【摘要】 目的 系统分析音乐干预对眼科手术患者围手术期焦虑与生理反应的影响，为其临床应用提供参考。方法 系统检索国内外相关文献，从患者焦虑特征、理论基础、实施方法、干预效果及影响因素等方面进行综合分析。结果 眼科手术患者围术期焦虑发生率较高，焦虑可降低术中配合度、增加麻醉用药等风险。音乐干预通过调节边缘系统及自主神经系统发挥作用，术前、术中持续应用可显著降低焦虑评分，稳定心率、降低血压。听觉敏感性、基线焦虑水平、年龄及干预方案特征是影响干预效果的关键因素。结论 音乐干预能有效缓解眼科手术患者围手术期焦虑，具有良好应用潜力。未来需开展大样本随机对照试验，结合人工智能等技术开发个性化方案，并建立标准化实施方法。
【Abstract】Objective To systematically evaluate the effects of music intervention on perioperative anxiety and physiological responses in ophthalmic surgery patients, and to provide evidence for clinical practice. Methods Domestic and international literature on anxiety characteristics, mechanisms, implementation, efficacy, and influencing factors was systematically searched and reviewed. Results Perioperative anxiety is common in ophthalmic surgery patients and may reduce intraoperative cooperation and increase anesthetic consumption. Music intervention acts on the limbic system and the autonomic nervous system, and can effectively reduce anxiety scores, stabilize heart rate, and lower blood pressure when applied preoperatively and intraoperatively. Key influencing factors include auditory sensitivity, baseline anxiety, age, and intervention features. Conclusions Music intervention safely and effectively relieves perioperative anxiety in ophthalmic surgery patients. Further large-sample randomized controlled trials, AI-based personalized programs, and standardized protocols are needed.
目的 分析对肺癌化学治疗（化疗）患者采取个性化营养干预联合分级步行运动方案的应用价值。方法 将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象，通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案，观察组则联合分级步行运动方案，两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏［Piper疲乏修订量表（PFS-R）］、营养状况、睡眠质量［匹茨堡睡眠质量指数（PSQI）］、生活质量［生活质量评估量表（SF-36）］水平予以比较。结果 相较于对照组，干预后观察组PFS-R、PSQI评分较低，白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高（P＜0.05）。结论 对肺癌化疗患者采取个性化营养干预联合分级步行运动方案，有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。
Objective To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy．Methods A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects．They were divided into an observation group and a control group，with 99 cases in each group，by the random number table method．The control group only received individualized nutritional intervention，while the observation group received graded walking exercise additionally．Both groups of patients were enrolled at the same time and received continuous intervention for three months．Cancer-related fatigue（Piper’s Fatigue Scale-Revised［PFS-R］），nutritional status，sleep quality（Pittsburgh Sleep Quality Index［PSQI］），and quality of life（Quality of Life Scale［SF-36］） before and after the intervention were compared between the two groups．Results Compared with the control group，the observation group had lower PFS-R and PSQI scores and higher albumin，prealbumin，hemoglobin，transferrin levels and SF-36 scores after the intervention（P＜0.05）．Conclusions Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status，sleep quality and quality of life．
脑卒中后认知障碍（PSCI）是脑卒中患者常见的并发症，严重影响患者的生活质量和社会功能。近年来，随着认知储备理论的发展和早期干预理念的普及，PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展，包括干预的理论基础、具体措施及未来发展方向，以期为临床实践和科研提供参考。
Post-stroke cognitive impairment（PSCI）is a common complication among stroke patients．It seriously affects the patients’ quality of life and social functions．In recent years，with the development of the cognitive reserve theory and the popularization of the concept of early intervention，the early intervention model for PSCI has gradually become a research hotspot．This article reviews the current research status and progress of the early intervention model for PSCI，including the theoretical basis of the intervention，specific measures，and future development directions，aiming to provide references for clinical practice and scientific research．
目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．
目的 观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法 选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组，益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果 益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降，中医临床症状评分的有效率优于益生菌组。结论 桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。
