目的 探究血脂异常对左心室结构的影响及其与微循环损伤之间的关联。方法 将20只新西兰大白兔随机划分为血脂异常组和正常对照组。饲养8周后获取所有实验兔的离体心肌组织，测量左心室心肌结构评估指标（包括心肌质量、心腔内径大小以及室壁厚度）和病理学指标（心肌微血管密度和胶原体积百分比）；另外，通过对心肌组织氧化应激标记物的测定，评估实验兔心肌组织中一氧化氮（NO）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）以及丙二醛（MDA）等生化指标。结果 对于左心室结构指标，血脂异常组的左心室心肌质量及室间隔厚度较正常对照组显著增加（P均＜0.001）；对于组织病理学指标，血脂异常组的心肌微血管密度显著降低，而胶原体积百分比则显著升高（P均＜0.001）。对于生化指标，血脂异常组NO、SOD以及GSH-Px水平均显著降低，MDA水平显著升高（P均＜0.001）。室间隔厚度与心肌组织胶原体积百分比、MDA水平呈正相关，与心肌组织微血管密度、NO、SOD、以及GSH-Px水平呈负相关（P均＜0.001）。与正常对照组对比，血脂异常组心肌组织出现明显脂肪变性、炎细胞浸润以及心肌纤维组织增生、排列紊乱。结论 血脂异常可导致新西兰大白兔左心室不良重塑，且与心肌微循环损伤之间存在密切关联，这提示血脂异常早期防控可能有助于改善心血管事件不良预后。

      Objective To explore the impact of dyslipidemia on left ventricular（LV） structure and its association with myocardial microcirculatory injury．Methods Twenty New Zealand white rabbits were randomly divided into the dyslipidemia group and the normal control group．After 8 weeks of feeding，the isolated myocardial tissues of all experimental rabbits were obtained．The LV myocardial structure assessment indicators（including myocardial mass，heart cavity diameter and ventricular wall thickness） and pathological indicators（myocardial microvascular density and collagen volume fraction［CVF］） were measured．Additionally，the biochemical indicators such as nitric oxide（NO），superoxide dismutase（SOD），glutathione peroxidase（GSH-Px） and malondialdehyde（MDA） in the myocardial tissues of the experimental rabbits were evaluated by measuring the oxidative stress markers in the myocardial tissues．Results For the LV structural indicators，the myocardial mass and interventricular septal thickness in the dyslipidemia group were significantly increased compared with the normal control group（P＜0.001 for both）．For the histopathological indicators，the myocardial microvascular density in the dyslipidemia group was significantly decreased，while the CVF was significantly increased（P＜0.001 for both）．For the biochemical indicators，the levels of NO，SOD，and GSH-Px in the dyslipidemia group were significantly decreased，while the MDA level was significantly increased（P＜0.001 for all）．The interventricular septal thickness was positively correlated with the CVF and MDA level in myocardial tissue，and negatively correlated with the myocardial microvascular density，NO，SOD，and GSH-Px levels（P＜0.001 for all）．Compared with the normal control group，the myocardial tissue in the dyslipidemia group showed obvious fatty degeneration and inflammatory cell infiltration，as well as myocardial fibrous tissue hyperplasia and disordered arrangement．Conclusions Dyslipidemia can lead to adverse LV remodeling in New Zealand white rabbits and is closely related to myocardial microcirculatory injury．This suggests that early prevention and control of dyslipidemia may help improve the poor prognosis of cardiovascular events．

