The relationship between body mass index, thickness of subcutaneous fat, and the gluteus muscle as the intramuscular injection site

An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this study was to determine the influence of body mass index (BMI), subcutaneous fat, and muscular thickness of the dorsogluteal IMI site among healthy Japanese women. There were 39 healthy female subjects who volunteered and met the criteria. Their ages ranged from 40s to 60s (50.82 ± 6.04). With the data collected using the B-mode ultrasound images of the dorsogluteal site, it was found that the distance from the epidermis to the under-fascia (DEUF) of the gluteus maximus was dissimilar between the subject’s right and left buttocks. It was found that the distance from the epidermis to the iliac bone (DEI) was significantly more on the right than on the left buttocks. In the case of an adult Japanese woman with a BMI of 21 or more, the DEUF of the gluteus medius was found to be about 30 mm, and the DEI was approximately 50 mm or more. Based on these findings, it is recommended that a needle length of 38 mm (1.5 inches) can be safely used to administer IMIs to the gluteus medius muscle to effectively and efficiently deliver medications through the IMI route.

Refractory lipoatrophy treated with autologous whole blood injection:A case report

BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO2 laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.

The effect of subcutaneous injection duration on patients receiving low-molecular-weight heparin:Evidence from a systematic review

To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.

The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design

Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.

ShotBlocker versus cryotherapy for reducing pain and anxiety associated with subcutaneous injection

Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,low-dose administration of drugs.Considering that these drugs may require prolonged administration,new devices and methods of injection are needed to decrease pain and anxiety associated with repeated drug injections.Methods:A quasi-experimental study design on a purposive sample of 54 patients comprised of both sexes has been utilized.The subjects were divided into 2 equal groups(group 1,Shot Blocker;group 2,cryotherapy),and 3 tools were used,namely the sociodemographic and medical data sheet,Verbal Descriptor Scale for measuring pain,and Beck Anxiety Inventory.Results:A significant reduction in pain and anxiety mean scores was observed after using cryotherapy and Shot Blocker techniques during subcutaneous injection.In addition,the Shot Blocker group exhibited significantly lower pain and anxiety mean scores compared with the cryotherapy group.Conclusions:Our findings revealed that Shot Blocker and cryotherapy were effective non-pharmacological methods for reducing pain and anxiety levels associated with repeated subcutaneous injections.

Comparison of the single-injection volar subcutaneous block and the two-injection dorsal block for digital anesthesia

Objectives: Local digital nerve blockade is frequently used in many trauma cases. Two commonly used techniques of digital nerve block with local anesthetic are the two-injection dorsal technique and the single-injection volar subcutaneous technique. In this study we compare various parameters of the single-injection volar subcutaneous block and the two-injection dorsal block. Pain score, amount of injected anesthetic, time of effect onset, patients’ and physicians’ satisfaction scores in each injection technique was compared. Methods: 128 participating patients were randomly divided into two equal experimental groups. Two-percentage Lidocaine was used as an anesthetic agent. Doses of 1.8 and 3-4 ml were used in the single-injection subcutaneous block and the two-injection dorsal block groups, respectively. Following injections, the patients were asked to score their discomfort experience on a standard visual analog scale of 0 (no pain) to 10 (most pain imaginable). They also were asked to score the rate of their satisfaction from 1(no satisfaction) to 5 (most satisfaction). The onset of effect was determined using the pinprick test. Results: Our results demonstrate that the two-injection dorsal block technique imposes more pain but the pain score difference was not statistically significant. Both patients and physicians were more comfortable with the single-injection subcutaneous digital block method. This satisfaction difference was statistically significant. Conclusions: The single-injection method is more efficient and the patients were more pleased. The advantages of this method are its safety, user friendly, need of lower amount of anesthetic drug and its easiness to teach and learn.

