目的 探討針刺治療在防治術后惡心嘔吐(PONV)中的作用與療效。 方法 通過對2012年6月收治的1例全身麻醉下行小腦血腫清除術后出現持續性惡心嘔吐癥狀,后輔以針刺治療好轉的病例報道,就針刺治療對PONV的穴位選擇,刺激方式,介入時間等相關研究進行復習和總結。 結果 患者惡心嘔吐癥狀在選取中脘、足三里(雙)、內關(雙)穴針刺治療3次后(30 min/次)明顯減少,自訴惡心程度較前緩解,連續針灸6次后嘔吐現象得到有效控制。 結論 目前有關針刺治療PONV的研究越來越多,但尚無統一的治療標準。
Objective?To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods?Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results?A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion?Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.