在胸部或腹部手术后,侵袭性针治疗胃衰竭:系统性审查和元分析
Zhenjia Fan1, Yuqin Qiu2, Xuewei Qi1
1Department of minimally invasive acupuncture Oncology, Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China.
BMJ open
|June 27, 2023
概括
针与药物结合可显著提高腹部手术后术后胃衰竭综合征 (PGS) 的康复率. 然而,它对与胸部手术相关的PGS的疗效需要进一步研究.
科学领域:
- 胃肠病学和外科手术结果
- 综合医学和针研究 综合医学和针研究
- 基于证据的医学和元分析.
背景情况:
- 术后胃衰竭综合征 (PGS) 是胸部或腹部手术后的衰弱状况,影响患者的康复和生活质量.
- 目前PGS的治疗策略通常涉及药理干预,但它们的有效性可能有限,需要探索补充疗法.
- 针已经成为各种胃肠道疾病的潜在治疗选择,促使人们评估其在PGS管理中的作用.
研究的目的:
- 系统地评估针治疗术后胃衰竭综合征 (PGS) 的疗效.
- 为了比较针与常规药物相结合的疗效,与单独用于PGS的药物相比.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 包括15个涉及759名患者的RCT.
- 使用风险比率和平均差异提取和分析数据,通过GRADE和试验顺序分析 (TSA) 评估证据质量.
主要成果:
- 针结合药物显著改善了腹部手术后PGS的总有效率 (TER) 和恢复率 (RCR).
- 没有发现针在治疗与胸部手术相关的PGS时具有显著的优势.
- 副作用是最小的,只有一个报告的轻度,短暂的皮下出血和疼痛.
结论:
- 针,当用作药物治疗的辅助,提供了显著的好处,在改善的总有效率和恢复率为术后胃衰竭综合征特别是在腹部手术后.
- 目前的证据不支持针对胸部手术后的术后胃衰竭综合征的显著益处.
- 需要进一步进行高质量的研究,以阐明针在治疗胸部手术引起的PGS中的作用,并探索最佳的治疗方案.
相关概念视频
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:23Gastritis III: Clinical Manifestations and Management
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:26Peptic Ulcer Disease IV: Management
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease