Реферат
【Objective】 To evaluate the clinical efficacy and safety of platelet-rich plasma(PRP) in acute achilles tendon injury by meta-analysis. 【Methods】 Literature on clinical randomized controlled trial of PRP in the treatment of acute achilles tendon injury from Wanfang database, CNKI, VIP database, The Chinese Biological Literature Database, The Chinese Clinical Trials Registry, PubMed, Embase, Cochrane and The US Clinical Trials Registry as of August 2023 were retrieved. The control group received conventional treatment for acute achilles tendon injury, while PRP treatment group received additional PRP treatment. The primary outcome measure was visual analogue pain scale, and the secondary outcome measures were the achilles tendon fracture score, maximum heel rise height, calf circumference and ankle range of motion. The quality of the literature was assessed using the Cochrane manual, and a meta-analysis of qualified literature was performed using RevMan 5.3 software. 【Results】 Seven articles were finally included, involving 421 patients with acute achilles tendon injury, including 212 patients in the PRP treatment group, and 209 patients in the conventional treatment group. The results of meta-analysis showed that there was no difference between the conventional treatment group and the PRP treatment group in terms of the visual analogue pain scale(SMD=-0.44, 95%CI: -0.94~0.06, P>0.05), calf circumference (MD=1.14, 95% CI: -1.56-3.84, P>0.05), ankle joint toe flexion range of motion (SMD=1.85, 95%CI: -1.38-5.09, P>0.05), ankle dorsiflexion range of motion(SMD=2.61, 95%CI: -0.95-6.17, P>0.05), achilles tendon fracture score (MD=-5.60, 95%CI: -15.36-4.16, P>0.05) and the maximum heel rise height (MD=-2.48, 95%CI: -5.30-0.33, P>0.05). And there was no difference in the incidence of adverse reactions between the two groups (X2=2. 455, P>0.05). 【Conclusion】 PRP injection for acute achilles tendon injury does not improve the biomechanical and clinical outcomes of patients, and the use of PRP does not increase the occurrence of adverse reactions.
Реферат
Objective:To investigate the effect of optimized catheter clipping training and automatic balloon retraction ureteral catheter removal on first urination of patients after neurosurgery, and provide guidance for postoperative micturition of these patients.Methods:From August 2020 to August 2021, 208 patients admitted to Department of Neurosurgery, the Affiliated Hospital of Xuzhou Medical University, undergoing craniocerebral surgery under general anesthesia and indurating catheter were selected as the study subjects by convenient sampling. They were divided into control group ( n=69), observation group A ( n=69) and observation group B( n=70) by random number table method. The control group received routine catheter clipping training and routine ureteral catheter removal, the observation group A received optimized catheter clipping training and routine ureteral catheter removal, and the observation group B received optimized catheter clipping training and automatic balloon retraction ureteral catheter removal. The first micturition time, first micturition volume, micturition circumstance, pain score and urethral irritation sign of the three groups were observed and compared. Results:The first urination time in observation group A and B were (11.58 ± 6.59) min and (10.06 ± 5.91) min, respectively, lower than (37.14 ± 13.74) min in control group, and the difference was statistically significant ( t=13.94, 15.07, both P<0.05); there was no significant difference between observation group B and observation group A ( P>0.05). The first urine volume were (303.66 ± 43.74) ml in control group, (299.06 ± 41.26) ml in observation group A and (299.28 ± 43.17) ml in observation group B, and the difference was not statistically significant ( P>0.05). The incidence of urination (spontaneous urination, induced urination and urinary retention) in observation group A was better than control group ( χ2=16.47), while observation group B was better than observation group A and control group ( χ2=8.59, 37.83), the differences were statistically significant (all P<0.05). There was no significant difference in pain score of ureteral catheter removal between observation group A (2.71 ± 0.67) and control group (2.87 ± 0.78) ( P>0.05). The score of observation group B (1.41 ± 0.65) was lower than that of control group and observation group A, the differences were statistically significant ( t=11.93, 11.62, both P<0.05). There was no significant difference of the incidence of urethral irritation (grade 0, 1, 2, and 3) between observation group A and control group ( P>0.05). Observation group B was lower than control group and observation group A, the differences were statistically significant ( t=38.81, 25.27, both P<0.05). Conclusions:Optimized catheter clipping training and automatic balloon retraction ureteral catheter removal can effectively shorten the first urination time of patients after neurosurgery, reduce the pain of ureteral catheter removal and urethral irritation during the first urination, improve the success rate of the first urination, and effectively prevent the occurrence of urinary retention.