目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料，按照7︰3比例随机化分为训练列（293例）和验证队列（126例）。统计基于开发队列数据，采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素，并构建风险预测模型。基于开发队列和验证队列数据，采用校准曲线、受试者操作特征（ROC）曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎，发生率为26.97%。美国国立卫生研究院卒中量表（NIHSS）评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值（NPAR）、中性粒细胞计数与淋巴细胞计数比值（NLR）、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素（P＜0.05）。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型，校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近；ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906（95%CI：0.867~0.937）、0.884（95%CI：0.815~0.934）；决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。

      Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage（ICH）and validate the predictive performance of the model．Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022．They were randomly divided into a development cohort（293 cases）and a validation cohort（126 cases）according to a 7∶3 ratio．The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data，and a risk prediction model was constructed．Based on the development cohort data and validation cohort data，the predictive performance of the model was analyzed using calibration curves，receiver operating characteristic（ROC）curve，and decision curve analysis．Results Among 419 patients，113 developed stroke associated pneumonia，with a rate of 26.97%．The National Institutes of Health Stroke Scale（NIHSS）score，swallowing difficulties，initial hematoma volume，neutrophil percentage to albumin ratio（NPAR），neutrophil count to lymphocyte count ratio（NLR），surgical treatment，endotracheal intubation，and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH（P＜0.05）．Based on the above influencing factors，a risk prediction model for stroke associated pneumonia in patients with ICH was constructed．The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence．The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906（95%CI：0.867-0.937）and 0.884（95%CI：0.815-0.934），respectively．The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%，and the threshold probability of the validation cohort was between 2%-76%，the intervention using this model was more clinically valuable than all/no intervention．

Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score，swallowing difficulties，initial hematoma volume，NPAR，NLR，surgical treatment，tracheal intubation，and indwelling gastric tube has good predictive performance and clinical application value．

       目的 探索Nrf2/HO-1通路是否参与远志皂苷元（远志）在脑出血体外细胞模型中对BV2小胶质细胞炎症反应的调控作用。方法 采用红细胞与BV2小鼠小胶质细胞共培养构建体外脑出血模型。分别给予远志单独处理、远志联合Nrf2抑制剂ML385处理，检测炎症因子水平。收集细胞上清制备条件培养基，用于培养SH-SY5Y人神经母细胞瘤细胞，并检测其铁死亡水平。结果 模型组BV2细胞炎症因子（IL-1β，IL-6，TNF-α）水平较对照组显著升高（P＜0.001）；高浓度远志（20 μM）可降低炎症因子水平，并上调Nrf2/HO-1通路蛋白表达，而ML385能逆转该作用。模型组条件培养基可诱导SH-SY5Y细胞铁死亡，而经远志处理的BV2细胞条件培养基则减轻该现象；ML385预处理可削弱远志对SH-SY5Y细胞的保护作用，远志组铁离子、丙二醛、转铁蛋白受体1水平低于远志联合ML385组（P＜0.05），铁转运蛋白、谷胱甘肽和谷胱甘肽过氧化物酶水平高于远志联合ML385组（P＜0.05）。结论 远志皂苷元通过激活Nrf2/HO-1通路抑制BV2小胶质细胞炎症反应，并在脑出血体外模型中发挥神经保护作用。

     Objective To investigate whether the Nrf2/HO1 signaling pathway is involved in the regulatory effect of tenuigenin（TEN）on the inflammatory response of BV2 microglial cells in an in vitro intracerebral hemorrhage（ICH）model．Methods An in vitro ICH model was established by coculturing BV2 murine microglial cells with red blood cells．Cells were treated with TEN alone or in combination with the Nrf2 inhibitor ML385，and the levels of inflammatory factors were measured．The conditioned medium collected from the cell supernatant was used to culture SHSY5Y human neuroblastoma cells，and ferroptosis levels were assessed．Results The levels of inflammatory factors（IL-1β，IL-6，TNF-α）in BV2 cells of the model group were significantly higher than those in the control group（P＜0.001）．High concentration of TEN（20 μM）could reduce the levels of inflammatory factors and up-regulate the expression of Nrf2/HO-1 pathway proteins，while ML385 could reverse this effect．The conditioned medium of the model group could induce ferroptosis in SH-SY5Y cells，while the conditioned medium of BV2 cells treated with TEN could alleviate this phenomenon．Pretreatment with ML385 could weaken the protective effect of TEN on SH-SY5Y cells．The levels of iron ions，malondialdehyde and transferrin receptor protein 1 in the TEN group were lower than those in the TEN combined with ML385 group（P＜0.05），while the levels of ferroportin glutathione and glutathione peroxidase 4 were higher than those in the TEN combined with ML385 group（P＜0.05）．Conclusions TEN inhibits the inflammatory response of BV2 microglial cells by activating the Nrf2/HO1 pathway and exerts a neuroprotective effect in the in vitro ICH model．