Comparative effects of insulin pump and injection on gestational diabetes mellitus pregnancy outcomes and serum biomarkers

BACKGROUND Insulin injection is the basic daily drug treatment for diabetic patients.AIM To evaluate the comparative impacts of continuous subcutaneous insulin infusion(CSII).METHODS Based on the treatment modality received,the patients were allocated into two cohorts:The CSII group and the multiple daily injections(MDI)group,with each cohort comprising 210 patients.Comparative assessments were made regarding serum levels of serum-secreted frizzled-related protein 5,homocysteine,and C1q/TNF-related protein 9.Furthermore,outcomes such as fasting plasma glucose,2-hour postprandial glucose levels,pain assessment scores,and the incidence of complications were evaluated post-treatment.RESULTS The CSII group displayed notably lower fasting plasma glucose and 2-h postprandial glucose levels in comparison to the MDI group(P<0.05).Subsequent analysis post-treatment unveiled a significantly higher percentage of patients reporting no pain in the CSII group(60.00%)in contrast to the MDI group(36.19%)(P<0.05).Additionally,the CSII group exhibited a markedly reduced occurrence of fetal distress and premature rupture of membranes compared to the MDI group(P<0.05).However,there were no significant variances observed in other pregnancy outcomes between the two groups(P>0.05).A statistical analysis revealed a significant difference in the incidence of complications between the groups(χ^(2)=11.631,P=0.001).CONCLUSION The utilization of CSII via an insulin pump,as opposed to MDI,can significantly enhance the management of insulin administration in patients with GDM by diversifying the sites of insulin delivery.This approach not only promotes optimal glycemic control but also regulates metabolic factors linked to blood sugar,reducing the likelihood of adverse pregnancy outcomes and complications.The clinical relevance and importance of CSII in GDM management highlight its wide-ranging clinical usefulness.

Appropriate Needle Lengths Determined Using Ultrasonic Echograms for Intramuscular Injections in Japanese Infants

Adjuvanted vaccines are recommended for administration through an intramuscular route. The Centers for Disease Control and Prevention (CDC) has recommended the anterolateral thigh using a 22 - 25-G 25-mm (1 inch) needle for infants, injected at a 90° into the skin surface, and using a 16 mm (5/8 inch) for newborns. Appropriate needle lengths may differ depending on racial backgrounds. In the present study, the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone were measured using ultrasonic echograms in order to determine suitable needle lengths for Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months old. The thickness of the epidermis was 1.44 - 1.54 mm (95% CI), and the lengths from the skin surface to the muscle fascia and bone were 11.52 - 12.28 mm (95% CI), and 25.66 - 26.93 mm (95% CI), respectively, at the anterolateral thigh. At the center of the deltoid muscle, skin thickness was similar to that at the thigh, furthermore the lengths from the skin surface to the muscle fascia and bone were 8.49 - 9.10 mm (95% CI), and 17.38 - 18.31 mm (95% CI), respectively. The lengths from the skin surface to the muscle fascia and bone were 1 - 2 mm shorter in 2-month-old infants than those in older generations. Therefore, the appropriate needle length for intramuscular injections in Japanese infants was 16 mm (5/8 inch) at any age and sites, and with 25 mm (1 inch) needles at a 90° angle being associated with the risk of over-penetration.

A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry

There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.

Efficacy of Subcutaneous Administration of Gonadotropin-releasing Hormone Agonist on Idiopathic Central Precocious Puberty

In order to assess the feasibility of subcutaneous administration of Triptorelin with 6-week intervals for the suppression of pituitary-gonadal axis and changes of clinical signs in girls with idiopathic central precocious puberty （ICPP）, 46 girls with ICPP were treated with GnRHa. Triptorelin （Decapeptyl, 3.75 mg） was administered subcutaneously （SC） at 6-weeks intervals or intramuscularly （IM） at 4-weeks intervals randomly for more than 12 months consecutively. During GnRHa therapy, clinical parameters and laboratory data, including height, weight, pubertal stage, bone age, uterine volume and ovarian size, serum levels of luteinizing hormone （LH）, follicle stimulating hormone （FSH） and estradiol （E2）, were monitored and analyzed. It was found that both treatment regimes led to regression of precocious puberty and reversal of secondary sexual characteristics. Breast developments regressed. Uterine volume was decreased after treatment, but there was no statistically significant difference. Mean ovarian volume did not change significantly during treatment. The height velocity was decreased significandy from 6.3±1.4 cm/year to 5.8：1：1.2 cm/year in group SC and 6.7±1.3 cm/year to 5.4±1.0 cm/year in group IM, respectively. The rate of bone maturation was reduced significantly during treatment. The ratio of deltaBAgdeltaCA was 1.2±0.2 or 1.3±0.3 at the onset of therapy and decreased significantly after the treatment to 0.7±0.2 or 0.9±0.1, respectively. The predicted adult height was increased significantly and progressively during therapy. The levels of serum LH, FSH and E2 returned to the prepubertal condition. No significant side effects of therapy were noted. The most common side effect during SC treatment was that a non-irritating, 1 cm in di- ameter mass was palpated at the site of subcutaneous injection in the abdominal wall of patients, which disappeared after 6- 12 weeks. Two girls had minimal withdrawal vaginal bleeding episodes after the first injection. It was concluded that both IM and SC triptorelin administrations were clinically effective. They induce profound suppression of hypothalamic-pituitary-gonadal axis while stabilizing height velocity, slowing bone maturation and increasing predicted adult height. These results suggest that subcutaneous injection of triptorelin in 6-weeks intervals at a dosage of 3.75 mg be a safe and acceptable regimen for ICPP.