       目的 研究数字化口内扫描印模技术（DIOS）对重度牙周炎（SP）患者口腔种植修复效果及龈沟液炎症因子水平的影响并进行分析。方法 选取医院2022年1月—2025年1月收治的100例SP患者进行研究。以密封信封抽签法分为数字化组（n=50）及常规组（n=50）。两组均开展口腔种植修复，常规组采用常规硅橡胶印模技术，数字化组则采用DIOS。对比两组印模制取时间、印模过程中疼痛程度及种植成功率、修复体满意度、龈沟液炎症因子水平、并发症发生情况。结果 数字化组印模制取时间短于常规组，VAS评分低于常规组，而种植成功率高于常规组（均P＜0.05）。数字化组边缘密合度、咬合关系、邻接关系满意度均高于常规组（均P＜0.05）。修复3个月后两组龈沟液各项炎症因子水平均低于修复前，且数字化组低于常规组（均P＜0.05）。数字化组并发症总发生率低于常规组（P＜0.05）。结论 DIOS可显著提高SP患者口腔种植修复效果，降低龈沟液炎症因子水平，减少并发症的发生。

      Objective To investigate the effects of digital intraoral scanner（DIOS）on the oral implant restoration effect and the levels of inflammatory factors in gingival crevicular fluid in patients with severe periodontitis（SP）．Methods A total of 100 SP patients admitted to the hospital from January 2022 to January 2025 were selected for the study．They were divided into the digital group（n=50）and the conventional group（n=50）by the sealed envelope lottery method．Both groups underwent oral implant restoration．The conventional group used the conventional silicone rubber impression technology，while the digital group underwent DIOS．The time of impression preparation，the degree of pain during the impression process，the success rate of implantation，the satisfaction of restorations，the levels of inflammatory factors in gingival crevicular fluid，and the occurrence of complications were compared between the two groups．Results The impression acquisition time of the digital group was shorter than that of the conventional group，the VAS score was lower than that of the conventional group，while the implantation success rate was higher than that of the conventional group（all P＜0.05）．The marginal fit，occlusal relationship and adjacent relationship in the digital group were all higher than those of the conventional group（all P＜0.05）．Three months after repair，the levels of various inflammatory factors in gingival crevicular fluid in both groups were lower than those at admission，and the digital group was lower than the conventional group（all P＜0.05）．The total incidence of complications in the digital group was lower than that in the conventional group（P＜0.05）．Conclusions DIOS can significantly improve the oral implant restoration effect of SP patients，reduce the levels of inflammatory factors in gingival crevicular fluid，and reduce the occurrence of complications．

目的 了解危重产妇代理决策者的决策困境现状及其影响因素。方法 选择2022年10月—2023年10月许昌市中心医院产科及ICU的262例危重产妇及其代理决策者作为研究对象。应用一般资料问卷、母婴健康素养问卷、决策困境量表、决策参与期待量表进行调查。结果 决策困境量表总分为（39.38±14.58）分,其中信息提供和价值观明确总分为（13.91±7.16）分、社会支持和决策有效性总分为（20.41±8.25）分、不确定性总分为（5.06±1.96）分。多元线性回归分析发现,性别、学历、决策时间和脑卒中防治知识总分对危重产妇代理决策者决策困境均有影响（P<0.05）。结论 危重产妇代理决策者存在决策困境,医护人员需要根据代理决策者的人口学特征、疾病防治知识以及患者疾病特征进行决策辅助,减轻其决策困境,提升决策质量。

Objective To understand the current situation and influencing factors of decision-making difficulties among surrogate decision-makers for critically ill puerpera．Methods A total of 262 critically ill puerpera and their surrogate decision-makers from the obstetrics and ICU of Xuchang Central Hospital from October 2022 to October 2023 were selected．A survey was conducted using the General Information Questionnaire,Maternal and Child Health Literacy Questionnaire,Decision Dilemma Scale,and Decision Participation Expectancy Scale．Results The total score of the Decision Dilemma Scale was（39.38±14.58）,with a total score of（13.91±7.16）for information provision and clear values,（20.41±8.25）for social support and decision effectiveness,and（5.06±1.96）for uncertainty．Multiple linear regression analysis found that gender,education level,decision time and total score of stroke prevention and control knowledge all have an impact on the decision-making difficulties of surrogate decision-makers in critically ill puerpera（P<0.05）．Conclusions There is a decision-making dilemma for the surrogate decision-makers of critically ill puerpera．Medical staff need to provide decision-making assistance based on the demographic characteristics,disease prevention and control knowledge,and patient disease characteristics of the surrogate decision-makers,in order to alleviate their decision-making difficulties and improve the quality of decision-making．

