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．

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．

目的 探讨以整合照护理念为基础的综合干预体系对稳定性冠心病患者衰弱的影响。方法 选择2021年8月—2022年6月在驻马店市中医院诊治的老年稳定性冠心病患者78例,根据1∶1随机数字表法分为两组,每组各39例。常规组给予常规护理,整合组在常规组护理的基础上给予以整合照护理念为基础的综合干预体系,记录两组患者的预后情况。结果 两组患者在护理3个月后的平衡测试评分、座椅站立测试评分均低于护理前,整合组护理3个月后的平衡测试评分、座椅站立测试评分与常规组相比也降低（P<0.05）。整合组护理3个月后的躯体、心理、社会、精神等维度的生活质量评分均高于常规组（P<0.05）。整合组随访1年的靶血管重建、心肌梗死、心源性死亡、冠状动脉再狭窄等主要心血管事件不良事件发生率为5.13%,常规组为25.64%,整合组低于常规组（P<0.05）。结论 以整合照护理念为基础的综合干预体系能缓解老年稳定性冠心病患者的衰弱状况,改善患者的生活质量,降低主要心血管事件不良事件发生率。

Objective To explore and analyze the effects of a comprehensive intervention based on integrated care on the frailty of elderly stable coronary heart disease（CHD）patients．Methods From August 2021 to June 2022,78 cases of elderly stable CHD patients who were diagnosed and treated in Zhumadian City Hospital of Traditional Chinese Medicine were selected．According to a 1：1 random number table method,78 patients were divided into the integrated group and the traditional group,with 39 cases of each group．The traditional group was given routine care,while the integrated group was given a comprehensive intervention based on integrated care concepts on the basis of the traditional group's care,and the patients' prognosis was recorded．Results The balance test scores and chair stand test scores of both groups after 3 months of nursing care were lower than those before nursing care．The balance test scores and chair stand test scores of the integrated group after 3 months of nursing care were also significantly lower than those of the traditional group（P<0.05）．After 3 months of nursing care,the quality of life scores in physical,psychological,social,and spiritual dimensions in the integrated group were significantly higher than those in the traditional group（P<0.05）．The incidence of major cardiovascular adverse events such as cardiac death,myocardial infarction,target vessel reconstruction,and coronary artery restenosis during a one-year follow-up in the integrated group was 5.13%,compared to 25.64% in the traditional group．The integrated group was significantly lower than the traditional group（P<0.05）．Conclusions The application of a comprehensive intervention based on integrated care concept in elderly stable CHD patients can alleviate frailty,improve quality of life,and reduce the incidence of major cardiovascular adverse events．

目的 探讨在分化型甲状腺癌（DTC）患者的治疗中,采用早期积极心理进行干预,对患者负性情绪和癌因性疲乏的影响。方法 抽取2021年6月—2023年1月平煤神马医疗集团总医院收治的160例DTC癌患者,随机分为对照组（常规护理）和研究组（常规护理+早期积极心理干预）,每组各80例,评估患者干预前后的心理状态、癌因性疲乏、生活质量、护理工作满意度。结果 护理干预1~4周后,两组患者汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分均降低,并且研究组患者评分更低（P<0.05）;干预后,两组患者的癌因性疲乏评分均升高,但是研究组患者的以上指标升高幅度小于对照组（P<0.05）;此外,两组患者的护士观察量表（NOSIE）评分均明显改善,并且研究组变化幅度大于对照组（P<0.05）;研究组患者的护理满意度高于对照组（95.00% vs 82.50%,P<0.05）。结论 对DTC患者开展早期积极心理干预,能够帮助患者改善负性情绪,减轻癌因性疲乏,提高患者的生活质量和护理满意度。

Objective To investigate the effect of early positive psychological intervention on negative emotions and cancer-related fatigue in the treatment of differentiated thyroid cancer（DTC） patients．Methods From June 2021 to January 2023,160 patients with DTC admitted to General Hospital of Pingmei Shenma Group were randomly divided into the control group（routine nursing）and the research group（routine nursing + early positive psychological intervention）,with 80 patients in each group．The psychological state,cancer-related fatigue,quality of life and nursing satisfaction of patients before and after intervention were evaluated．Results After 1~4 weeks of intervention,the scores of Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）were decreased in both groups,and the scores of research group were lower（P<0.05）．After intervention,the cancer-related fatigue scores of both groups were increased,but the increase of research group were less than that of control group（P<0.05）．Moreover,NOSIE scores of both groups were significantly improved,and the change range of research group was greater than that of control group（P<0.05）．The nursing satisfaction of research group was higher than that of control group（95.00% vs 82.50%,P<0.05）．Conclusions Early positive psychological intervention for patients with DTC can effectively improve negative emotions,reduce cancer-related fatigue,and improve nursing satisfaction of patients．