       目的 汇总分析肝硬化患者消化道出血风险预测模型，为今后模型的建立和优化提供参考。方法   系统检索中国知网、维普、PubMed数据库在2025年4月22日前公开发表的所有肝硬化患者消化道出血风险预测模型，按纳入标准筛选文献，对最终纳入文章分析摘录并系统汇总，包括模型特征、危险因素及模型预测评估效果等信息。结果   共检索3 603篇预测模型相关研究论文，最终纳入30篇，其中中国27篇、韩国1篇、印度1篇、埃及1篇。22项研究收集了肝硬化病因，其中病毒性肝病最多（72.94%，2 922/4 006），药物性肝病及非酒精性脂肪性肝病最少（均为0.02%，1/4 006）。在研究类型上，有28篇单中心研究，2篇为多中心研究，其中有12个模型未进行验证，只有1个模型进行了外部验证，其余模型只进行了内部验证，曲线下面积（AUC）范围0.680~0.994。根据模型纳入因素特点，分为血常规指标、凝血指标、生化指标、影像学指标、复合指标、其他指标共6种，其中纳入因素最多为影像学指标，最少为凝血指标。在纳入危险因素中，第1位为门静脉直径，第2位为血小板计数，第3位为血红蛋白水平及脾脏硬度，所有因素中与脾脏相关的指标最多。结论   肝硬化患者消化道出血风险预测模型研究质量有待提升，影像学指标应用最广，脾脏相关指标重要性突出，门静脉直径、血小板计数、血红蛋白水平及脾脏硬度为最常用的危险预测因素。

       Objective  To  summarize and analyze the  prediction models for gastrointestinal  bleeding  risk in  patients with cirrhosis，providing references for the establishment and optimization of future models．Methods  A systematic search was conducted in CNKI，VIP，and PubMed for all published prediction models for gastrointestinal bleeding risk in patients with cirrhosis before April 22，2025．Articles were screened according to the inclusion criteria，and the finally included articles were analyzed and summarized，including model characteristics，risk factors，and model prediction evaluation effects．Results  A total of 3 603 related research papers on prediction models were initially retrieved，and 30 were finally included，with 27 from China，one from South Korea，one from India，and one from Egypt．Among the 22 studies that collected the etiology of cirrhosis，viral hepatitis was the most common（72.94%，2 922/4 006），while drug-induced liver disease and non-alcoholic fatty liver disease were the least common（0.02%，1/4 006）．In terms of study type，28 were single-center studies and two were multicenter studies．Among them，12 models were not validated，only one model was externally validated，and the rest were only internally validated，with an area under the curve range of 0.680-0.994．According to the characteristics of the factors included in the models，they were divided into six types of indicators：blood routine，coagulation，biochemistry，imaging，composite，and others，among which imaging indicators were the most common and coagulation indicators were the least．In the included risk factors，the first was portal vein diameter，the second was platelets count，and the third was hemoglobin level and spleen stiffness，with the most factors related to the spleen．Conclusions  The quality of studies on prediction models for gastrointestinal bleeding risk in cirrhosis patients needs to be improved．Imaging indicators are the most widely used，and spleen-related indicators are of prominent importance，with portal vein diameter，platelets count，hemoglobin level，and spleen stiffness being the most commonly used risk prediction factors．

       目的 探讨自发性脑出血（SICH）患者静脉血栓栓塞症（VTE）的独立危险因素,并评估针对性分层预防措施的有效性及安全性, 为临床优化防治策略提供依据。方法 回顾性纳入2022年1月—2025年1月收治的86例SICH患者, 根据下肢深静脉超声结果分为深静脉血栓（DVT）组（n=16）与非DVT组（n=70）。采集患者基线资料、临床特征及实验室指标, 采用单因素及多因素Logistic回归分析VTE危险因素, 并基于独立危险因素制定分层预防方案。结果 多因素分析显示, 体质指数（BMI）升高（OR=1.22, 95%CI：1.06~1.41）、中心静脉置管（OR=5.23, 95%CI：1.37~19.95）、止血药物使用（OR=4.80, 95%CI：1.21~19.01）及NIHSS评分升高（OR=1.20, 95%CI：1.02~1.42）是VTE的独立危险因素（均P<0.05）。因此需针对SICH患者进行针对性干预, 包括基于BMI的个体化干预、中心静脉置管的精细化管控、止血药物的动态调控及神经功能保护与早期康复。结论 SICH患者VTE发生与代谢、医源性及神经功能损伤多因素交互作用密切相关, 应针对患者构建基于BMI、中心静脉管理及凝血监测的分层预防策略。