Combined IL-2/IL-3 gene therapy of glioblastoma by in situ injection of recombinant adenovirus

Several features of adenoviruses make them anattractive option as a vehicle to transfer genes intoprimary malignant neoplasms in vivo. These viruseshave low pathogenicity in humans and are notneurotoxic. In addition, high titers of the virus can beachieved to allow higher levels of gene transfectionefficiency than the other vector systems. In vivotumorigenicity of G422 glioblastoma cells transfectedwith IL-2 and/or IL-3 genes decreased significantly inour privious report. In this study, recombinantadenoviruses were used to evaluate the therapeuticpotential of combined IL-2/IL-3 gene therapy in thetreatment of established subcutaneous tumor model ofG422 glioblastoma. Murine IL-2, IL-3 recombinantadenoviruses (2×10~8 pfu) were injected directly

Change of Subcutaneous Tissue Mass at the Deltoid and Thigh Areas in Japanese Infants Followed from 2 to 15 Months

We previously investigated the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone based on measurements taken from the ultrasonic echograms of Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months. The appropriate needle length for intramuscular injection was 16 mm (5/8 inch) in Japanese infants at any age and site. In the present study, we examined these lengths in 21 infants with physical growth from 2 to 15 months. Average height increased from 58.5 to 73.6 cm and average body weight from 5835 to 9226 g until 15 months. The circumference of the thigh increased from 22.3 cm at 2 months to a maximum of 25.9 cm at 6 months, while that of the deltoid area was 15.2 cm at 2 months and 15.9 cm at 6 months. Subcutaneous mass (length from the skin surface to the muscle fascia) at the thigh increased between 3 and 4 months and decreased at 12 - 15 months and showed good relationship to the circumference of the thigh. Subcutaneous mass at the center of the deltoid area showed the same size until 6 months. Muscle mass (lengths from the muscle fascia to the bone) at thigh and deltoid areas remained the same until 6 months. Ultrasonic echogram is an effective tool for evaluating subcutaneous and muscle mass in young infants.

Cutaneous allergic reaction to subcutaneous vitamin K_(1):A case report and review of literature

BACKGROUND Vitamin K1(phytomenadione)is a fat-soluble naturally occurring vitamin that is widely used to treat certain coagulation disorders.Adverse cutaneous reactions to vitamin K1 can occur;however,owing to its low incidence and considerable variability in presentation and morphology,its diagnosis can be easily overlooked.Managing these reactions may be challenging for patients and clinicians.Therefore,reviewing the adverse cutaneous reactions to vitamin K1 is important.CASE SUMMARY Here we report the case of a 50-year-old woman with no pre-existing hepatic disease who developed a cutaneous allergic reaction to subcutaneous vitamin K1 that presented as localized eczematous plaques at the vitamin K1 injection site.The eruption developed within 5 d of the injection and persisted for 32 mo despite treatment with topical and intralesional steroids.Eczema was diagnosed based on the results of the pathological examination,immunohistochemical staining,and a skin biopsy.The patient was advised to take herbal medicines orally twice daily.After treatment and follow-up,the patient’s eczematous urticarial plaques improved and her condition stabilized.CONCLUSION Here we present the first case of a cutaneous allergic reaction to subcutaneous vitamin K1 that was successfully treated with Chinese medicine.

