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[1]王逸松,詹紅生,王輝昊.2012—2023年手法治療頸椎病不良事件的發(fā)生與變化情況及防范對策[J].中醫(yī)正骨,2024,36(11):15-20,57.
　WANG Yisong,ZHAN Hongsheng,WANG Huihao.Occurrence and changes of adverse events in manipulative treatment of cervical spondylosis during 2012—2023 and the prevention countermeasures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(11):15-20,57.
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2012—2023年手法治療頸椎病不良事件的發(fā)生與變化情況及防范對策()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年11期
頁碼:
15-20,57
欄目:
文獻(xiàn)研究
出版日期:
2024-11-20

文章信息/Info

Title:
Occurrence and changes of adverse events in manipulative treatment of cervical spondylosis during 2012—2023 and the prevention countermeasures
作者:
王逸松; 詹紅生; 王輝昊
上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院,上海 201203
Author(s):
WANG Yisong; ZHAN Hongsheng; WANG Huihao
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
關(guān)鍵詞:
頸椎病;  肌肉骨骼手法;  不良事件;  文獻(xiàn)分析
Keywords:
cervical spondylosis;  musculoskeletal manipulations;  adverse events;  document analysis
摘要:
目的:分析2012—2023年手法治療頸椎病不良事件的發(fā)生與變化情況,并探討相應(yīng)的防范對策。方法:應(yīng)用計(jì)算機(jī)檢索中國生物醫(yī)學(xué)文獻(xiàn)服務(wù)系統(tǒng)、中國知網(wǎng)、萬方數(shù)據(jù)庫、維普網(wǎng)中關(guān)于手法治療頸椎病不良事件的文獻(xiàn),檢索時(shí)限為2012年1月1日至2023年12月31日。統(tǒng)計(jì)分析不良事件的種類、等級、結(jié)局及引起不良事件的手法類型等信息,并將統(tǒng)計(jì)分析結(jié)果與前期文獻(xiàn)(1979—2011年)研究所得的結(jié)果進(jìn)行比較分析。結(jié)果:①文獻(xiàn)檢索與篩選結(jié)果。共檢索到997篇相關(guān)文獻(xiàn),經(jīng)過逐層篩選后最終納入42篇文獻(xiàn),涉及219例患者和224件不良事件(如果1例患者同時(shí)出現(xiàn)頭暈、上肢麻木、惡心嘔吐,則計(jì)為3件不良事件)。②2012—2023年手法治療頸椎病不良事件發(fā)生情況分析結(jié)果。不良事件種類位于前3位的依次為頭暈(22.32%)、局部疼痛(20.54%)、惡心嘔吐(15.63%); 引起不良事件的手法類型為旋轉(zhuǎn)復(fù)位法(83例)、按揉穴位法(77例)和拔伸手法(12例),47例未描述引起不良事件的手法類型; 輕度不良事件217件,中度不良事件3件,嚴(yán)重不良事件4件; 35例描述了不良事件的結(jié)局且均為恢復(fù)或基本恢復(fù),184例未描述不良事件的結(jié)局。③2012—2023年手法治療頸椎病不良事件變化情況分析結(jié)果。與12年前(1979—2011年)相比,近12年頸椎病手法治療不良事件的種類更加多樣化,中度、嚴(yán)重不良事件的數(shù)量明顯下降,頭暈仍為占比最高的不良事件; 旋轉(zhuǎn)復(fù)位類手法引起的不良事件仍最多,其次為按揉穴位類手法,拔伸類手法引起的不良事件明顯增多; 不良事件主要以輕度不良事件為主,中度和嚴(yán)重不良事件占比明顯減小; 未描述不良事件結(jié)局的病例數(shù)大幅增多,且未篩選到死亡病例。結(jié)論:與12年前相比,2012—2023年手法治療頸椎病不良事件,仍多由旋轉(zhuǎn)復(fù)位類手法和按揉穴位類手法引起,以輕度不良事件為主且均能恢復(fù),中度、嚴(yán)重不良事件的數(shù)量明顯減少,但不良事件的種類更加多樣化,拔伸類手法引起的不良事件明顯增多。通過完善病例資料、規(guī)范操作手法、厘清手法機(jī)制、嚴(yán)格規(guī)范從業(yè)人員準(zhǔn)入資格、提高醫(yī)務(wù)人員風(fēng)險(xiǎn)意識,以及加強(qiáng)醫(yī)患之間的積極溝通,可有效防范和減少手法治療頸椎病不良事件的發(fā)生。
Abstract:
Objective:To analyze the occurrence and changes of adverse events in manipulative treatment of cervical spondylosis(CS)during 2012—2023,and to explore the corresponding prevention countermeasures.Methods:All the articles about adverse events in mani-pulative treatment of CS included from January 1,2012 to December 31,2023 were retrieved from the Chinese Biomedical Literature Service System,China National Knowledge Infrastructure,Wanfang Database,and Vip Database through computer,followed by statistics and analysis on the types,grades,and outcomes of adverse events as well as the types of manipulations causing adverse events,and the results were compared with the findings of the articles published during 1979—2011.Results:①Article retrieval and screening results.Nine hundred and ninety-seven articles were searched out.After screening,42 articles were included in the final analysis,involving 219 patients and 224 adverse events(3 adverse events were recorded if one patient experienced dizziness,upper limb numbness,as well as nausea and vomiting simultaneously).