Experience of Drug Abusers Participating in Community-Based Drug Rehabilitation Services Provided by the Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in Hong Kong

Despite the official statistics showing that the number of drug users has been declining, the problem of drug abuse remains serious in Hong Kong. This problem is evidenced by the trend of hidden and prolonged drug abuse. The recovery of drug abusers is an important process, because the misuse of drugs can cause many bio-psycho-social complications. Therefore, 11 Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in different districts in Hong Kong play an important role on those drug abusers [1]. As a core community-based drug rehabilitation service in Hong Kong, studies about CCPSAs are limited. This study uses a descriptive qualitative approach to explore the experience of drug abusers participating in community-based drug rehabilitation services provided by CCPSAs. Five CCPSA users, who utilized the services for more than two months, participated in the semi-structured face-to-face interviews. Data collected were then analysed by thematic analysis, and five themes were generated: 1) receiving supportive counselling service in CCPSAs, 2) revealing variance towards nonmandatory services in CCPSAs, 3) encountering intrapersonal conflicts when participating in CCPSAs, 4) expanding social network through integration in group activities and 5) wishing to be a companion to other drug abusers. Findings of this study provide valuable insights towards services modification and the enhancement of drug rehabilitation and drug abusers’ wellbeing over the collaboration of healthcare workers, services providers and the media. However, this study has some limitations, and it presents suggestions for future research.

Impact of community-based rehabilitation on quality of life and self-esteem of persons with physical disabilities and their family members

Objective:Community-based rehabilitation(CBR)is a strategy by which persons living with disability(PWDs)access comprehensive rehabilitation services with limited evidence regarding its impact on the quality of life(QOL)and self-esteem(SE)of PWDs and their family members.This study compared the QOL and SE of Nigerian PWDs in communities with and without a CBR programme(CBR and non-CBR respectively),and the family quality of life(FQOL)of their family members.Methods:Cross-sectional study involving 2604 PWDs(1302 in CBR and 1302 in non-CBR);5208 family members of PWDs(2604 in CBR and 2604 non-CBR),recruited from four randomly selected geo-political zones in Nigeria,purposive/consecutive selection of eight CBR programmes,PWDs and their family members(CBR and non-CBR).Outcomes assessed using Rosenberg Self-Esteem Scale(RSES),World Health Organization Quality of Life Instrument-short form(WHOQOL-BREF)and Beach Centre Family Quality of Life Instrument(BCFQOL).Mann-Whitney U test and Spearman's rank order correlation were used to analyse data at P<0.05.Results:PWDs in CBR scored higher in all domains of WHOQOL-BREF(P<0.0001 in all cases)and RSES than non-CBR group(P<0.0001).The CBR families scored significantly higher than non-CBR families in all domains(P<0.05)except Emotional Well-Being of the BCFQOL.The CBR group scores on Psychological and Social Health domains of the WHOQOL-BREF showed significant positive correlation with CBR families'Family Interaction(P=0.06)and Parenting(P=0.07)domains and total FQOL(P=0.07).Conclusion:Community-based rehabilitation positively impacted on SE and QOL of PWDs and their family members.

Characterization of α-conotoxin TxIB and TxID for smoking cessation and drug rehabilitation

Nicotinic acetylcholine receptors(nAChRs) are widely distributed ligand gated ion channels throughout the peripheral and central nervous systems of mammals.There are 16 different n AChR subunits,α1-α7,α9,α10 and β1-β4,as well as γ,δ,and ε,which assemble into pentamers to form different nAChR subtypes with distinct pharmacological properties in mammals.Among them α6β2*(*designates other possible subunit),α3β4 and α4β2 nAChR subtypes are potential therapeutic targets for the treatment of addiction.However,various n AChR subtypes are very difficult to pharmacologically distinguish from each other.The α6* n AChRs are expressed by dopaminergic neurons in the central nervous system,which modulate the release of dopamine and are believed to be important in mediating tobacco,morphine,cocaine and ethanol addiction.The α3β4 nAChRs present in the medial habenula with important role in influencing nicotine addiction.Blockage of α3β4 nAChRs in the medial habenula decreased the dose of nicotine that rodents would self-administer.Thus,new antagonists of α6β2* or α3β4 nA ChR subtypes are of considerable interest,which would give strategies to selectively modulate α6β2* or α3β4 nA ChR function.We characterized an α-conotoxin(α-CTx)TxIB with 16 amino acids and an α-CTx TxID with 15 amino acids from Conus textile.The sequence of TxIB is GCCSDPPCRNKHPDLCamide.The sequence of TxID is GCCSHPVCSAMSPIC with C-terminal amidation too.Both peptides with a Ⅰ-Ⅲ and Ⅱ-Ⅳ disulfide con-nectivity were chemically synthesized.The residues between Cys-Ⅱ and Cys-Ⅲ and Cys-Ⅲand Cys-Ⅳ of α-CTx are commonly referred to as loops 1 and 2,respectively.The number of residues in each of these loops is used to further classify the α-CTx.So TxIB is classified as a 4/7α-CTx,whereas the α-CTx TxIB has a 4/6 spacing.Both peptides were tested on rat nAChRs heterologously expressed in Xenopus laevis oocytes.The α-CTx TxIB blocked α6/α3β2β3 nAChR with an IC50 of 28 nmol·L^(-1),which showed little or no block of all the other tested subtypes at concentrations up to 10 μmol·L^(-1).TxIB blocking α6/α3β2β3 nAChR is rapidly reversed after toxin washout.The ability ofα-CTx TxIB to discriminate between α6/α3β2β3 and the other nAChR receptors is unique.There are no small molecules have this selectivity profile.Previously described α-CTx that potently blockα6/α3β2β3 nA ChR s also block either α6/α3β4 nAChRs,α3β2 nAChRs and(or) other nAChRs subtypes.TxID was the very potent α3β4 nAChR antagonists blocking rat α3β4 n AChRs with an IC-50 of 12.5 nmol·L1.However,TxID also blocked the closely related α6/α3β4 with an IC50 of 94 nmol·L^(-1).In fact,the expression profile ofα3β4 nAChRs and α6/α3β4 nAChRs overlap in a variety of tissues.So TxI D can′t differentiate α3β4 nA ChR from α6/α3β4 nA ChR effectively.To distinguish between these two close subtypes,positional-scanning mutagenesis of TxID was performed to identify critical residues that confer potency for α3β4 nAChRs,and hope to obtain more selective mutant to discriminate between these two close subtypes.The effects of 15 analogues and TxID were tested on both α3β4 and α6/α3β4 nAChRs.An analogue,ie [S9 A]TxID had46-fold greater potency for α3β4 versus α6/α3β4 nAChRs,which showed significantly improved selectivity for α3β4 versus α6/α3β4 nAChRs.Both TxI D and [S9 A]TxI D had little activity on other nA ChR subtypes.The three-dimensional solution structures of TxIB,TxID and [S9 A]TxID were determined using NMR spectroscopy.α-CTx TxI B,TxID and [S9 A]TxID represent uniquely selective ligand for probing the structure and function of α6β2*and α3β4 nA ChR s respectively.It is known about20% people have used drugs recreationally resulting in a substance use disorder finally.Therefore,structural insights derived from these ligands may facilitate the development of novel therapeutics for addiction involving α6β2* and α3β4 nA ChR s.

Work as An Effective Intervention Strategy and Rehabilitation Treatment Program for People Who Abuse Drugs And Alcohol

Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify!they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be exqlored and tested for effectiveness, and applied.

BCI+VR Rehabilitation Design of Closed-Loop Motor Imagery Based on the Degree of Drug Addiction

After abusing drugs for long,drug users will experience deteriorated self-control cognitive ability,and poor emotional regulation.This paper designs a closed-loop virtual-reality(VR),motorimagery(MI)rehabilitation training system based on brain-computer interface(BCI)(MI-BCI+VR),aiming to enhance the self-control,cognition,and emotional regulation of drug addicts via personalized rehabilitation schemes.This paper is composed of two parts.In the first part,data of 45 drug addicts(mild:15;moderate:15;and severe:15)is tested with electroencephalogram(EEG)and near-infrared spectroscopy(NIRS)equipment(EEG-NIRS)under the dual-mode,synchronous signal collection paradigm.Using these data sets,a dual-modal signal convolutional neural network(CNN)algorithm is then designed based on decision fusion to detect and classify the addiction degree.In the second part,the MIBCI+VR rehabilitation system is designed,optimizing the Filter Bank Common Spatial Pattern(FBCSP)algorithm used in MI,and realizing MI-EEG intention recognition.Eight VR rehabilitation scenes are devised,achieving the communication between MI-BCI and VR scene models.Ten subjects are selected to test the rehabilitation system offline and online,and the test accuracy verifies the feasibility of the system.In future,it is suggested to develop personalized rehabilitation programs and treatment cycles based on the addiction degree.