目的 调查分析ICU转出患者的陪床家属即照顾者的准备度对其迁移应激的影响作用。方法 纳入2020年1月—2022年12月在焦作市第二人民医院ICU住院治疗的患者家属106人为研究对象,以问卷调查法对患者及家属一般资料、家属准备度水平以及迁移应激水平进行数据分析。结果 ICU转出患者家属的照顾者准备度测试总分为（14.92±3.86）分,为中等水平,迁移应激总分为（57.21±5.88）分,为中度应激水平,照顾准备度与迁移应激呈负相关。结论 ICU转出患者家属的照顾者准备度水平不足,且与迁移应激水平呈负相关。

Objective To investigate and analyze the effect of readiness of accompanying family members,i.e．caregivers,on migration stress in patients transferred out of the ICU．Methods From January 2020 to December 2022,106 patients hospitalized in ICU were included in the study,general data of patients and their caregives,preparation level and migration stress level of caregives were investigated and analyzed by questionnaire survey．Results The caregivers of patients transferred out of the ICU had a total readiness test score of（14.92±3.86）,which was moderate level,and the total score of migration stress was（57.21±5.88）,which was moderate stress level,and was negatively correlated with readiness．Conclusions The readiness level of the caregivers of patients transferred out of the ICU is insufficient and negatively correlated with the migration stress level．

目的 观察布托啡诺联合舒芬太尼镇痛方案在重症监护病房（ICU）机械通气患者中的效果及对血流动力学的影响。方法 采用前瞻性、随机对照研究,选取2021年3月—2023年3月商丘市第三人民医院ICU收治的118例机械通气患者,按1∶1随机分为观察组、对照组各59例。观察组采取布托啡诺联合舒芬太尼镇痛方案,对照组采取舒芬太尼镇痛方案。比较两组镇静、镇痛情况（镇静起效时间、停药后苏醒时间、机械通气时间、ICU住院时间、丙泊酚总用量）。以用药前（T0）、用药后6 h（T1）、12 h（T2）、24 h（T3）为时间节点,比较两组血流动力学指标[心率（HR）、平均动脉压（MAP）]。以用药后6 h（t1）、12 h（t2）、18 h（t3）、24 h（t4）为时间节点,比较两组Ricker镇静-躁动评分（SAS）、重症监护疼痛观察工具（CPOT）评分。比较两组不良反应发生情况。结果 用药后观察组镇静起效、停药后苏醒、机械通气、ICU住院时间均短于对照组,丙泊酚总用量少于对照组（P<0.05）;t1~t4时观察组CPOT评分均低于对照组,SAS评分均高于对照组（P<0.05）;T1、T2、T3时观察组HR、MAP波动幅度小于对照组（P<0.05）;观察组不良反应总发生率为10.17%,与对照组15.25%相比,差异无统计学意义（P>0.05）。结论 布托啡诺、舒芬太尼联合治疗ICU机械通气患者,可有效增强镇静、镇痛效果,维持血流动力学稳定,且安全性较高,有利于促进患者病情转归。

