论著

住院老年患者PICC相关性血栓的影响因素分析

Analysis of influencing factors for PICC-related thrombosis in hospitalized elderly patients

:433-445
 
      目的 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.
论著

消化系统恶性肿瘤患者营养风险及营养知信行分析

Research on nutritional risk and nutritional knowledge - attitude - behavior among patients with digestive system malignant tumors

:491-499
 
      目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为(知信行)水平的现状,探究各因素是否对患者的营养风险、营养知信行水平具有影响,并分析两者之间的相关性。方法 选取中山大学附属第八医院(深圳福田)2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象,采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查,数据收集后进行统计分析,从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险,营养风险评分为(2.72±1.42)分。消化系统恶性肿瘤患者营养知识水平得分为(12.30±5.26)分、营养态度水平得分为(14.80±2.68)分、营养行为水平得分为(22.82±4.55)分、营养知信行水平总分为(49.96±9.50)分。家庭经济收入是患者营养风险水平的核心影响因素(P<0.05),学历水平是患者营养知信行水平的核心影响因素(P<0.05)。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关(r=-0.143,P<0.05)。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平,但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要,这将有助于提升患者的营养知识水平,从而整体性改善其营养知信行素养并降低其营养风险,但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。
    Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors,to analyze the influencing factors of nutritional risk,nutritional knowledge-attitude-behavior,and explore the correlation between them.Methods From February 2024 to October 2024,244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects.A general information questionnaire,Nutritional Risk Screening 2002,and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3,and the overall score was(2.72±1.42).The scores of nutritional knowledge,attitude,behavior and total score of digestive system malignant tumors patients were(12.30±5.26),(14.80±2.68),(22.82±4.55)and(49.96±9.50),respectively.Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors,while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior.Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level,but there is a widespread situation of relatively high nutritional risk.It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period,which will help enhance patients’ nutritional knowledge level,thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks.However,when conducting nutrition education and formulating personalized nutrition plans,the patient’s family economic income,medical payment methods and educational level should be fully considered.

论著

广州市公职人员眼睑黄色瘤患病情况及影响因素分析

Xanthelasma palpebrarum in Guangzhou government employees:Prevalence and risk factors

:500-506
 
      目的 探讨广州市公职人员中眼睑黄色瘤(XP)患病情况与生化检验指标异常的相关性。方法 从2018年来广州市干部和人才健康管理中心体检的公职人员中选取1 090例,其中筛选患XP人员545例,作为病例组,依性别、年龄分层随机抽取的未患XP的人员作为对照组,测定空腹血糖、血脂、甲状腺功能等生化指标,采用回顾性病例对照研究的方式,比较两组相关指标水平。P<0.05为差异有统计学意义。结果 XP的患病率为0.94%(男性为0.89%,女性为1.01%)。男性和女性的XP患病率比较差异无统计学意义(χ2=2.142,P=0.143)。两组间体质量、舒张压、血脂等多项指标上的差异具有统计学意义(P<0.05)。高体质量(OR=1.021,95%CI:1.004~1.038,P=0.017)、高舒张压(OR=1.019,95%CI:1.004~1.035,P=0.011)、低高密度脂蛋白(OR=6.127,95%CI:2.568~14.619,P<0.001)、高低密度脂蛋白(OR=2.084,95%CI:1.456~2.981,P<0.001)是患病的危险因素。结论 广州市公职人员中XP的患病率男性和女性接近;高体质量、高舒张压、高密度脂蛋白水平降低、低密度脂蛋白水平升高是患XP的危险因素。
   Objective To investigate the correlation between xanthelasma palpebrarum(XP)and abnormal biochemical indices in healthy individuals in Guangzhou,China.Methods A retrospective case-control study was conducted,selecting 1 090 individuals from a total of 58 053 who underwent health examinations at the Guangzhou Cadre and Talent Health Management Centre in 2018.The case group consisted of 545 individuals diagnosed with XP,while the control group included age- and sex-matched individuals without XP,randomly selected from the same database.Biochemical indices analyzed included fasting blood glucose,blood lipids,liver and kidney function,thyroid indicators,body weight,and blood pressure.Statistical significance was set at P<0.05.Results The prevalence of XP was 0.94%(0.89% in men and 1.01% in women).No significant difference was observed in the prevalence of XP between men and women(χ2=2.142,P=0.143).Similarly,no significant differences were observed in thyroid-stimulating hormone(P=0.937),free triiodothyronine(P=0.216),free thyroxin(P=0.206),or fasting blood glucose levels(P=0.668)between the case and control groups.However,significant differences were noted in body weight,diastolic blood pressure,blood lipid levels,and liver and renal biochemical indicators between the two groups(P<0.05).Specifically,higher body weight(OR=1.021,95%CI:1.004–1.038,P=0.017),higher diastolic blood pressure(OR=1.019,95%CI:1.004–1.035,P=0.011),lower high-density lipoprotein(OR=6.127,95%CI:2.568–14.619,P<0.001),and higher low-density lipoprotein(OR=2.084,95%CI:1.456–2.981,P<0.001)were identified as risk factors for XP.Conclusions The prevalence of XP did not differ between males and females.However,high body weight,high diastolic blood pressure,low high-density lipoprotein,and high low-density lipoprotein are risk factors for XP.