Study on the feasibility of five tones combined with electric acupuncture therapy for drug rehabilitation

Objective:To explore the feasibility of five tones combined with electro-acupuncture for drug rehabilitation.Methods:Search and screen the literature related to drug rehabilitation with musical electrico-acupuncture in PubMed,CNKI,CQVIP and Wanfang data to May 2019,and summarize and analyze the literature.Results:Either music therapy or acupuncture therapy has therapeutic responses respectively,and the combined use of both is more effective than the single-use.Conclusion:The combination of five tones and acupuncture is highly feasible for drug rehabilitation.

戒毒服务型平台使用意愿影响因素及构建研究

自“智慧戒毒”概念提出以来,我国积极建设了许多戒毒服务型平台,为社会有寻求戒毒相关内容与线上服务人群提供了专业、便捷的途径,然而,当前这类平台普遍未深入用户视角设计平台功能。以技术接受模型为理论基础,构建戒毒服务型平台的使用意愿模型,再通过线上线下相结合的问卷调查方式,采用SPSS 21.0软件对311份有效问卷进行统计分析,将所得数据导入AMOS对模型进行测试,以了解用户对现有戒毒服务型平台的使用意愿及影响因素,从而推进我国戒毒康复平台的构建与发展。结果表明:感知有用性、感知易用性、交互体验和自我效能感对戒毒服务型平台使用意愿有正向显著影响。

脑卒中后认知障碍患者非药物治疗的研究进展

脑卒中后认知障碍(PSCI)是脑卒中患者常见并发症之一,严重影响患者的生活质量及预后。本研究通过搜集相关文献资料,分析PSCI的危险因素、评估及干预措施,总结其非药物治疗在临床的应用研究进展,为进一步制定全方位、科学化、规范化、优质化的非药物治疗干预措施提供参考。

耳穴疗法联合八段锦对女性强制戒毒人员稽延性戒断综合征睡眠质量的影响

目的观察耳穴疗法联合八段锦对女性强制戒毒人员稽延性戒断综合征睡眠质量的影响。方法选取2022年1月至8月福建省女子司法强制隔离戒毒所康复期的女性强制戒毒人员90例,采用随机数字表法分为对照组、八段锦组及耳穴+八段锦组(每组30例),最终完成研究82例(对照组27例、八段锦组27例、耳穴+八段锦组28例)。3组均进行包括行为教育、戒毒教育和心理咨询等常规教育。对照组采用广播体操锻炼,90 min/d,每周5 d;八段锦组采用八段锦锻炼,90 min/d,每周5 d;耳穴+八段锦组采用耳穴疗法(神门、心、皮质下+配穴)联合八段锦锻炼,八段锦锻炼90 min/d,每周5 d,耳穴疗法每穴单侧耳郭贴压,3 min/次,于八段锦休息时间段进行,每隔2 d更换至对侧耳穴交替进行。共治疗12周。观察3组治疗前及治疗6、12周后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)及其睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍等各项评分变化,并观察临床疗效、不良反应发生情况。结果与治疗前比较,3组在治疗6、12周后PSQI总分均降低(P<0.05);与对照组比较,耳穴+八段锦组在治疗6、12周后PSQI总分均降低(P<0.05),且在治疗12周后睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物和日间功能障碍评分均降低(P<0.05);与八段锦组比较,耳穴+八段锦组在治疗6、12周后PSQI总分均降低(P<0.05),在治疗12周后睡眠质量、入睡时间、睡眠效率、睡眠障碍和日间功能障碍评分均降低(P<0.05)。治疗后,八段锦组显效率高于对照组(P<0.05),耳穴+八段锦组显效率高于对照组和八段锦组(P<0.05)。治疗期间,3组均未见肌肉酸痛和耳部皮肤青紫、红斑、破损、疼痛等不良反应。结论在治疗女性强制戒毒人员稽延性戒断综合征的睡眠障碍上,相较于广播体操、八段锦锻炼,耳穴疗法联合八段锦可更快改善睡眠质量,尤其在降低入睡时间、睡眠效率、睡眠障碍和日间功能障碍评分上,值得推广应用。