Objective To observe the effect of butorphanol and sufentanil combined analgesia regimen in patients with mechanical ventilation in intensive care unit（ICU）and its influence on hemodynamics．Methods A prospective,randomized controlled study was carried out on 118 patients with mechanical ventilation in ICU from March 2021 to March 2023,and the enrolled patients were randomly divided into observation group and control group with 59 cases in each group．The observation group received butorphanol combined with sufentanil analgesia regimen,and the control group received sufentanil analgesia regimen．The conditions of sedation and analgesia（sedation onset time,recovery time after drug withdrawal,mechanical ventilation time,ICU stay length,total dosage of propofol）were compared between the two groups．The hemodynamic indexes [heart rate（HR）and mean arterial pressure（MAP）] of the two groups were compared before medication（T0）,6 h（T1）,12 h（T2）and 24 h（T3）after medication as time nodes．At 6 h（t1）,12 h（t2）,18 h（t3）,24 h（t4）after medication,Ricker Sedation-Agitation Scale（SAS）and Critical Care Pain Observation Tool（CPOT）score were compared between the two groups．The occurrence of adverse reactions was compared between the two groups．Results The onset of sedation,recovery after drug withdrawal,mechanical ventilation and ICU stay in the observation group were shorter than those in the control group,and the total dosage of propofol was lower than that in the control group（P<0.05）．At t1 to t4,CPOT score of observation group was lower than that of control group,and SAS score was higher than that of control group（P<0.05）．The fluctuation amplitude of HR and MAP in the observation group was smaller than that in the control group at T1,T2 and T3（P<0.05）．The total incidence of adverse reactions in the observation group was 10.17%,compared with 15.25% in the control group,the difference was not statistically significant（P>0.05）．Conclusions The combination of butorphanol and sufentanil in the treatment of patients with mechanical ventilation in ICU can effectively enhance sedation and analgesia,maintain hemodynamic stability,and have high safety,which is conducive to promote the outcome of the disease．

目的 探讨子宫内膜异位症（EMT）患者卵泡液来源的外泌体差异微小RNA（miRNA）对卵母细胞质量的影响。方法 收集2021年12月—2022年3月在广州市第一人民医院生殖医学中心进行体外受精-胚胎移植/卵细胞浆内单精子注射助孕的20例不孕症患者的卵泡液,分为EMT组（EMT不孕症患者10例）和对照组（单纯男性因素不孕症患者10例）。采用高通量测序对卵泡液外泌体微小RNA（miRNA）谱进行分析,选出具有组间差异的miRNAs。结果 与单纯男性因素不孕患者相比,EMT组有18个外泌体miRNAs差异有统计学意义,其中上调9个、下调9个。靶基因预测并采用GO和KEGG富集分析发现,这些靶基因主要参与磷脂酰肌醇-3-激酶/蛋白激酶B（ PI3K-Akt）、核苷酸结合寡聚结构域NOD样受体、Ras等信号通路。结论 EMT患者卵泡液来源的外泌体miRNA存在差异,差异的外泌体miRNAs可能通过多个信号通路影响EMT患者卵母细胞质量。

Objective To investigate the effect of differential microRNA（miRNA）derived from follicular fluid exosomes on oocyte quality in patients with endometriosis（EMT）. Methods Follicular fluid was collected from 20 infertile patients undergoing IVF-ET / ICSI in the Reproductive Medicine Center of Guangzhou First People's Hospital from December 2021 to March 2022,including EMT group（10 patients with EMT infertility）and control group（10 patients with simple male factor infertility）．The miRNA spectrum in follicular fluid exosomes was analyzed by high-throughput sequencing and miRNAs with differences between groups were selected. Results Compared with patients with infertility due to simple male factors,there were significant differences in 18 exosomal miRNAs in the EMT group,of which 9 were up-regulated and 9 were down-regulated．GO and KEGG enrichment analysis showed that these target genes were mainly involved in phosphatidylinositol-3-kinase / protein kinase B,Nucleotide binding oligomerization domain-like receptor and other signaling pathways. Conclusions There are differences in follicular fluid-derived exosomal miRNAs in EMT patients．Differential exosomal miRNAs may affect oocyte quality in EMT patients through multiple signaling pathways．