Current Practices in Prescribing Auto-Injectable Epinephrine during Immunotherapy amongst Otolaryngic Allergists

Purpose: Allergen immunotherapy (AIT) while usually safe, is not without risk. Both sublingual (SLIT) and subcutaneous immunotherapy (SCIT) have the potential for systemic reactions including anaphylaxis. Materials and Methods: A short survey was distributed to fellows of the American Academy of Otolaryngic Allergy (AAOA) (n = 553) in July of 2019 to determine current prescribing practices. Results: A total of 103/553 surveys were completed, giving a response rate of 18.6%. Prescribing patterns for SCIT showed 79.6% prescribed auto-injectable epinephrine (AIE) to all patients, 11.7% prescribed only to high risk patients, while 1.9% did not prescribe AIE at all. SLIT showed similar patterns with 71.8% prescribing AIE to all, 11.7% to high risk or letting patient choose, and 6.8% did not prescribe to anyone. Just under half of the physicians responded affirmatively to giving a written anaphylaxis plan to patients on immunotherapy. 48.5% physicians reported treating in-office anaphylaxis due to SCIT or skin testing in the past year, while 6% reported anaphylaxis due to SLIT. Conclusions: A majority of otolaryngic allergists are still prescribing AIE for both SCIT and SLIT. With the recent higher costs attributed to AIE as well as drug shortages, some physicians are risk-stratifying patients. While SCIT has a higher risk for treatment related systemic reactions, anaphylaxis does occur with SLIT, thus making it imperative to counsel patients on a clear anaphylaxis protocol in all forms of AIT.

二甲双胍联合胰岛素泵皮下注射对妊娠期糖尿病患者妊娠结局及血清CysC、CRP、Betatrophin水平的影响

目的:探讨二甲双胍联合胰岛素泵皮下注射治疗妊娠期糖尿病效果及对妊娠结局和血清胱抑素C(CysC)、C反应蛋白(CRP)、促代谢因子(Betatrophin)水平影响。方法:选取2017年2月-2018年2月本院确诊的126例妊娠期糖尿病患者,随机数表法分为观察组(n=65)和对照组(n=61),对照组采用胰岛素泵皮下注射治疗,观察组采用二甲双胍联合胰岛素泵皮下注射治疗。观察两组血糖指标[空腹血糖(FBG)、2hPG、糖化血红蛋白(HbAlc)],血清Cys C、CPR、Betatrophin水平,妊娠结局。结果:治疗后,观察组FBG(3.98±0.93mmol/L)、2hPG(5.90±0.70)mmol/L、HbAlc(5.18±0.65%)均低于对照组(6.05±1.02mmol/L、9.02±0.85mmol/L、6.07±0.84%),Cys C(0.71±0.15mg/L)、CPR(1.43±0.31pg/L)、Betatrophin(572.39±87.61pg/ml)水平均低于对照组(0.92±0.20mg/L、 2.16±0.46pg/L、703.21±97.82pg/mL),孕妇妊娠不良情况(6.2%)低于对照组(37.7%),新生儿并发症发生率(12.3%)低于对照组(37.7%)(均P<0.05)。结论:二甲双胍联合胰岛素泵皮下注射可有效控制妊娠期糖尿病患者血糖水平,改善妊娠结局,减少产妇及新生儿并发症,降低血清CysC、CRP、Betatrophin水平。

氢吗啡酮静脉自控镇痛与皮下注射对口腔肿瘤患者术后疼痛控制效果及安全性比较

目的 :比较氢吗啡酮静脉自控镇痛(patient-controlled intravenous analgesia,PCIA)与皮下注射对口腔肿瘤患者术后镇痛的疼痛控制效果及安全性。方法:选择2022年1月—2023年3月上海交通大学医学院附属第九人民医院收治的口腔肿瘤术后患者200例,根据随机数表法分为试验组和对照组,每组各100例。试验组采用氢吗啡酮PCIA镇痛,对照组采用氢吗啡酮皮下注射镇痛。比较2组疼痛控制效果(BPI-C评分)、血清标志物[前列腺素E2(PGE2)、5羟色胺(5-HT)、一氧化氮(NO)、生长激素(GH)、皮质醇(Cor)、泌乳素(PRL)]、炎症因子表达水平[血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素1β(IL-1β)]、睡眠质量(失眠严重指数)及安全性。采用SPSS 23.0软件包对数据进行统计学分析。结果:术后48 h,试验组BPI-C评分中的目前疼痛程度、平均疼痛程度、过去24 h内最痛的疼痛程度、过去24 h内最轻的疼痛程度、过去24 h内接受疼痛处置后疼痛缓解程度评分及PGE2、5-HT、NO、GH、Cor、PRL、TNF-α、IL-6、IL-1β水平显著低于对照组(P<0.05);术后1周,试验组ISI评分中的入睡困难、睡眠维持困难、早醒、睡眠模式、日常功能、生活质量、睡眠问题评分显著低于对照组(P<0.05);试验组不良反应发生率为10.00%,对照组为13.00%,差异无统计学意义(P>0.05)。结论:口腔肿瘤术后患者应用氢吗啡酮PCIA,不仅能有效缓解疼痛感受,还能降低血清疼痛介质及炎症因子表达,进而减轻应激反应,改善患者睡眠质量,且不会增加不良反应发生率,值得临床推广。