运动干预对女性戒毒人员复吸倾向的影响

运动戒毒现如今已发展成为一种重要的戒毒干预方式,也渐渐成为女性戒毒人员的新疗法。降低戒毒人员回归社会后的复吸率是戒毒工作的一大难题。女性担任的社会角色具有一定特殊性,影响其复吸倾向的因素错综复杂。采用文献分析法总结归纳针对女子戒毒人员开展的运动治疗方式与复吸倾向研究的相关文献,论述影响女性戒毒人员复吸倾向的相关因素与机制,现阶段运动戒毒方式对女性戒毒者的影响以及发展方向,总结其对生理健康、心理健康与社会健康的改善效果,以期为运动干预策略提供理论基础,帮助真正达到戒断和防止复吸的目的。

获得性脑损伤患者多重耐药菌感染现状及其对脑功能的影响

目的调查获得性脑损伤康复住院患者多重耐药菌(MDRO)感染特征,并分析其对脑功能的影响。方法回顾性调查浙江省中医药大学附属第一医院2021年6月~2023年5月收治的获得性脑损伤康复住院患者334例,记录入院时多重耐药菌感染情况,将患者分为MDRO组96例和非MDRO组238例,并在入院和出院时通过格拉斯哥昏迷量表(GCS)、Barthel指数(BI)进行脑功能评估。结果96例MDRO组共采集到204份微生物标本,分别来源于痰液(152/204,74.5%)、尿液(46/204,22.5%)、伤口分泌物(6/204,2.9%),耐碳青霉烯肠杆菌科细菌(CRZ)为最主要MDRO类型,病原菌前三位是铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌。两组患者功能量表评分结果显示,MDRO组入院及出院时的功能障碍程度高于非MDRO组(P<0.01),且经过住院康复治疗后,两组出院时的GCS、Barthel指数均有改善(P<0.01)。结论28.7%的康复科获得性脑损伤患者在入院时存在多重耐药菌感染,主要来源于呼吸系统感染,最主要MDRO类型为CRE,其脑功能明显低于未感染患者,故今后在MDRO防控基础上,确保MDRO患者的康复治疗效果,以期改善患者的脑功能预后。

宫颈癌根治术后盆底康复非药物干预的最佳证据总结

目的:检索、评价并整合宫颈癌根治术后盆底康复非药物干预的最佳证据。方法:按照“6S”证据模型检索国内外数据库中关于宫颈癌根治术盆底康复相关的相关文献,检索时限为建库至2023年3月,由2名研究者对纳入文献的质量进行评价,并提取相关证据。结果:共纳入9篇文献,其中指南3篇,证据总结3篇,系统评价2篇,专家共识1篇。从患者评估、膀胱管理、康复指导、健康教育4个方面总结出18条最佳证据。结论:该研究总结了宫颈癌根治术后盆底康复非药物干预的最佳证据,在临床应用证据时应结合临床实际情况及患者意愿进行选择,提高宫颈癌根治术后盆底康复非药物干预的效果。

社区戒毒康复“中药治疗+社会工作”模式探究

结合“基于中药治疗的社区戒毒康复服务体系建构研究”项目,系统梳理并学习借鉴戒毒康复相关研究成果,审视中药治疗和社会工作在戒毒康复中融合渐进的路径,洞察从西医药主导到中医药应用推广的发展趋势,探讨了药物治疗在社区戒毒康复中的功能和价值;通过比较中西方社会工作介入毒品治理和社区戒康的历程,充分肯定了社会工作助力社区戒毒康复的作用和影响;分别以复旦大学和甘肃试点的社区戒毒康复项目为例,比较“中药治疗+心理干预”和“中药治疗+社会工作”两种模式,分析了社会工作融入中药治疗助益社区戒毒康复的优势,为构建社区戒毒康复服务体系开辟了新思路,拓展了新载体。

司法行政戒毒社会化延伸工作的研究——以NF所为例

随着疫情管控的解封,戒毒工作社会化延伸工作全面铺开,面临政策滞后、机制落后等诸多风险挑战。研究围绕新发展理念、构建新发展格局、高质量发展等关键内容,着力解决戒毒场所深化全国统一戒毒模式社会化延伸建设工作重点、难点问题,应完善顶层设计,探索关怀救助合作新机制,统筹发展,助力司法行政戒毒社会化延伸高质量发展。