医院管理

基于药品集中带量采购政策下的医院药品供应保障的现状及对策分析

Analysis of the current situation and countermeasures of hospital drug supply guarantee based on the policy of centralized and volume-based procurement

:529-533
 
       目的 分析药品集中带量采购(集采)政策下医院药品供应保障实况,提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据,描述性统计分析集采药品供应情况。结果 采购的416个中标药品中,69个在购销合同期内短缺,短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关,季节性强,以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力,保障供应。
   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement(hereinafter referred to as “central procurement”),and proposes optimization strategies and suggestions for the policy and guarantee.Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024,descriptive statistical analysis of the drug supply situation through centralized procurement was conducted.Results Among the 416 selected drugs purchased,69 were in short supply during the contract period,with a shortage rate of 16.59%.The reasons for the shortage were related to the production capacity of the enterprise,seasonal demand fluctuations,strong seasonality,and mainly chronic diseases and anti-infective.Conclusions It is suggested to build a monitoring platform,improve the reporting system,formulate emergency plans,and evaluate the supply capacity to ensure supply.

基于Logistic多因素回归分析糖尿病肾病患者发生贫血的影响因素分析及联合诊断模型构建

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目的 基于Logistic多因素回归分析探讨糖尿病肾病(DKD)患者发生贫血的独立影响因素,并构建诊断模型。方法 回顾性选取2020年1月—2025年8月我院收治的200例DKD患者,依据贫血发生情况,将患者分为贫血组(80例)与非贫血组(120例)。比较2组临床资料,采用Logistic多因素回归分析DKD患者发生贫血的影响因素,并构建DKD患者发生贫血的联合诊断模型。结果 贫血组糖尿病病程、肾病分期G3~G4患者占比、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、甘油三酯(TG)水平高于非贫血组,免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、白蛋白(ALB)、低密度脂蛋白胆固醇(LDL-C)水平低于非贫血组,差异有统计学意义(P<0.05);糖尿病病程(OR=1.723,95%CI:1.317~2.254)、肾病分期(OR=5.202,95%CI:2.338~11.573)、TNF-α(OR=2.861,95%CI:1.636~5.001)、hs-CRP(OR=2.073,95%CI:1.440~2.985)、IgM(OR=0.470,95%CI:0.331~0.667)、ALB(OR=0.533,95%CI:0.378~0.753)、TG(OR=3.016,95%CI:1.833~4.962)均为DKD患者发生贫血的影响因素,差异有统计学意义(P<0.05);基于Logistic回归分析构建联合诊断模型:Logit(P)=-0.218+0.544×糖尿病病程+1.649×肾病分期+1.051×TNF-α+0.729×hs-CRP+(-0.756)×IgM+(-0.629)×ALB+1.104×TG,经校准曲线和决策曲线检验显示,该模型诊断结果与实际预测结果具有较高一致性,且具有较高净获益。结论 糖尿病病程、肾病分期、TNF-α、hs-CRP、IgM、ALB、TG水平是DKD患者发生贫血的影响因素,临床应关注上述影响因素,以早期预防患者贫血的发生。