Objective To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders（FAPDs）．Methods A total of 100 children diagnosed with FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected．These children were randomly divided into two groups：the probiotics group（50 cases）and the probiotics+traditional Chinese medicine individualized intervention group（50 cases）．Both groups received continuous treatment for 1 week．Parameters including supine/upright heart rates，supine/upright blood pressure，Rutter Children’s Behavior Questionnaire，and improvements in traditional Chinese clinical symptom scores were recorded．Results The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group．The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group．Conclusions Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children．
目的 探讨基于思维导图的绿色通道急救干预对急性心肌梗死患者介入治疗的效果。方法 对天津市人民医院2022年1月—2024年12月收治的80例AMI患者进行研究，依照收治时间进行分组，将2022年1月—2023年6月采取常规急救流程干预的40例患者分为常规组，将2023年7月—2024年12月的采取基于思维导图的绿色通道急救干预的40例患者分为思维导图组。比较两组患者急救效率、急救前后生命体征（心率、舒张压、收缩压）、心肌损伤指标［磷酸肌酸激酶（CK-MB）及肌钙蛋白Ⅰ（cTnI）］，最后比较两组患者干预满意度。结果 对比急救效率发现，思维导图组的预检时间、会诊时间、导管室激活时间、急诊送至PCI手术时间均短于常规组（P＜0.05）；对比急救前后生命体征发现，与急救前对比，急救后两组的心率、舒张压、收缩压均降低（P＜0.05），急救前后两组心率、舒张压、收缩压比较差异无统计学意义（P＞0.05）；对比急救前后心肌损伤指标发现，急救前两组CK-MB、cTnI比较差异无统计学意义（P＞0.05），急救后，思维导图组CK-MB、cTnI低于常规组与急救前（P＜0.05）；对比干预满意度发现，思维导图组干预满意度为100.00%，高于常规组的85.00%（P＜0.05）。结论 基于思维导图的绿色通道急救干预可提升AMI患者的急救效率，稳定患者生命体征，减轻心肌损伤的同时，提升患者干预满意度。
Objective To explore the effect of green channel emergency nursing based on mind mapping on percutaneous coronary intervention（PCI） of patients with acute myocardial infarction（AMI）．Methods A study was conducted on 80 AMI patients admitted to Tianjin People’s Hospital from January 2022 to December 2024．The patients were divided into two groups based on their admission time．The 40 patients who received routine emergency nursing interventions from January 2021 to June 2023 were assigned to the conventional group，while the 40 patients who received green channel emergency nursing based on mind mapping from July 2023 to November 2024 were assigned to the mind mapping group．The emergency treatment efficacy，vital signs（heart rate，diastolic blood pressure，systolic bloodpressure），myocardial injury indicators（phosphocreatine kinase［CK-MB］，and troponin I［cTn1］）between two groups of patients before and after emergency treatment were compared．Results The pre-examination time，consultation time，catheterization room activation time and emergency room to PCI operation time of mind mapping group were all shorter than those of conventional group（P＜0.05）．Compared with the vital signs before and after emergency treatment，we found that the heart rate，diastolic pressure and systolic blood pressure of the two groups decreased after emergency treatment（P＜0.05），and there was no significant difference between the heart rate，diastolic pressure and systolic blood pressure of the two groups before and after emergency treatment（P＞0.05）．Comparing the myocardial injury indicators before and after emergency treatment，there was no significant difference in CK-MB and cTn1 between the two groups before emergency treatment（P＞0.05）．After emergency treatment，CK-MB and cTn1 in the mind map group were lower than those in the conventional group and before emergency treatment（P＜0.05）．Comparing the intervention satisfaction，it was found that the mind mapping group of 100.00% was higher than the conventional group of 85.00%（P＜0.05）．Conclusions Green channel emergency nursing based on mind mapping can improve the efficiency of emergency treatment for AMI patients，stabilize their vital signs，reduce myocardial injury，improve patient intervention satisfaction．
目的 探讨基于区域专科联盟模式,在联盟医院内建立淋巴水肿专科干预小组的有效策略及其对患者干预效果的影响。方法 对区域医联体内7家联盟医院（包括德阳市人民医院、广汉市人民医院、罗江区人民医院、广汉妇幼保健院、德阳肿瘤医院、中江妇幼保健院、什邡市妇幼保健院）20名医护人员进行淋巴水肿知识及干预技能培训,建立区域性淋巴水肿专科干预小组,制定小组工作职责、实施专科质量控制。选取2024年5—8月淋巴水肿专科干预小组干预模式开展期间作为观察组, 选取2024年1—4月淋巴水肿专科干预小组干预模式开展前作为对照组。对比两组医护人员淋巴水肿相关知识掌握合格率、住院患者淋巴水肿风险筛查率、淋巴水肿高风险患者措施落实率、出院随访患者上肢功能评定评分及患者就医满意度。结果 干预后,护理人员淋巴水肿知识各维度得分[基础知识（17.36±2.54）、诊断与评估（25.66±4.34）、治疗与管理（25.08±4.73）、预防与康复（15.36±2.53）、总分（85.36±8.52）]均高于干预前[基础知识（11.35±2.29）、诊断与评估（17.87±3.18）、治疗与管理（18.28±3.85）、预防与康复（10.39±2.24）、总分（55.35±7.56）]（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）; 观察组住院患者淋巴水肿风险筛查率高于对照组（80.72% vs 61.24%）, 对比差异有统计学意义（χ2=31.454, P<0.001）; 观察组患者出院时及出院后1月上肢功能评定（DASH）量表评分[（23.36±8.63）（20.16±7.34）分]低于对照组[（25.32±9.16）（22.25±7.67）分], 对比差异有统计学意义（t=2.884, P=0.004; t=3.646, P=0.001）; 观察组患者出院时患者就医满意度评分（83.36±8.63）高于对照组（71.37±10.33）, 对比差异有统计学意义（t=16.460, P<0.001）。结论 基于区域专科联盟体的联盟医院淋巴水肿专科干预小组能够有效地实现三级医院优质干预资源下沉, 在联盟内可实现淋巴水肿防治同质化、专科人才培训基地建设,整体提升区域内淋巴水肿防控效果,提高患者就医满意度。
Objective To explore effective strategies for establishing a lymphoedema specialty nursing team within alliance hospitals based on a regional specialty alliance and assess its impact on patient care outcomes．Methods A regional lymphedema specialty nursing team was established by training 20 healthcare professionals from 7 hospitals（Deyang City People’s Hospital,Guanghan People’s Hospital, Luojiang People’s Hospital, Guanghan Maternal and Child Health Hospital, Deyang Tumor Hospital, Zhongjiang Maternal and Child Health Hospital, and Shifang Maternal and Child Health Hospital）in a regional medical consortium, focusing on lymphedema knowledge and intervention skills．The team’s responsibilities and nursing quality control protocols were standardized．The observation group included data from May to August in 2024（post-intervention period）, while the control group comprised data from January to April in 2024（pre-intervention period）．Comparisons were made between the two groups regarding healthcare professionals’qualification rate in lymphedema knowledge,inpatients’ lymphedema risk screening rate, implementation rate of preventive measures for high-risk patients, upper extremity function assessment scores（using the Disabilities of the Arm,Shoulder and Hand [DASH] scale）at discharge and 1-month post-discharge, and patient satisfaction．Results After the intervention, healthcare professionals’ lymphedema knowledge scores significantly improved across all domains：basic knowledge（17.36±2.54 vs 11.35±2.29）, diagnosis/assessment（25.66±4.34 vs 17.87±3.18）, treatment/management（25.08±4.73 vs 18.28±3.85）,prevention/rehabilitation（15.36±2.53 vs 10.39±2.24）,and total score（85.36±8.52 vs 55.35±7.56）（t=7.859, P<0.001; t=6.475, P<0.001; t=4.986, P<0.001; t=6.578, P<0.001; t=11.782, P<0.001）．The observation group demonstrated a higher lymphedema risk screening rate（80.72% vs 61.24%,χ2=31.454,P<0.001）．DASH scores in the observation group were significantly lower than the control group at discharge（23.36±8.63 vs 25.32±9.16）and 1-month post-discharge（20.16±7.34 vs 22.25±7.67）（t=2.884, P=0.004; t=3.646, P=0.001）．Patient satisfaction scores at discharge were higher in the observation group（83.36±8.63 vs 71.37±10.33, t=16.460, P<0.001）．Conclusions The lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance effectively facilitates the high-quality nursing resources homogenization in primary hospitals．Within the alliance, it achieves homogenization of lymphoedema prevention and treatment, establishes a training base for specialty talents, and overall enhances lymphoedema prevention and control within the region, thereby improving patient satisfaction with healthcare．
目的 探讨基于健康意识理论（HEC）的健康管理联合早期活动护理干预应用于急性胰腺炎（AP）患者的效果。方法 将南阳市第一人民医院2020年1月—2023年1月期间收治的80例AP患者作为研究对象,按照随机数字表法分为对照组（n=40）和观察组（n=40）。两组患者均按照AP护理常规进行护理,对照组予早期活动护理干预,观察组予早期活动护理和基于HEC的健康管理,观察两组健康行为能力、健康促进行为和并发症发生情况。结果 干预后,两组患者健康行为能力自评量表得分均高于干预前,且观察组得分高于对照组（P<0.05）;两组患者健康促进生活方式量表Ⅱ得分均高于干预前,且观察组得分高于对照组（P<0.05）;观察组并发症发生率（5.00%）低于对照组（20.00%）。结论 基于HEC的健康管理联合早期活动护理可以有效改善AP患者的健康行为能力、健康促进行为减少并发症的发生。
Objective To explore the effect of health management combined with early activity nursing intervention based on health as expanding consciousness（HEC）on patients with acute pancreatitis（AP）．Methods Eighty patients with AP admitted to the First People’s Hospital of Nanyang City from January 2020 to January 2023 were selected as the study subjects．They were randomly divided into a control group（n=40）and an observation group（n=40）using a random number table method．Both groups of patients received routine AP nursing care．The control group received early activity nursing intervention,while the observation group received early activity nursing and HEC based health management．The health behavior ability,health promotion behavior,and incidence of complications were observed in both groups．Results After the intervention,both groups of patients had higher scores on the Self Rating Health Behavioral Ability Scale than before the intervention,and the observation group had higher scores than the control group（P<0.05）．The scores of the Health Promotion Lifestyle Scale II for both groups of patients were higher than before intervention,and the scores of the observation group were higher than those of the control group（P<0.05）．The incidence of complications in the observation group（5.00%）was lower than that in the control group（20.00%）．Conclusions Health management based on HEC combined with early activity nursing can effectively improve the health behavior ability of AP patients,promote health behavior,and reduce the occurrence of complications．