目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%（χ²=3.887,P<0.05）,观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为（3.09±1.25）（4.17±2.24）（3.95±1.53）（4.05±1.77）d,均低于对照组（5.14±2.43）（7.03±3.23）（6.40±2.62）（6.32±1.81）d（t=5.143、4.988、5.536、6.147,P<0.05）,观察组的 C 反应性蛋白（C-reactive protein,CRP）、白细胞介素-6（Interleukin-6,IL-6）以及Toll样受体4（Toll-like receptor 4,TLR-4）水平分别为（3.64±0.87）mg/L、（54.59±10.65）ng/mL、（7.94±1.57）%,均低于对照组（7.51±1.43）mg/L、（87.66±11.17）ng/mL、（12.11±2.48）%（t=15.850、14.690、9.740,P<0.05）,观察组的气道压力、动脉血二氧化碳分压（partial pressure of carbon dioxide in artery,PaCO₂）水平分别为（6.92±3.60）cmH₂O、（43.19±6.29）mmHg,低于对照组（8.68±2.98）cmH₂O、（55.43±5.95）mmHg,观察组动脉氧分压（Partial arterial oxygen pressure,PaO₂）（86.06±5.31）mmHg、血氧饱和度（oxyhemoglobin saturation,SpO₂）（98.03±6.63）%高于对照组（68.04±5.19）mmHg、（90.22±5.51）%要高（t=2.582、9.692、16.638、6.221,P<0.05）,观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义（χ²=2.849,P>0.05）。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。

Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group．The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration．The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group（χ²=3．887,P<0.05）．The relief time of fever,pulmonary rale,cough and sputum in observation group was（3.09±1.25）d,（4.17±2.24）d,（3.95±1.53）d,and（4.05±1.77）d,respectively,which were significantly lower than the control group[（5.14±2.43）d,（7.03±3.23）d,（6.40±2.62）d and（6.32±1.81）d]（t=5.143,4.988,5.536,6.147,P<0.05）．The levels of CRP,IL-6 and TLR-4 in the observation group were（3.64±0.87）mg/L,（54.59±10.65）ng/mL and（7.94±1.57）%,respectively．They were significantly lower than（7.51±1.43）mg/L,（87.66±11.17）ng/mL and（12.11±2.48）% in the control group（t=15.850,14.690,9.740,P<0.05）．The airway pressure and PaCO₂ levels of the observation group were（6.92±3.60）cmH₂O and（43.19±6.29）mmHg,respectively,which were significantly lower than those of the control group[（8.68±2.98）cmH₂O and（55.43±5.95）mmHg]．The levels of PaO₂[（86.06±5.31）mmHg] and SpO₂[（98.03±6.63）%] in the observation group were higher than those in the control group[（68.04±5.19）mmHg and（90.22±5.51）%],and there were statistically significant differences（t=2.582,9.692,16.638,6.221,P<0.05）．The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference（χ²=2.849,P>0.05）. Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients．

目的 探讨常规超声心动图联合二维斑点追踪技术评估急性白血病患儿在接受蒽环类药物治疗后产生的心脏毒性,早期检测左心功能障碍。方法 采用前瞻性非随机观察研究,选取新诊断急性淋巴细胞白血病患儿20例,分别于确诊白血病后接受蒽环类药物治疗前、接受所有蒽环类药物剂量后以及确诊白血病1年后,进行常规超声心动图和二维斑点技术监测评估心脏毒性。结果 左室流出道速度积分TVI和E、E/E’在治疗期间下降,并在诊断后1年恢复至治疗前数值。在二维斑点追踪纵向应变中,GLPS-LAX、GLPS-A2C、LV-GLPS在完成所有蒽环类药物剂量后与诊断后比较差异有统计学意义,以及诊断后1年与蒽环类药物治疗后比较差异有统计学意义。但GLPS-A4C各时间点比较差异无统计学意义。结论 常规超声心动图联合二维斑点追踪技术的纵向整体应变可早期发现白血病患儿化疗所致的左室功能障碍。