手术联合辅助放化疗治疗老年口腔颌面部肿瘤的疗效与安全性分析

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探讨手术联合辅助放化疗治疗老年口腔颌面部肿瘤的疗效与安全性。方法:选取2023年1月至2025年9月收治的110例老年口腔颌面部肿瘤患者,采用随机分组分为联合治疗组与单纯手术组,各55例。单纯手术组行根治性肿瘤切除术;联合治疗组在相同手术后接受辅助放化疗。比较两组1年、2年总生存率(OS)与无进展生存率(PFS)、肿瘤控制情况(局部复发、区域淋巴结及远处转移)及治疗相关不良反应。结果:联合治疗组1年、2年OS及PFS均显著高于单纯手术组(均P<0.05)。联合治疗组局部复发率、区域淋巴结转移率及远处转移率均显著更低(均P<0.05)。在安全性方面,联合治疗组因接受了标准化的预防性止吐与支持治疗,其≥3级恶心(5.45% vs 14.55%)、呕吐(3.64% vs 12.73%)发生率显著低于单纯手术组(P<0.05),其他不良反应发生率组间无统计学差异;长期随访显示,联合治疗组张口受限(9.09% vs 21.82%)及吞咽功能异常(7.27% vs 18.18%)发生率亦显著更低(P<0.05)。结论:在精细化支持治疗与先进放疗技术支持下,手术联合辅助放化疗可提升老年口腔颌面部肿瘤患者生存率与肿瘤控制率,不增加治疗相关毒副反应,还能更好保留长期功能,表明该综合治疗方案兼具疗效与安全性。

沙库巴曲缬沙坦对慢性心力衰竭心电稳定性及心脏负荷的改善作用分析

Analysis of the Improvement Effect of Sacubitril Valsartan on Electrocardiogram Stability and Cardiac Load in Chronic Heart Failure