目的 探讨时机理论的护理干预在三叉神经痛微血管减压术中的应用效果。方法 选取2020年7月—2023年6月厦门大学附属第一医院神经外科三叉神经痛患者85例,均实施微血管减压术治疗,通过奇偶数抽签的方式分组,即对照组（n=43,予以常规护理）与观察组（n=42,实施常规护理基础上给予基于时机理论的护理干预）,通过专业调查表对两组患者疼痛、负面情绪及生活质量进行全面评估。结果 观察组出院时数字分级评分表（NRS）、抑郁自评量表（SDS）、焦虑自评量表（SAS）评分分别为（2.13±0.57）（42.45±3.17）（42.45±3.17）分,低于对照组的（3.23±0.78）（52.34±4.45）（48.23±3.23）分（P<0.05）;观察组术后1个月简明健康状况调查表（SF-36）生理功能、生理职能、躯体功能、活力、社会功能、情感职能、心理健康及总体健康状态等维度评分分别为（38.12±8.27）（42.22±9.12）（52.34±8.23）（64.11±8.92）（70.12±9.03）（34.46±6.18）（71.34±8.17）（75.24±8.46）分,高于对照组的（35.23±8.13）（38.56±9.23）（45.03±8.11）（60.57±8.23）（65.23±8.78）（30.14±6.13）（66.23±8.08）（72.12±8.35）分（P<0.05）。结论 三叉神经痛患者实施微血管减压术治疗的同时,采取基于时机理论的护理干预不仅可减轻其疼痛程度,改善其负面情绪,还可全面提高其生活品质。

Objective To explore the application effect of timing theory nursing intervention in microvascular decompression surgery for trigeminal neuralgia．Methods The research period was from July 2020 to June 2023．The study subjects were 85 patients with trigeminal neuralgia selected from the Neurosurgery Department of the First Affiliated Hospital of Xiamen University,all of whom underwent microvascular decompression surgery．They were divided into a control group（n=43,receiving routine care）and an observation group（n=42,receiving timing based nursing intervention on the basis of routine care）through odd and even number drawing．A preliminary assessment of pain,negative emotions,and quality of life for two groups of patients were conducted through a professional questionnaire．Results The scores of NRS,SDS and SAS in the observation group at discharge were（2.13±0.57）,（42.45±3.17）and（42.45±3.17）respectively,which were significantly lower than those in the control group（3.23±0.78）, （52.34±4.45）and（48.23±3.23）．The scores of physiological function,physiological function,physical function,vitality,social function,emotional function,mental health and general health status in the observation group one month after operation were（38.12±8.27）,（42.22±9.12）,（52.34±8.23）, （64.11±8.92）, （70.12±9.03）, （34.46±6.18）, （71.34±8.17） and（75.24±8.46）, which were significantly higher than those of the control group（35.23±8.13）, （38.56±9.23）, （45.03±8.11）, （60.57±8.23）, （65.23±8.78）, （30.14±6.13）, （66.23±8.08）and（72.12±8.35）（P<0.05）．Conclusions While implementing microvascular decompression surgery for patients with trigeminal neuralgia,nursing interventions based on timing theory can not only alleviate their pain,improve their negative emotions,but also comprehensively improve their quality of life．