Objective To evaluate cardiotoxicity in children with acute lymphoblastic leukemia treated with anthracyclines by echocardiography combined with 2D speckle tracking imaging,and to detect left heart dysfunction early．Methods In this prospective nonrandomized study,20 children with newly diagnosed acute lymphoblastic leukemia were assessed for cardiotoxicity by echocardiography and 2D speckle tracking imaging in three periods during the treatment．Results The left ventricular outflow tract velocity integral TVI and E,E/E’ decreased during treatment,and went back to the pre-treatment value one year after diagnosis．In the longitudinal strain of 2D speckle tracking imaging,in GLPS-LAX,GLPS-A2C,LV-GLPS,there were statistical differences between treatment completed and after diagnosis,and between 1 year after diagnosis and treatment completed．However,GLPS-A4C has no statistical significance．Conclusion sThe conventional echocardiography combined with longitudinal overall strain of 2D speckle tracking imaging can comprehensively evaluate the early changes of left ventricular dysfunction caused by chemotherapy in children with leukemia．

目的 探讨超声监测导向下早期肠内营养（EEN）在重症脓毒血症（SS）有创通气（IV）患者中的应用效果。方法 选取2021年2月—2023年11月连州市人民医院收入的115例SS-IV患者,依据随机数字表法分为对照组（n=57）、超声监测组（n=58）。所有患者均予重症监护病房（ICU）综合治疗,在此基础上对照组实施临床经验的传统肠内营养（EN）干预,超声监测组实施超声监测导向下EEN干预,均监测至治疗结束。统计两组IV时间、ICU停留时间、EN达标时间、EN不耐受发生率、相关并发症发生率,比较干预前、EN结束时营养状况[白蛋白（ALB）、总蛋白（TP）、前白蛋白（PA）]、序贯器官衰竭评分（SOFA）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。结果 对照组剔除放弃治疗1例,死亡2例,纳入54例;超声监测组剔除放弃治疗1例,死亡1例,纳入56例。超声监测组EN达标时间[（40.18±8.46）h]、IV时间[（7.12±1.44）d]、ICU停留时间[（9.21±1.63）d]短于对照组[（46.03±10.15）h、（8.02±1.62）d、（10.18±1.54）d]（t=3.288、3.082、3.206,均P<0.05）。EN结束时超声监测组SS-IV患者血清ALB[（32.05±3.13）g/L]、TP[（65.36±3.62）g/L]、PA[（0.24±0.06）g/L]高于对照组[（30.28±2.24）g/L、（63.28±4.24）g/L、（0.21±0.05）g/L]（t=3.400、2.770、2.843,均P<0.05）。EN结束时超声监测组APACHEⅡ评分[（15.85±1.93）分]、SOFA评分[（7.42±1.64）分]低于对照组[（17.02±2.04）分、（8.35±2.03）分]（t=3.091、2.648,均P<0.05）。超声监测组EN不耐受发生率[12.50%（7/56）]低于对照组[29.63%（16/54）],超声监测组相关并发症发生率[8.93%（5/56）]低于对照组[24.07%（13/54）]（χ²=4.878、4.608,均P<0.05）。结论 超声监测导向下EEN干预应用于SS-IV患者,可改善患者病情与营养状况,降低EN不耐受及相关并发症发生风险,缩短恢复时间。