       Objective To explore the independent risk factors for venous thromboembolism（VTE）in patients with spontaneous intracerebral hemorrhage（SICH）and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic．Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025．Based on lower-extremity venous ultrasound findings, patients were divided into a deep venous thrombosis（DVT）group（n=16）and a non-DVT group（n=70）．Baseline characteristics, clinical features, and laboratory indicators were collected．Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors, and a stratified prevention protocol was developed based on independent risk factors．Results Multivariate analysis revealed that elevated body mass index（BMI）（OR=1.22, 95%CI：1.06-1.41）, central venous catheterization（OR=5.23, 95%CI：1.37-19.95）, hemostatic drug use（OR=4.80, 95%CI：1.21-19.01）, and higher NIHSS scores（OR=1.20, 95%CI：1.02-1.42）were independent risk factors for VTE（all P<0.05）．Consequently, targeted nursing interventions should be implemented for SICH patients, including BMI-based personalized care, refined management of central venous catheters, dynamic regulation of hemostatic drugs, and neuroprotective early rehabilitation．Conclusions VTE in SICH patients is closely associated with the interplay of metabolic, iatrogenic,and neurological injury factors．A stratified prevention strategy incorporating BMI monitoring, central venous catheter management, and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety．

目的 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系, 并应用于临床,为急诊脑出血患者护理质量管理、监测与评价提供客观、科学的参考依据。方法 通过文献查阅、筛查与评价, 提取可行性资料, 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系的框架, 并采用德尔菲法完成两轮专家函询,确定最终的指标体系。选择2021年1月—2024年1月本院收治的230例急诊脑出血患者为研究对象, 将2021年1月—2022年6月作为干预前监测节点,该阶段的165例患者为传统组, 实施常规的护理质量管理;将2022年7月—2024年1月作为干预后监测节点,该阶段的165例患者为观察组, 实施以急诊脑出血患者护理质量评价指标进行护理质量监测管理。结果 两轮函询中专家积极系数分别为95%和100%, 意见提出率分别为56.25%和35.54%; 两轮函询专家权威系数为0.945、0.893; 第1轮函询中各项指标变异系数（CV）均值为0~0.136, Kendall’s W协调系数为0.065; 第2轮函询中变异系数（CV）均值为0~0.110, Kendall’s W协调系数为0.186。最终形成的急诊脑出血患者护理质量评价体系共涵盖一级指标3个、二级指标11个、三级指标55个。观察组入院-用药时间合格率、吞咽障碍患者动态评估率、气道管理合格率、早期被动/主动活动落实率高于传统组,差异具有统计学意义（χ²=14.850、12.261、8.183、37.420, P<0.05）, 观察组患者满意度明显高于传统组（χ²=14.049, P<0.001）。结论 本研究构建的急诊脑出血患者护理质量评价体系具有一定的科学性、可靠性和实用性, 可作为临床实现护理质量持续改进的重要评价工具。

