI：0.22～0.47,P＜0.00001）。而对于术后恶心的发生率,试验组和安慰剂组比较,差异无统计学意义（OR=0.70,95%CI：0.47～1.04,P＞0.05）。结论 穴位按压腕带作用于内关穴可以有效降低妇科术后患者呕吐的发生率和止吐药的使用率,而对改善恶心效果不显著,尚需大样本、高质量的临床随机对照试验予以验证。     

Improved Perioperative Sleep Quality or Quantity Reduces Pain after Total Hip or Knee Arthroplasty: A Systematic Review and Meta‐Analysis

ObjectiveTo investigate the effects of improved perioperative sleep on pain, analgesic consumption, and postoperative nausea and vomiting (PONV) in patients who were undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).MethodsOriginal studies published from 1 January 1970 to 30 September 2020 were queried in three unique databases using a common search term. The searches sought randomized controlled trials (RCT) investigating the effectiveness of sleep quality or quantity interventions for pain control early after TKA or THA. Grey literature was also searched by screening trial registers. There was no limitation on published language and patients. Two reviewers then assessed studies for eligibility. Eligible studies should have primary outcomes including perioperativeWe have comfirmed the edits. visual analogue scale (VAS) pain score and analgesic consumption; and secondary outcomes including side effects, such as PONV. Data extracted from the literature were abstracted into a comma‐separated database spreadsheet using Microsoft Excel. A meta‐analysis was then performed. Pooled statistics were calculated with weighting by inverse variance assuming a random effect model. I² was calculated as a quantifier of heterogeneity and interpreted according to the Cochrane manual. All data analysis was performed using Revman software.ResultsFrom a total of 1285 potential records identified in the electronic search, six studies eventually fulfilled the eligibility criteria. The six controlled RCTs consisted of 207 patients in the sleep‐improving group and 209 patients in the control group. The severity of rest pain was significantly lower in the sleep‐improving group compared with the control group at day 1 and day 3 postoperatively; the severity of active pain was significantly lower in the sleep‐improving group compared with the control group at day 3 postoperatively. Data concerning analgesic drugs could not undergo a meta‐analysis due to the difference of eligible studies. No significant difference was found in the incidence of PONV between the sleep‐improving group and the control group.ConclusionImproved perioperative sleep, regardless of quality or quantity, could significantly reduce the pain level at the early stage after TKA or THA, thus the total amount of analgesic drugs consumed was decreased, without significant increase in the incidence of PONV.     

枢星联合方案预防顺铂(DDP)致恶心呕吐的观察及护理

目的:研究枢星联合方案(枢星联合地塞米松及胃复安)预防顺铂联合化疗所致恶心呕吐的疗效及护理干预。方法:将93例接受以顺铂为主联合化疗的患者随机分为两组,实验组53例接受70周期化疗并给予护理干预;对照组40例接受57周期常规化疗,观察1~5d,对两组恶心、呕吐控制率进行比较。结果:实验组对急性恶心、呕吐控制率分别为90%及94.3%,均较对照组(77.2%和80.87%)明显提高(P<0.05)。结论:枢星联合方案结合护理干预可较好地预防顺铂所致的急性恶心、呕吐,使患者以更为舒适的状态接受化疗。     

延迟性化疗相关恶心呕吐的干预及护理

目的 探讨肿瘤患者延迟性相关恶心呕吐干预举措的效果。方法 选取2015年1月至2015年12月在上海交通大学医学院附属瑞金医院肿瘤科收治的接受含顺铂（>70mg/m2）联合化疗方案的实体肿瘤患者45例。评估入组患者在使用阿瑞匹坦后恶心呕吐发生率的差异。同时根据相关量表,评估干预处理后,患者焦虑抑郁的改善情况。结果 阿瑞匹坦联合相关护理干预措施后III度以上恶心呕吐发生率较干预前明显降低,且焦虑抑郁情绪较前明显好转,差异具有显著统计学差异（P<0.001）。结论 在止吐药物合理组合应用的基础上,相应的护理干预举措能进一步减少化疗相关恶心呕吐的发生,对于减少患者痛苦,促进护患关系的和谐发展起到了重要的作用。     

恩丹西酮合用地塞米松预防腹腔镜胆囊切除术后恶心呕吐的临床研究

目的 :探讨预防性应用高选择 5 -HT3 受体拮抗剂恩丹西酮合用地塞米松预防腹腔镜胆囊切除术后恶心呕吐 (Postoperativenauseaandvomiting ,PONV)的效果。方法 :择期行腹腔镜胆囊切除术病人 10 5例随机分为三组 ,每组 35例。对照组 (C组 )在胆囊取出时静脉注射 0 .9%生理盐水 5ml作为对照 ;恩丹西酮组 (O组 ) :在胆囊取出时静脉给予恩丹西酮 8mg ;恩丹西酮合用地塞米松 (O Dex组 ) ,在胆囊取出时静脉给予恩丹西酮8mg ,地塞米松 10mg。观察手术后 2 4h内恶心、呕吐发生率。结果 :术后 2 4h恶心、呕吐发生率恩丹西酮组显著低于对照组 (P <0 .0 1) ,术后 2 4h恶心、呕吐发生率恩丹西酮组高于恩丹西酮合用地塞米松组 (P <0 .0 1)。结论 :恩丹西酮合用地塞米松和恩丹西酮均能有效预防腹腔镜胆囊切除术PONV的发生 ,恩丹西酮合用地塞米松优于恩丹西酮