Objective To investigate the effect of ultrasound monitoring guided early enteral nutrition（EEN）in patients with severe sepsis（SS）and invasive mechanical ventilation（IV）．Methods A total of 115 SS-IV patients admitted to Lianzhou People's Hospital from February 2021 to November 2023 were randomly divided into control group（n=57）and ultrasound monitoring group（n=58）．All patients were given comprehensive treatment in intensive care unit（ICU）．On this basis,traditional enteral nutrition（EN）intervention with clinical experience was implemented in control group,and EEN intervention guided by ultrasonic monitoring was implemented in ultrasound monitoring group．All patients were monitored until the end of treatment．IV time,ICU stay time,EN compliance time,incidence of EN intolerance,and incidence of related complications were analyzed in the 2 groups．Nutritional status [albumin（ALB）,total protein（TP）,prealbumin（PA）],sequential organ failure assessment（SOFA）,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）were compared before intervention and at the end of EN．Results In control group,1 cases gave up,2 cases died,and 54 cases were included．In ultrasound monitoring group,1 case gave up,1 case died,and 56 cases were included．The EN compliance time [（40.18±8.46）h],IV time [（7.12±1.44）d] and ICU stay time [（9.21±1.63）d] of ultrasound monitoring group were shorter than those of control group [（46.03±10.15）h,（8.02±1.62）d,（10.18±1.54）d]（t=3.288,3.082,3.206,all P<0.05）．At the end of EN,serum ALB[（32.05±3.13）g/L],TP[（65.36±3.62）g/L],PA[（0.24±0.06）g/L] of SS-IV patients in ultrasound monitoring group were higher than those in control group [（30.28±2.24）g/L,（63.28±4.24）g/L,（0.21±0.05）g/L]（t=3.400,2.770,2.843,all P<0.05）．At the end of EN,APACHEⅡ scores [（15.85±1.93）points] and SOFA scores [（7.42±1.64）points] of ultrasound monitoring group were lower than those of control group [（17.02±2.04）points and（8.35±2.03）points]（t=3.091,2.648,all P<0.05）．The incidence of EN intolerance in ultrasound monitoring group [12.50%（7/56）] was lower than that in control group [29.63%（16/54）],and the incidence of related complications in ultrasound monitoring group [8.93%（5/56）] was lower than that in control group [24.07%（13/54）]（χ²=4.878,4.608,all P<0.05）．Conclusions EEN intervention guided by ultrasonic monitoring in SS-IV patients can improve the nutritional status of patients,reduce the risk of EN intolerance and related complications,shorten the recovery time,and reduce the progression of patients' disease．

目的 探讨高频超声对小儿梅克尔憩室所致肠梗阻的诊断价值。方法 选取广州市妇女儿童医疗中心2018年1月—2023年12月经手术证实的由梅克尔憩室引起的肠梗阻患儿41例作为研究对象,回顾性分析患儿临床资料及超声表现,并与术中所见和病理结果进行对照。结果 41例患儿,发病平均年龄为（3.97±3.69）岁,其中男32例、女9例。术前超声诊断肠梗阻38例,诊断符合率为92.7%;诊断梅克尔憩室所致肠梗阻9例,诊断符合率为21.9%。术中诊断梅克尔憩室索带卡压肠管24例,腹内疝8例,肠扭转1例;肠套叠10例;梅克尔憩室炎症、粘连6例,粘连穿孔1例;憩室内异物并穿孔1例。结论 高频超声对小儿肠梗阻有重要的诊断价值,仔细探查可以明显提高梅克尔憩室所致肠梗阻的临床诊断率,为临床尽早手术提供重要依据。

Objective To investigate the diagnostic value of high frequency ultrasound for intestinal obstruction caused by Meckel's diverticulum in children．Methods From January 2018 to December 2023,41 children with intestinal obstruction caused by Meckel's diverticulum were selected as the study objects．The clinical data and ultrasound images of the children were analyzed retrospectively,and compared with the intraoperative and pathological results．Results In 41 patients,the average age of onset was（3.97±3.69）years ,including 32 males and 9 females．Preoperative ultrasonic diagnosis of intestinal obstruction in 38 cases,diagnosis coincidence rate was 92.7%．Intestinal obstruction caused by Meckel's diverticulum was diagnosed in 9 cases,the diagnosis coincidence rate was 21.9%．During the operation,24 cases of Meckel's diverticulum intestinal compression were diagnosed,8 cases of abdominal hernia,1 case of intestinal torsion,and intussusception of 10 cases．Meckel's diverticulum had inflammation and adhesion in 6 cases and adhesion perforation in 1 case．A case of foreign body in diverticulum with perforation．Conclusions High-frequency ultrasound has an important diagnostic value for intestinal obstruction in children．Careful exploration can significantly improve the clinical diagnosis rate of intestinal obstruction caused by Meckel's diverticulum,and provide an important basis for early clinical operation．