Objective Based on the Donabedian model,the nursing quality evaluation system of emergency cerebral hemorrhage patients was constructed, and applied to clinical practice, providing an objective and scientific reference basis for realizing the nursing quality management, monitoring and evaluation of emergency cerebral hemorrhage patients．Methods Through literature review, screening and evaluation, the feasibility data was extracted, and the framework of the nursing quality evaluation system for patients with emergency cerebral hemorrhage was constructed based on the Donabedian model, and the Delphi method was adopted to complete two rounds of expert letter inquiry to determine the final index system．The study selected 230 patients with acute cerebral hemorrhage admitted to our hospital from January 2021 to January 2024 as the research subjects．The period from January 2021 to June 2022 was used as the pre-intervention monitoring period, during which 165 patients were in the traditional group, receiving routine nursing quality management．The period from July 2022 to January 2024 was used as the post-intervention monitoring period, during which 165 patients were in the observation group,implementing nursing quality monitoring and management based on evaluation indicators for the care of patients with acute cerebral hemorrhage．Results In the two rounds of letter inquiry, the positive coefficient of experts was 95% and 100%, respectively, and the rate of suggestions was 56.25% and 35.54%, respectively; the authority coefficient of experts in the two rounds of letter inquiry was 0.945 and 0.893．In the first round the mean value of coefficient of variation（CV）of each index was 0~0.136, and the coordination coefficient of Kendall’s W was 0.065; in the second round the mean value of variation coefficient（CV）was 0-0.110, and the coordination coefficient of Kendall's W was 0.186．The final nursing quality evaluation system for emergency cerebral hemorrhage patients covers 11 first-level indicators, 11 second-level indicators and 55 third-level indicators．The results showed that the pass rate of admission-medication time, dynamic assessment rate of dysphagia patients, airway management rate, and early passive / active activity implementation rate of the observation group were statistically significant different from those in the traditional group（χ²=14.850,12.261, 8.183, 37.420, P<0.05）, and the patient satisfaction in the observation group was significantly higher than that in the traditional group（χ²=14.049, P<0.001）．Conclusions The nursing quality evaluation system for emergency cerebral hemorrhage patients constructed in this study is scientific,reliable and practical, and can be used as an important evaluation tool to achieve continuous improvement of nursing quality in clinical practice．

自发性脑出血由于外伤性原因引起脑实质出血作为神经系统急危重症,该患病率约占所有脑卒中的10%~15%, 具有高患病率、高死亡率、高致残率的特点, 随着年龄的不断增长血管逐渐变薄、失去弹性,受到外在原因干扰时, 导致出血, 形成血肿, 依据血肿的不同程度, 患者的生存及预后有着显著的差异。因此快速且及时识别自发性脑出血尤为重要,可为临床医生评估患者病情变化及预后具有重要指导的意义, 然而在临床实践过程中对于快速识别脑出血的方法有所欠缺, 需要进一步优化其监测方法。因此本文综述了自发性脑出血的监测方法, 探讨通过无创监测、有创监测及联合监测自发性脑出血为临床快速高效判断脑出血提供科学的依据和参考。

The incidence of spontaneous cerebral hemorrhage accounts for about 10% to 15% of the stroke cases, and it has the characteristics of high incidence, high mortality rate, and high disability rate．It is very important to quickly identify spontaneous cerebral hemorrhage, which has important guiding significance for clinical doctors to evaluate patient condition changes and prognosis．This article reviews the latest research on non-invasive monitoring, invasive monitoring, and combined monitoring of spontaneous cerebral hemorrhage.

目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为（48.58±6.34）分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素（F=30.872,P<0.001）,解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。

目的 研究同轴微导管聚乙烯醇颗粒（PVA）栓塞治疗动脉性下消化道出血患者的应用效果。方法 本研究为前瞻性研究,选择河南科技大学第一附属医院2022年1月—2023年6月收治的118例动脉性下消化道出血患者为研究对象,以计算机随机分组法将其分为常规组和试验组,各59例。两组均行数字减影血管造影检查明确出血情况,常规组予以内镜下注射止血治疗,试验组经同轴微导管PVA栓塞进行止血治疗,比较两组患者的治疗效果及预后情况。结果 在不同治疗方案下,试验组的技术成功率、临床成功率分别为89.83%（53/59）、84.75%（50/59）,均高于常规组[71.19%（42/59）、64.41%（38/59）]（χ²=11.071、10.911,P<0.05）;试验组的止血时间、凝血酶原时间（PT）、凝血酶时间（TT）分别为（50.25±10.37）min、（10.25±2.31）s、（16.33±4.47）s,均低于常规组[（55.36±10.72）min、（12.44±3.61）s、（19.35±4.23）s]（t=2.632、3.925、3.769,P<0.05）;试验组治疗后的动脉搏动指数（PI）、阻力指数（RI）分别为（1.12±0.33）（0.51±0.21）,均低于常规组[（1.65±0.41）（0.73±0.22）]（t=7.735、5.556,P<0.05）;试验组治疗7、14、30 d后的再出血率分别为5.08%（3/59）、8.47%（5/59）、10.17%（6/59）,均低于常规组[20.34%（12/59）、25.42%（15/59）、28.81%（17/59）]（χ²=10.495、10.207、11.071,P<0.05）;试验组的并发症发生率8.47%（5/59）低于常规组22.03%（13/59）,差异均具有统计学意义（χ²=7.113,P<0.05）。结论 与常规内镜下止血相比,同轴微导管PVA栓塞可显著提升动脉性下消化道出血患者的止血成功率,对缩短患者止血时间、促进凝血系统恢复、降低再出血风险及相关并发症发生风险均有积极意义。