②Analysis result of occurrence of adverse events in manipulative treatment of CS during 2012—2023.Among the 224 adverse events in manipulative treatment of CS during 2012—2023,the top three ones were dizziness(22.32%),local pain(20.54%),nausea and vomiting(15.63%)in turn,and the mild,moderate,and severe adverse events were 217,3,and 4,respectively.Among the 219 patients,the adverse events were caused by rotation reduction in 83 cases,acupoint massage in 77 cases,and pulling-stretching manipulation in 12 cases,with 47 cases not specifying the manipulations that led to the adverse events,and the outcomes of adverse events were reported in 35 cases,all of which were recovery or basic recovery,while the outcomes were not reported in 184 cases.③Changes of adverse events in manipulative treatment of CS during 2012—2023.Compared with the period of 1979—2011,the period of 2012—2023 witnessed increased types of adverse events,but decreased number of moderate and severe adverse events in manipulative treatment of CS,with dizziness accounting for the highest proportion in the adverse event.Rotation reduction manipulation led to the most adverse events,followed by acupoint massage,and the adverse events caused by pulling-stretching manipulation increased significantly.In addition,the adverse events were dominant by the mild ones,the proportion of the moderate and severe ones decreased significantly.Besides,the number of cases without reporting the outcomes of adverse events substantially increased,and no death case was identified in the screening process.Conclusion:During 2012—2023,the adverse events in manipulative treatment of CS were still mostly caused by rotation reduction manipulation and acupoint massage,predominantly by mild ones,which can be recoverable.Compared with the period of 1979—2011,the period of 2012—2023 witnessed decreased number of moderate and severe adverse events but increased types of adverse events,with a significant increase in adverse events caused by pulling-stretching manipulation.Efforts should be made to improve case data,standardize the operation of manipulations,decipher the functioning mechanisms of manipulations,strictly regulate the qualifications of practitioners,enhance the risk awareness of medical staff,and strengthen the active communication between doctors and patients,which can effectively prevent and reduce the occurrence of adverse events in manipulative treatment of CS.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國家自然科學(xué)基金項(xiàng)目(81973871); 上海市2020年度“科技創(chuàng)新行動計(jì)劃”醫(yī)學(xué)創(chuàng)新研究專項(xiàng)項(xiàng)目(20MC1920600); 上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院第二輪《促進(jìn)市級醫(yī)院臨床技能與臨床創(chuàng)新三年行動計(jì)劃》重大臨床研究項(xiàng)目(SHDC2020CR1051B)
通訊作者:王輝昊 E-mail:[email protected]
更新日期/Last Update: 1900-01-01