胰岛素不同注射方式对糖尿病血糖控制效果的影响研究

目的分析胰岛素不同注射方式对2型糖尿病患者血糖控制情况的影响。方法选取2021年9月—2023年9月安溪县医院收治的186例2型糖尿病患者为研究对象,利用最新统计学软件生成随机序列后将其分为对照组、观察组,各93例。两组研究对象均选用门冬胰岛素治疗,其中对照组注射方式为多次胰岛素皮下注射,观察组注射方式为胰岛素泵持续泵注。对比两组血糖控制情况、胰岛素使用剂量、血糖达标情况以及胰岛β细胞功能。结果观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。观察组平均每天胰岛素使用量低于对照组,血糖达标时间短于对照组,且在达标即刻使用的胰岛素总量少于对照组,差异有统计学意义(P均<0.05)。观察组胰岛β细胞功能优于对照组,差异有统计学意义(P<0.05)。结论对于2型糖尿病患者,采用胰岛素泵持续泵注这一注射方式,有利于改善血糖、血压及血脂水平,同时改善胰岛β细胞功能,且使用胰岛素剂量更低,能够更快速地达到控糖标准。

肝素钠注射液皮下注射知信行现状调查研究

目的 调查肝素钠注射液皮下注射护理操作规范的知信行现状及其影响因素,为临床护士的培训及管理提供参考依据。方法 使用方便抽样法选取2022年4-5月西安交通大学第一附属医院、西北妇女儿童医院和深圳市人民医院临床护士720人为研究对象,采用临床护士肝素钠注射液皮下注射护理操作规范的知信行调查问卷,进行问卷调查并寻找其影响因素。结果 临床护士肝素钠注射液皮下注射知信行得分(145.33±19.94)分,知识、态度、行为三维度分别是(19.23±4.48)分、(44.33±6.82)分、(81.73±15.05)分;多元线性回归结果显示临床护士对肝素钠注射液皮下注射操作知识的显著影响因素是工作时长、有无接受肝素钠注射液皮下注射操作培训;态度的显著影响因素是工作时长;行为的显著影响因素是知识、态度及有无接受肝素钠注射液皮下注射培训等。结论 临床护士关于肝素钠注射液皮下注射操作护理态度积极程度较好,但知识水平和行为执行情况有待进一步促进和提高。管理者只有采取多样化形式培训,做好肝素钠注射液皮下注射的质控管理,才能确保病人的用药安全。

变应原皮下特异性免疫治疗依从率及影响因素的系统评价与Meta分析

目的良好的患者依从率是保证变应原特异性免疫治疗的关键,本研究系统评价变应原皮下特异性免疫治疗(皮下脱敏治疗)患者的依从率及影响因素。方法检索PubMed、Cochrane library、Web of Science、CINAHL,中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台和维普(VIP)数据库,检索时限为建库至2023年8月。采用澳大利亚JBI循证卫生保健中心研究真实性评价标准进行文献评价。采用Revman5.3版软件对皮下脱敏治疗依从率进行Meta分析,对影响依从率的因素采用描述性分析。结果共纳入符合条件的文献28篇,结果显示皮下特异性免疫治疗依从率在23.00%~91.46%之间,合并依从率为67.00%(95%CI:57.00%~77.00%);影响依从率的主要因素包括药物不良反应(1.40%~29.00%)、治疗效果未达预期(2.60%~44.00%)、症状改善(4.00%~60.60%)、经济原因(1.00%~47.90%)等;儿童患者的依从率明显高于成人(OR=0.53,95%CI:0.47~0.61,P<0.000)。结论皮下脱敏治疗的总体依从率偏低,且影响依从率的因素较多,采取个性化措施增加患者依从率是提高皮下脱敏治疗的关键。