Objective To study the effect of coaxial microcatheter PVA embolization in the treatment of patients with arterial lower gastrointestinal bleeding．Methods This study is a prospective study,118 patients with arterial lower gastrointestinal bleeding admitted between January 2022 and June 2023 were selected as the study subjects．They were randomly divided into a conventional group（59 cases）and an experimental group（59 cases）using computer randomization．Both groups underwent digital subtraction angiography examination to determine the bleeding situation．The conventional group received conventional endoscopic hemostasis treatment,while the experimental group received coaxial microcatheter PVA embolization for hemostasis treatment．The treatment efficacy and prognosis were compared between two groups．Results Under different treatment plans,the technical success rate and clinical success rate of the experimental group were 89.83%（53/59）and 84.75%（50/59）,respectively,which were higher than those of the conventional group [71.19%（42/59）and 64.41%（38/59）]（χ²=11.071、10.911,P<0.05）．The hemostatic time,PT,and TT of the experimental group were（50.25±10.37）min,（10.25±2.31）seconds,and（16.33±4.47）seconds,respectively,which were shorter than those of the conventional group [（55.36±10.72）min,（12.44±3.61）seconds,and（19.35±4.23）seconds]（t=2.632、3.925、3.769,P<0.05）．The arterial PI and RI of the experimental group after treatment were（1.12±0.33） and（0.51±0.21）,lower than those of the conventional group [（1.65±0.41）and（0.73±0.22）]（t=7.735、5.556,P<0.05）．The rebleeding rates of the experimental group after 7 days,14 days and 30 days of treatment were 5.08%（3/59）,8.47%（5/59） and 10.17%（6/59）,respectively,which were lower than those of the conventional group [20.34%（12/59）,25.42%（15/59） and 28.81%（17/59）]（χ²=10.495,10.207,11.071,P<0.05）．The incidence of complications in the experimental group was 8.47%（5/59）,which was lower than that in the conventional group 22.03%（13/59）（χ²=7.113,P<0.05）．Conclusions Compared with conventional endoscopic hemostasis,coaxial microcatheter PVA embolization can significantly improve the success rate of hemostasis in patients with arterial lower gastrointestinal bleeding,shorten the hemostasis time,promote coagulation system recovery,reduce the risk of rebleeding and related complications,with a positive significance．

目的 分析产后出血预测评分与产妇凝血指标的相关性,以及出血预测评分对阴道分娩产后出血的预测效能。方法 采用回顾性研究,纳入2021年1月—2022年12月河南科技大学第二附属医院收治的136例阴道分娩产妇,根据产后出血情况,将合并产后出血的36例患者列为病例组,其余100例列为对照组,比较两组患者的产后出血预测评分及凝血指标,经Spearman相关性系数验证产后出血预测评分结果与凝血指标的相关性,依据实际出血情况,验证产后出血预测评分、各凝血指标对产后出血的预测效能。结果 病例组患者的产后出血预测评分为（7.33±2.46）分,D-二聚体（D-D）为（2.62±0.41）mg/L,均高于对照组[（6.14±2.06）分、（2.17±0.45）mg/L],纤维蛋白原（FIB）为（4.42±1.25）g/L,低于对照组（5.23±1.16）g/L;活化部分凝血活酶时间（APTT）为（37.44±10.25）s,凝血酶原时间（PT）为（15.45±4.12）s,凝血酶时间（TT）为（16.77±4.25）s,均高于对照组[（30.11±10.12）s、（12.49±4.11）s、（13.34±4.18）s],差异具有统计学意义（P<0.05）。经Spearman相关性系数分析,产后出血预测评分与经阴道分娩产妇的D-D、APTT、PT、TT呈正相关,与FIB呈负相关。通过绘制受试者工作特征曲线（ROC）后得知,产后出血预测评分及凝血指标对产后出血均有一定预测价值,但产后出血预测评分的AUC值大于各凝血指标。结论 产后出血预测评分与产妇凝血功能指标呈正相关,将产后出血预测评分与凝血指标检测相结合能实现对产后出血的早期识别及诊断。

