目的系统评价呼吸训练对中风患者吞咽功能的影响。方法计算机检索Cochrane Library、PubMed、Web of Science、AMED、CINAHL、EMbase、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中关于呼吸训练对中风患者吞咽...目的系统评价呼吸训练对中风患者吞咽功能的影响。方法计算机检索Cochrane Library、PubMed、Web of Science、AMED、CINAHL、EMbase、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中关于呼吸训练对中风患者吞咽障碍随机对照试验,检索时限为建库至2019年6月。根据纳入和排除标准筛选文献、提取数据并评价纳入研究的方法学质量,采用RevMan 5.3软件进行Meta分析。结果纳入13篇文献,906例患者。Meta分析结果显示,与对照组相比,干预组患者总有效率(MD=1.19,95%CI(1.11~1.27),P<0.01)、吞咽造影检查(VFSS)评分(MD=1.53,95%CI(1.00~2.05),P<0.01)、吞咽障碍特异性生活质量量表(SWAL-QOL)评分(MD=19.77,95%CI(13.18~26.36),P<0.01)高于对照组,洼田饮水试验评分(MD=-0.70,95%CI(-0.93^-0.46),P<0.01)、吸入性肺炎发生率(MD=0.35,95%CI(0.16~0.74),P=0.006)低于对照组。Rosenbek误吸程度评分低于对照组,但差异无统计学意义(MD=-0.77,95%CI(-1.63~0.09),P=0.08)。结论在常规治疗、护理和康复训练的基础上对中风吞咽障碍患者进行呼吸训练可以改善吞咽障碍程度、预防呼吸并发症的发生、提高生活质量。但鉴于该研究纳入文献较少、各研究间干预方案存在差异以及干预时间较短,所以以上结论需要更高质量的随机对照试验加以验证。未来的研究应优化呼吸训练方案,开展更加严谨的研究。展开更多
This paper studies the distribution features, the chemical elements beyond standards and the influencing factors of shallow groundwater quality in the Guanzhong Basin through the data monitored in the last twenty year...This paper studies the distribution features, the chemical elements beyond standards and the influencing factors of shallow groundwater quality in the Guanzhong Basin through the data monitored in the last twenty years. The final purpose is to comprehensively evaluate the divisions of groundwater quality in the Guanzhong Basin. Results show that, the groundwater quality is in good shape, and suitable for drinking. Drinking accounts for 16.02% of the total, most of which are distributed in the lubotan of Weibei. Some come from loess plateau of Qian-Liquan County and some are generated by the industrial pollution of Xingping City. Materials exceeding standards include chloride, sulfate, three nitrogen, fluoride, manganese, iron, hexavalent chromium and so on. The main factors influencing the quality of shallow groundwater include groundwater exploitation, natural background value of special components and precipitation, among which the groundwater exploitation poses the greatest impact. The depth of water is positively correlated with the concentration of sulfate, nitrate and total hardness.展开更多
文摘目的系统评价呼吸训练对中风患者吞咽功能的影响。方法计算机检索Cochrane Library、PubMed、Web of Science、AMED、CINAHL、EMbase、中国生物医学文献数据库、中国知网、万方数据库和维普中文期刊数据库中关于呼吸训练对中风患者吞咽障碍随机对照试验,检索时限为建库至2019年6月。根据纳入和排除标准筛选文献、提取数据并评价纳入研究的方法学质量,采用RevMan 5.3软件进行Meta分析。结果纳入13篇文献,906例患者。Meta分析结果显示,与对照组相比,干预组患者总有效率(MD=1.19,95%CI(1.11~1.27),P<0.01)、吞咽造影检查(VFSS)评分(MD=1.53,95%CI(1.00~2.05),P<0.01)、吞咽障碍特异性生活质量量表(SWAL-QOL)评分(MD=19.77,95%CI(13.18~26.36),P<0.01)高于对照组,洼田饮水试验评分(MD=-0.70,95%CI(-0.93^-0.46),P<0.01)、吸入性肺炎发生率(MD=0.35,95%CI(0.16~0.74),P=0.006)低于对照组。Rosenbek误吸程度评分低于对照组,但差异无统计学意义(MD=-0.77,95%CI(-1.63~0.09),P=0.08)。结论在常规治疗、护理和康复训练的基础上对中风吞咽障碍患者进行呼吸训练可以改善吞咽障碍程度、预防呼吸并发症的发生、提高生活质量。但鉴于该研究纳入文献较少、各研究间干预方案存在差异以及干预时间较短,所以以上结论需要更高质量的随机对照试验加以验证。未来的研究应优化呼吸训练方案,开展更加严谨的研究。
基金sponsored by the construction of urban geological environment monitoring network in Guanzhong urban agglomeration,China geological survey,Project No.Water[2012]01-007-002the research of groundwater dynamic monitoring in Shaanxi province,Shaanxi public welfare geological project,Project No.20130203
文摘This paper studies the distribution features, the chemical elements beyond standards and the influencing factors of shallow groundwater quality in the Guanzhong Basin through the data monitored in the last twenty years. The final purpose is to comprehensively evaluate the divisions of groundwater quality in the Guanzhong Basin. Results show that, the groundwater quality is in good shape, and suitable for drinking. Drinking accounts for 16.02% of the total, most of which are distributed in the lubotan of Weibei. Some come from loess plateau of Qian-Liquan County and some are generated by the industrial pollution of Xingping City. Materials exceeding standards include chloride, sulfate, three nitrogen, fluoride, manganese, iron, hexavalent chromium and so on. The main factors influencing the quality of shallow groundwater include groundwater exploitation, natural background value of special components and precipitation, among which the groundwater exploitation poses the greatest impact. The depth of water is positively correlated with the concentration of sulfate, nitrate and total hardness.