眩晕相关组织病理学、前庭康复、物理康复及中医西医治疗的文献计量学分析

背景:眩晕与临床神经科疾病密切相关。当神经元受损或死亡时,可能导致前庭系统的异常,引发眩晕症状,因此有必要探讨并分析临床神经科常见的眩晕相关热点问题。目的:采用文献计量学方法分析临床神经科常见的眩晕相关国内外的研究热点。方法:由第一作者检索2014-2023年万方数据库和Web of Science核心集数据库,检索临床神经科常见的眩晕治疗的研究相关文献,采用VOSviewer_1.6.19软件对文献的发文量、国家/地区、机构、关键词、共被引文献及高被引文献进行计量学分析,剖析总结该研究领域的研究热点。结果与结论:(1)Web of Science核心集数据库2022年该领域文献发文量174篇最高,万方数据库2020年该领域文献发文量最高133篇;发文量最高的国家前3位分别是美国、德国、中国;国际机构中发文量最高的是德国慕尼黑大学,中国机构中发文量最高的是成都中医药大学。(2)关键词分析结果显示,中国该领域的研究热点疾病主要为梅尼埃病、颈性眩晕、老年性眩晕、良性阵发性位置性眩晕、孤立性眩晕和高血压眩晕,治疗方法包括针刺、康复、药物(天麻素、半夏白术天麻汤)和手法复位。国际上该领域的研究热点疾病主要包括良性阵发性位置性眩晕、新冠病毒病例的前庭性疾病、梅尼埃病、前庭神经鞘瘤、听神经瘤和前庭性偏头痛等,热点治疗方法为传统抗眩晕药物、抗抑郁、抗焦虑治疗和显微手术等。(3)文献共被引分析结果显示,对于以持续性眩晕为主要症状的急性前庭综合征而言,三步骤床边眼动检查(HINTS:头部-冲击-眼球震颤-斜视测试)在急性前庭综合征患者合并脑卒中的诊断方面比早期MRI更敏感,此观点是最被同行认可的前庭综合征脑卒中检测方法;对以阵发性眩晕为主要症状的前庭神经炎患者而言,使用激素治疗更有效。(4)高被引文献分析结果显示,在万方数据库中近10年热点文献中,针刺风池穴、“小醒脑开窍”针刺法改善后循环缺血性眩晕均取得了一定成效,近3年文献发现银杏叶提取物+天麻素、针刺+半夏白术汤、倍他司汀+天麻素、前庭康复训练+Epley耳石复位法,都可以不同程度地改善眩晕症状。而近10年Web of Science核心集数据中的文献并无特色性抗眩晕药物受到关注,大部分以传统抗眩晕药物和显微手术为主,但近3年国际文献中有少数病例报告发现COVID-19感染后可能导致前庭神经炎并出现眩晕症状。(5)眩晕的发生和发展可能与神经元的损伤和再生密切相关,例如,病毒感染、炎症刺激或其他病理因素可能导致神经元损伤或死亡,从而影响前庭系统的功能。目前国内外都发布了眩晕相关的诊治规范指南,国际指南较为推荐前庭康复和物理康复联合治疗眩晕症状,中国指南较为推荐中西医药物、复位及针刺联合治疗,但研究证据级别并不高,因此未来还需要大量的大样本、多中心关于抗眩晕治疗的随机对照试验来验证。

新形势下强制隔离戒毒的衔接帮扶路径探索

衔接帮扶是司法行政强制隔离戒毒工作的“最后一公里”。在强制隔离戒毒人数大幅下降的戒毒工作新形势下,衔接帮扶工作需因势而变,切实补足完善短板性问题。当前,衔接帮扶存在制度与机制“缺失”、常态化工作“失位”、所内资源的功能社会化延伸难“突破”、社会支持存在“瓶颈”等问题,需以制度与机制建设为保障,以落实好常规工作为关键,以所内资源延伸为突破点,以社会面有效宣传为抓手,充分凸显衔接帮扶成效。

基于药物相互作用软件评析我院360名康复患者的药物相互作用

目的评价并分析我院360名康复患者的药物相互作用(DDI)。方法从我院2022年1~12月康复患者中随机抽取360名患者(212名男性和148名女性),平均年龄为(73.9±12.48)岁(16~93岁)。临床药师通过Lexi-Interact软件分析评估药物的相互作用的发生率及发生类型。结果Lexi-Interact共鉴定了360名康复患者的药物相互作用,这些患者中有62例存在药物的相互作用,其中40例患者发生C级药物相互作用,18例患者发生D级药物相互作用,4例患者发生X级药物相互作用,医嘱用药均数(6.6±2.07)种,共筛选出C级药物相互作用53个,D级药物相互作用18个,X级药物相互作用4个。最严重(X级)的相互作用是氯吡格雷+奥美拉唑、多潘立酮+氟康唑、胺碘酮+莫西沙星。结论我院康复患者大多为功能障碍患者、慢性病患者、老年患者、急性病恢复期患者,需同时服用多种药物,临床药师通过软件筛选潜在的药物相互作用,减少药物的不良事件,以便在临床治疗中更好的开展药学监护,提高康复患者用药安全。