目的 探讨与分析全面护理联合细节干预在创伤骨科手术质量及康复中应用价值。方法 选择2022年1月—2023年1月在福建省立医院骨科进行创伤骨科手术患者120例为研究对象,用随机数字表法分组,分为常规组、联合组,各纳入60例患者。前者进行常规护理,后者在前者基础上开展全面护理联合细节干预,对两组患者术后恢复情况进行观察比较。结果 在围术期指标方面,联合组手术时间、术中出血量、术后首次下床活动时间、术后住院时间与常规组相比减少（P<0.05）。联合组术后1 d、术后3 d、术后7 d、术后14 d的疼痛VAS评分与常规组相比减少（P<0.05）。联合组术后14 d的护理总满意度为100.00%,常规组为83.33%,联合组与常规组相比明显提高（P<0.05）。联合组术后14 d的社会关系、心理关系、生理关系等生活质量评分均高于常规组（P<0.05）。结论 全面护理联合细节干预在创伤骨科手术患者的应用促进患者康复,能持续缓解患者的疼痛状况,提高患者的护理满意度与生活质量。
Objective To explore and analyze the application value of comprehensive nursing combined with detailed intervention in the quality and rehabilitation of orthopedic trauma surgery．Methods From January 2022 to January 2023,120 cases of patients who underwent trauma orthopedic surgery in the Department of Orthopedic Surgery of Fujian Provincial Hospital were selected as the research subjects．And the randomized numerical table method was taken to operate in groups,which were divided into the conventional group and the combined group,and 60 patients were included in each group．The former group recieved conventional nursing care,and the latter group recieved comprehensive nursing care combined with detail intervention on its basis to observe and compare the postoperative recovery of patients in the two groups．Results In terms of perioperative indicators,the operation time,intraoperative bleeding,time to first postoperative bed movement and postoperative hospitalization time were significantly reduced in the combined group compared with the conventional group（P<0.05）．The pain VAS scores of the combination group were significantly reduced compared to the conventional group at 1 day,3 days,7 days and 14 days after surgery（P<0.05）．The total satisfaction rate of postoperative care in the combination group at 14 days was 100.00%,while in the conventional group it was 83.33%．The combination group showed there were significant improvements compared to the conventional group（P<0.05）．The social,psychological and physiological quality of life scores of the combination group were significantly higher than those of the conventional group 14 days after surgery（P<0.05）．Conclusions The application of comprehensive nursing combined with detailed intervention in orthopedic trauma surgery patients can promote their recovery,continuously alleviate their pain status and improve their nursing satisfaction and quality of life．
目的 研究基于儿童早期预警评分（PEWS）的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组（n=50）及对照组（n=50）。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程（相关指标涵盖症状持续时长及住院天数）、呼吸功能（涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量）、并发症发生情况（涵盖呼吸机相关性肺炎、肺大疱及胸膜炎）、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组（均P<0.05）。研究组各项呼吸功能指标水平均高于对照组（均P<0.05）。两组各项并发症发生率对比差异无统计学意义（P>0.05）。研究组患儿家属满意度高于对照组（96.00% vs 82.00%,P<0.05）。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。
Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score（PEWS）on the recovery process and respiratory function of children with severe pneumonia．Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed．Those children were divided into study group（n=50）and control group（n=50）according to the difference of intervention methods．Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group．The two groups were compared with each other in terms of recovery process（including duration of symptoms and length of stay）,respiratory function（including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity）,complications（including ventilators associated pneumonia,bullosa and pleurisy）,and family member satisfaction．Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group（all P<0.05）．The levels of respiratory function indexes in study group were higher than those in control group（all P<0.05）．There was no significant difference in the incidence of complications between the two groups（P>0.05）．The satisfaction of family member in the study group was higher than that in the control group（96.00% vs 82.00%）（P<0.05）．Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia．