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目的:探讨沙库巴曲缬沙坦钠对慢性心力衰竭(CHF)患者心电稳定性及心脏负荷的改善作用。方法:病例纳入2023年10月~2025年5月收治的102例CHF患者为研究对象,依据就诊时间段及治疗方案不同,将2023年3月~2024年6月沿用缬沙坦+螺内酯+比索洛尔治疗的51例患者列为常规组,将2024年7月~2025年9月采用沙库巴曲缬沙坦+螺内酯+比索洛尔治疗的51例患者列为试验组,比较两组患者的心肌纤维化,心电稳定性,心脏负荷及治疗安全性。所有患者均接受为期半年随访,比较两组患者的预后情况。结果:治疗后,试验组的基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、半乳糖凝集素-3(Gal-3)、可溶性生长刺激表达基因2蛋白(sST2)均低于常规组(t=5.045,2.889,4.115,4.582;P<0.05)。试验组的校正QT间期(QTc)、QT离散度(QTd)、T波峰-末间期(Tp-e)、室性早搏次数分别为(405.39±40.26)ms、(45.25±5.33)ms、(90.33±5.28)ms、(80.36±5.39)次/24h,均低于常规组[(450.22±42.19)ms、(50.37±6.15)ms、(95.29±6.44)ms、(85.27±6.18)次/24h](t=5.490,4.493,4.253,4.276;P<0.05)。试验组的收缩期肺动脉压(sPAP)、三尖瓣反流峰值速度(TRVmax)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)分别为(20.48±5.26)mmHg、(2.13±0.25)m/s、(45.29±5.62)mm、(30.61±5.33)mm,均低于常规组[(25.35±6.29)mmHg、(3.22±0.47)m/s、(50.45±6.15)mm、(35.49±6.27)mm](t=4.242,14.622,4.423,4.235;P<0.05)。试验组的药物相关副反应发生率与常规组比较,差异无统计学意义(P>0.05)。截至随访结束时,试验组的不良预后发生率9.80%(5/51)低于常规组27.45%(14/51)(x2=5.239;P<0.05)。结论:沙库巴曲缬沙坦钠能延缓CHF患者的心肌纤维化进程并改善心电稳定性,在有效改善心电稳定性并降低不良预后发生风险同时未显著增加治疗风险。
Objective:To explore the improvement effect of sacubitril valsartan sodium on electrocardiogram stability and cardiac load in patients with CHF.Methods:A total of 102 CHF patients admitted from October 2023 to May 2025 were included in the study. Based on the treatment period and regimen, 51 patients treated with valsartan, spironolactone, and bisoprolol from March 2023 to June 2024 were classified as the conventional group, while 51 patients treated with sacubitril/valsartan, spironolactone, and bisoprolol from July 2024 to September 2025 were designated as the experimental group. The myocardial fibrosis, electrocardiographic stability, cardiac workload, and treatment safety were compared between the two groups. All patients underwent a six-month follow-up to assess their prognosis.Results:After treatment, the levels of MMP-2, MMP-9, Gal-3, and sST2 in the experimental group were lower than the control group (t=5.045,2.889,4.115,4.582; P<0.05). The QTc, QTd, Tp-e, and number of ventricular premature beats in the experimental group were (405.39 ± 40.26) ms, (45.25 ± 5.33) ms, (90.33 ± 5.28) ms, and (80.36 ± 5.39) beats per 24 hours, lower than the control group [(450.22 ± 42.19) ms, (50.37 ± 6.15) ms, (95.29 ± 6.44) ms, and (85.27 ± 6.18) beats per 24 hours] (t=5.490,4.493,4.253,4.276; P<0.05). The sPAP, TRVmax, LVEDD, and LVESD of the experimental group were (20.48 ± 5.26) mmHg, (2.13 ± 0.25) m/s, (45.29 ± 5.62) mm, and (30.61 ± 5.33) mm, lower than the conventional group [(25.35 ± 6.29) mmHg, (3.22 ± 0.47) m/s, (50.45 ± 6.15) mm, and (35.49 ± 6.27) mm] (t=4.242,14.622,4.423,4.235; P<0.05). The incidence of drug-related side effects in the experimental group was not significantly different from that in the control group (P>0.05). As of the end of follow-up, the incidence of poor prognosis in the experimental group was 9.80% (5/51) lower than that in the conventional group 27.45% (14/51) (x2=5.239; P<0.05).Conclusion:Sacubitril valsartan sodium can delay the progression of myocardial fibrosis and improve electrocardiogram stability in CHF patients, effectively improving electrocardiogram stability and reducing the risk of adverse prognosis without significantly increasing treatment risk.

肿瘤PICC置管患者血浆D-二聚体水平与血栓形成风险分析

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目的:探讨肿瘤PICC置管患者血浆D-二聚体水平与血栓形成风险的相关性,为临床预防及早期诊断提供参考依据。方法:选取2021年6月至2024年6月我院120例肿瘤PICC置管患者为研究对象,收集其临床资料,并根据是否发生血栓形成分为血栓组(n=40)和非血栓组(n=80)。比较两组患者血浆D-二聚体水平、基本资料、PICC置管相关因素的差异,并分析血浆D-二聚体水平与血栓形成风险的相关性。结果:置管后第3天、第7天,血栓组血浆D-二聚体水平分别为(1.77±0.58)mg/L、(2.06±0.76)mg/L,均高于非血栓组的(0.93±0.44)mg/L、(1.34±0.38)mg/L,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血浆D-二聚体水平升高、置管时间超过3个月、化疗方案为含铂方案是肿瘤PICC置管患者发生血栓形成的独立危险因素(P<0.05)。ROC分析显示,血浆D-二聚体水平对肿瘤PICC置管患者血栓形成风险的预测价值良好。结论:肿瘤PICC置管患者血浆D-二聚体水平与血栓形成风险密切相关,可作为临床预防及早期诊断的重要指标。

惯性测量步态分析研究热点及护理转化前景

Research Hotspots and Nursing Translation Prospects of Inertial Measurement-Based Gait Analysis

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目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.

惯性测量步态分析研究热点及护理转化前景

Research Hotspots and Nursing Translation Prospects of Inertial Measurement-Based Gait Analysis

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目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.
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