头孢菌素类药物序贯疗法在小儿肺炎治疗中的应用

目的观察头孢菌素类药物序贯疗法在小儿肺炎治疗中的应用效果及安全性。方法选取110例肺炎患儿,按照随机数字表法分为两组,每组55例。常规组予以常规药物治疗,序贯组予以头孢菌素类药物序贯治疗,比较两组的症状缓解时间、炎症因子、免疫指标改善情况、用药安全性及医疗成本。结果治疗后,序贯组的咳嗽、吸气三凹征、发热等症状缓解时间均短于常规组,细菌清除率高于常规组,差异均有统计学意义(P<0.05);序贯组CD3^(+)、CD4^(+)的水平均高于常规组,CD8^(+)水平低于常规组(P<0.05);序贯组的C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)的水平及药物相关不良反应发生率均低于常规组(P<0.05);序贯组的住院时间、总治疗时间均短于常规组,总医疗支出少于常规组(P<0.05)。结论头孢菌素类药物序贯疗法能加快肺炎患儿的康复进程,对增强机体免疫力、缓解炎症反应、提升用药安全性并减少医疗成本均有积极作用。

中医康复护理结合改良催吐法对精神分裂症患者药物中毒急诊救治的效果

目的探讨中医康复护理+改良催吐法对精神分裂症患者药物中毒急诊救治的效果。方法回顾性分析2020年1月至2023年1月于聊城市第四人民医院收治的86例精神分裂症药物中毒患者的资料,按照不同的护理方法分为对照组(常规护理,43例)及观察组(中医康复护理+改良催吐法,43例)。比较2组患者的依从性、心理状态、精神状况、行为障碍和生活质量。结果观察组的总依从率高于对照组(P<0.05)。护理7 d和14 d后,观察组的汉密尔顿焦虑量表、汉密尔顿抑郁量表、简明精神病评定量表评分均低于同期对照组(P均<0.05),且2组均低于护理前(P均<0.05);观察组的护士用住院患者观察量表、健康调查问卷评分均高于同期对照组(P均<0.05),且2组均高于护理前(P均<0.05)。结论中医康复护理结合改良催吐法可提高精神分裂症药物中毒患者的依从性和生活质量,改善其心理状态、精神状况以及行为障碍。

围手术期重复剂量与单剂量地塞米松对全膝关节置换术后疼痛及康复影响的Meta分析

目的 系统评价围手术期重复剂量与单剂量地塞米松对全膝关节置换术(TKA)后疼痛及康复的影响。方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data、SinoMed、VIP数据库,搜集关于TKA围手术期重复剂量对比单剂量地塞米松的随机对照试验,检索时限为建库至2024年1月4日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.4软件进行Meta分析。结果 共纳入6项研究,包括674例患者,其中单剂量地塞米松组336例和重复剂量地塞米松组338例。Meta分析结果显示,与单剂量地塞米松相比,围手术期重复剂量地塞米松可降低TKA术后48h静息痛评分[SMD=-0.68,95%CI(-1.05,-0.30),P<0.001]、术后48h运动痛评分[SMD=-0.86,95%CI(-1.37,-0.34),P=0.001]、术后48hC-反应蛋白(CRP)水平[MD=-4.43,95%CI(-6.70,-2.16),P<0.001]、术后72h CRP水平[MD=-3.60,95%CI(-5.53,-1.67),P <0.001];2组术后24、72h静息痛评分、术后24、72h运动痛评分、各时段内恶心呕吐发生率、术后24h CRP水平、住院天数、药品不良反应发生率等指标差异均无统计学意义(P>0.05)。5项研究的结果均显示,重复剂量地塞米松组补救性应用镇痛药物剂量或患者比例未增加。结论 现有证据表明,与单剂量地塞米松相比,围手术期重复剂量地塞米松可显著降低TKA术后48h疼痛评分、术后48 h和72 h CRP水平,但未能明显降低术后恶心呕吐发生率和住院天数,也未增加药品不良反应风险。