Objective To analyze the correlation between postpartum bleeding prediction score and maternal blood coagulation index and the prediction efficiency of postpartum bleeding in vaginal delivery．Methods This is a retrospective study．The cases were included from January 2021 to December 2022．The subjects of the study were 136 vaginal delivery mothers． According to the delivery situation,36 patients with postpartum bleeding were included in the case group,and the rest 100 patients were included in the control group．The postpartum bleeding prediction score and coagulation indicators of the two groups were compared．The correlation between postpartum bleeding prediction score and coagulation indicators was verified by Spearman correlation coefficient．According to the actual bleeding situation,verify the predictive score for postpartum bleeding and the diagnostic efficacy of various coagulation indicators on postpartum bleeding．Results According to the test,the predictive score for postpartum bleeding in the case group was（7.33±2.46）,D-dimer（D-D）was（2.62±0.41）mg/L,which were higher than those in the control group [（6.14±2.06）,（2.17±0.45）mg/L]．Fibrinogen（FIB）was（4.42±1.25）g/L,lower than the control group（5.23±1.16）g/L,activated partial thromboplastin time（APTT）was（37.44±10.25）s,prothrombin time（PT）was（15.45±4.12）s,and thrombin time（TT）was（16.77±4.25）s．Compared with the control group [（30.11±10.12）s,（12.49±4.11）s,and（13.34±4.18）s）],the above indicators were all higher（P<0.05）．Through Spearman correlation coefficient analysis,the predictive score of postpartum bleeding was positively correlated with the D-D,APTT,PT,TT,negatively correlated with the FIB of the parturient who delivered through vagina．After drawing the ROC curve,it was found that both the postpartum hemorrhage prediction score and coagulation indicators had certain predictive value for postpartum hemorrhage,but the AUC value of the postpartum hemorrhage prediction score was greater than each coagulation indicator．Conclusions The prediction score of postpartum bleeding is positively correlated with the coagulation function indicators of the parturient,combining the score and indicators can achieve early identification and diagnosis of postpartum bleeding．

目的 探讨系统化护理流程干预对脑出血患者急救效果及预后的影响。方法 采用回顾性分析的方法,选取2022年2月—2023年2月新乡医学院第三附属医院急诊收治的210例脑出血患者,将2022年2月—2022年8月采取常规护理干预的105例患者作为常规组,将2022年9月—2023年2月采取系统化护理流程干预的105例患者作为研究组。对比两组患者抢救效率、急救效果、并发症发生率、预后水平、护理满意度情况。结果 研究组患者抢救总时间、会诊至确诊、分诊至会诊、接诊至分诊以及出诊反应时间短于常规组（P<0.05）;研究组急救总有效率高于常规组,并发症发生率低于常规组（P<0.05）;出院1个月、3个月后,两组患者神经功能缺损量表（NIHSS）评分均降低,简易智能状态检查量表（MMSE）评分升高,研究组变化幅度更大（P<0.05）;研究组患者护理满意度高于常规组（P<0.05）。结论 针对脑出血患者在急救过程中采取系统化护理流程干预能够提升患者的抢救效率和急救效果,并发症发生率低,改善患者的神经功能缺损情况,提升预后水平,且患者满意度较高。

Objective To explore the impact of systematic nursing process intervention on the emergency response and prognosis of patients with cerebral hemorrhage．Methods By retrospective analysis,210 patients with cerebral hemorrhage admitted to the emergency department of the Third Affiliated Hospital of Xinxiang Medical College from February 2022 to February 2023,105 patients with routine nursing intervention from February 2022 to August 2022 were selected as the routine group,and 105 patients with systematic nursing process intervention from September 2022 to February 2023 were selected as the study group．The rescue efficiency,first aid effect,complication rate,prognosis levels and nursing satisfaction of the two groups were compared．Results The total rescue time,consultation to diagnosis,triage to consultation,reception to triage and the response time to visit in the study group were significantly lower（P<0.05）．The total emergency response rate of the study group was higher than that of the conventional group,and the incidence of complications was significantly lower（P<0.05）．One month and 3 months after discharge,NIHSS score decreased in both groups,MMSE score increased,and the change range was greater in the study group（P<0.05）．The nursing satisfaction of the study group was significantly higher（P<0.05）．Conclusions For patients with cerebral hemorrhage,systematic nursing process intervention in the first aid process can improve the rescue efficiency and first aid effect of patients,reduce the incidence of complications,improve the neurological function defect of patients,improve the prognosis level,and the patient satisfaction is higher．