目的 探讨与分析基于信息-动机-行为（IMB）模型的护理干预对造口患者并发症及生活质量的影响。方法 选择2021年5月—2023年4月本院进行结直肠癌行肠造口患者84例作为研究对象,根据1∶1随机电脑抽签分配原则把患者分为IMB组42例与常规组42例。常规组给予常规护理干预,IMB组在常规组护理的基础上给予基于IMB模型的护理干预,IMB组与常规组护理观察时间为3个月,观察与记录IMB组与常规组患者并发症、生活质量、心理状况、自我管理能力评分变化情况。结果 IMB组护理3个月期间的腹腔脓肿、肠梗阻、肺部感染、造口感染等并发症发生率为4.8%,与常规组的19.0%相比降低更多（P<0.05）。IMB组护理3个月期间的遵医依从性为100.0%,与常规组的90.5%相比提高更多（P<0.05）。护理3个月后IMB组的症状识别、症状处理、处理后评价等自我管理能力评分与常规组相比提高更多（P<0.05）。IMB组与常规组护理3个月后的焦虑评分与抑郁评分与护理前相比都有统计学意义的降低（P<0.05）,护理3个月后IMB组的焦虑评分、抑郁评分与常规组对比降低（P<0.05）。护理3个月后IMB组的总生活质量量表、症状子量表、症状量表、功能量表评分都与常规组相比提高（P<0.05）。结论 基于IMB模型的护理干预在造口患者的应用能提高遵医依从性,缓解焦虑与抑郁情绪,提高患者自我管理能力,从而可有效减少患者并发症的发生,促进提高患者的预后生活质量。

Objective To explore and analysis the effects of nursing intervention based on Information-Motivation-Behavioral（IMB）model on complications and quality of life of patients with stoma. Methods Eighty-four cases of patients with colorectal cancer undergoing enterostomy in our hospital from May 2021 to Aprilt 2023 were selected as the study subjects．According to the principle of 1∶1 random computer lottery,the patients were divided into IMB group（42 cases）and traditional group（42 cases）．The traditional group were given routine nursing intervention,and the IMB group were given nursing intervention based on the IMB model on the basis of the traditional group．The nursing observation time of the traditional group and IMB group were 3 months,the changes in complications,quality of life,psychological status,and self-management ability scores of patients were observed and recorded. Results The incidence of complications such as abdominal abscess,intestinal obstruction,pulmonary infection and stoma infection in IMB group during nursing were 4.8%,which were significantly lower than 19.0% in the traditional group（P<0.05）．The compliance of IMB group during nursing were 100.0%,which were significantly higher than 90.5% in the traditional group（P<0.05）．After nursing of 3 months,the scores of self-management ability such as symptom recognition,symptom treatment and post-treatment evaluation in IMB group were significantly higher than those in the traditional group（P<0.05）．The scores of anxiety and depression in the traditional group and IMB group after nursing of 3 months were significantly lower than those before nursing（P<0.05）,and the scores of anxiety and depression in the IMB group after nursing of 3 months were also significantly lower than those in the traditional group（P<0.05）．After nursing of 3 months,the scores of IMB group on function scale,symptom scale,symptom subscale and total quality of life scale were significantly higher than those of the traditional group（P<0.05）. Conclusions The application of nursing intervention based on the IMB model in patients with stoma can improve the compliance with medical treatment,reduce the occurrence of complications,improve the self-management ability of patients,relieve anxiety and depression,and continue to improve the prognosis and quality of life of patients．

目的 探索干预因素对4~12岁孤独症谱系障碍（ASD）患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法 选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表（SRS）对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况（性别、共患病情况、干预时长、上学情况等）。结果 202例ASD患儿中,男性患儿162例（80.2%）,女性40例（19.8%）,性别对社交反应的影响比较差异无统计学意义（t=2.969,P>0.05）。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义（F=6.920,P<0.05）。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义（F=3.823,P<0.05）,但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义（P>0.05）。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义（F=4.477,P<0.05）,但干预<1年与未干预患儿相比,两者差异无统计学意义（P>0.05）。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。

Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder（ASD）aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected．The social behavior of the children was evaluated using the Social Response Scale（SRS）,and the parents were surveyed using a self-made general situation questionnaire．The survey content included the basic information of the children（gender,comorbidity,intervention duration,and school attendance,etc．）. Results Among the 202 cases of ASD,162 were male（80.2%）and 40 were female（19.8%）．There was no statistically significant difference in the impact of gender on social response（t=2.969,P>0.05）．In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder（F=6.920,P<0.05）．In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school（F=3.823,P<0.05）,but there was no statistically significant difference between children enrolled in special schools and those who did not attend school（P>0.05）．In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant（F=4.477,P<0.05）．However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant（P>0.05）. Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response．Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment．