目的：探讨年轻冠心病经皮冠状动脉介入治疗（PCI）术后患者康复管理行为的发展轨迹及其异质性亚组，并分析基线心理社会因素及临床特征对轨迹归属的影响，为制定精准化心脏康复管理策略提供依据。方法：采用回顾性研究设计，选取2022年1月至2025年3月在郑州大学第五附属医院心血管内科行首次PCI治疗的265例年轻冠心病患者（年龄22～45岁）为研究对象。于术后1个月（基线）、3个月、6个月、12个月采用冠心病PCI术后康复管理行为问卷进行纵向随访评估；基线时同时完成一般自我效能感量表、社会支持评定量表及医院焦虑抑郁量表测评。应用潜类别增长模型识别康复管理行为的发展轨迹，采用多元Logistic回归分析影响轨迹归属的因素。结果：年轻冠心病PCI术后患者术后1个月康复管理行为总分为（68.5±14.2）分，3个月升至（70.3±13.8）分，之后持续下降，12个月降至（63.2±18.1）分，各时间点差异有统计学意义（P＜0.001）。潜类别增长模型识别出3种行为发展轨迹：持续高行为组（75例，28.3%），行为始终维持高水平且无显著下降；中度下降组（120例，45.3%），行为早期尚可但逐渐下降；持续低行为组（70例，26.4%），行为起点低且下降速度最快。Pearson相关分析显示，基线康复管理行为总分与自我效能、社会支持呈正相关（r=0.523，0.452，均P＜0.01），与焦虑、抑郁呈负相关（r=-0.381，-0.346，均P＜0.01）。多因素Logistic回归分析表明，文化程度高中及以下（OR=2.15，95%CI 1.12～4.13）、合并糖尿病（OR=2.33，95%CI 1.10～4.95）、左心室射血分数＜50%（OR=2.80，95%CI 1.15～6.82）及焦虑得分升高（OR=1.12，95%CI 1.01～1.24）是未维持高水平康复行为的独立危险因素（均P＜0.05）；自我效能得分高（OR=0.92，95%CI 0.88～0.96）及社会支持得分高（OR=0.95，95%CI 0.91～0.99）为独立保护因素（均P＜0.05）。结论：年轻冠心病PCI术后患者康复管理行为整体呈先升后降趋势，且存在3种异质性发展轨迹，仅不足三成患者可长期维持高水平依从。低文化程度、合并糖尿病、心功能不全及高焦虑水平者更易归属行为低下或下降轨迹，而高自我效能、高社会支持则有助于行为维持。临床应建立基于轨迹分层的随访管理体系，对持续低行为组及中度下降组早期识别并实施针对性强化干预。

目的 分析年轻恒前牙活髓切断术中iRoot BP Plus和氢氧化钙的应用价值。方法 分析我院收治的年轻恒前牙活髓切断术治疗患者临床数据,对60例患者分组治疗,对照组使用氢氧化钙作为盖髓剂,研究组使用iRoot BP Plus作为盖髓剂,对比治疗相关数据。结果 研究组患者手术时间、术后肿胀时间以及疼痛时间较对照组更短（P<0.05）;两组患者语言功能、咀嚼功能评分比较差异无统计学意义（P>0.05）,而研究组患者固定、舒适以及美观程度评分较对照组更高（P<0.05）;研究组治疗成功率为95.12%,略高于对照组成功率的79.55%（P<0.05）。结论 对接受年轻恒前牙活髓切断术治疗的患者采用iRoot BP Plus作为盖髓剂能够取得更为理想的效果,不仅可以有效改善患者牙齿功能,提升美观度,还能够减少操作时间,且成功率更高,可作为主要治疗方案纳入考量。

目的 探讨配偶参与式护理对腹腔镜保留盆腔自主神经子宫切除术年轻患者功能恢复的影响效果。方法 按时间先后将96例患者分为实验组50例和对照组46例,对照组按常规护理,实验组采用先培训配偶,然后让配偶与护士共同对患者实施整体护理,6个月后测试患者膀胱和性功能恢复情况。结果 实验组术后7天膀胱功能恢复41例,尿管留置时间为(10.8±2.1),术后6个月FSFI评分为(29.11±3.65),均优于对照组,两组比较差异均有统计学意义(P＜0.05)。结论 配偶参与式护理可使腹腔镜保留盆腔自主神经子宫切除术年轻患者得到更多专业的照顾,利于术后膀胱功能和性功能的恢复。

Objective To evaluate the influence of spouse participatory nursing on functional recovery of young patients who experienced laparoscopic nerve-sparing radical hysterectomy. Methods 96 patients were divided into the experiment group (50 patients) and the control group (46 patients) according to the timeline. The control group accepted normal nursing while the experiment group accepted the method that the spouse was provided with training first and then nurses provided overall nursing to the patient along with the spouse. Six months later, patients' recovery of bladder and sexual function were assessed. Results In the experimental group, 41 patients' bladder function recovered in seven days after the surgery, and the catheter retention time was(10.8±2.1); the FSFI score was (29.11±3.65)in six months after the surgery, and the score was better than that in the control group. The differences between both groups had statistical significance (P<0.05). Conclusion Spouse participatory nursing can provide more professional care to young patients who experienced laparoscopic nerve-sparing radical hysterectomy, therefore help to recover bladder and sexual function.

目的 探讨年轻恶性肿瘤化疗女性的发病情况及保留生育功能和卵巢功能的意义。方法 回顾性分析和总结在我院行化疗的17～40岁年轻恶性肿瘤女性患者的年龄、肿瘤类别、构成等临床资料。结果 5年间在我院化疗的1261例女性恶性肿瘤患者中,年龄15～40岁者共786例(占62.3％),其中乳腺癌355例、大肠癌89例、白血病80例、宫颈癌67例、卵巢癌46例、恶性淋巴瘤39例,胃癌38例,肺癌30例,肝癌18例。15～25岁年龄段的女性恶性肿瘤化疗以白血病和卵巢癌为主。随年龄增长,大部分女性恶性肿瘤化疗的发生率增高。结论 15～40岁年轻恶性肿瘤化疗女性中乳腺癌占首位,其次为大肠癌、白血病和宫颈癌。保留年轻患者卵巢功能和生育功能的保守治疗具有重要意义。

Objective To analyze the clinical characteristics of malignant tumor in young women receiving chemotherapy aged from 15 to 40 and investigate the role of conservative treatment. Methods The clinical data of female aged from15 to 40 years old who were received chemotherapy in our hospital between 2010 and 2014 were retrospectively analyzed. Results 786 cases were identified from 1261 cases of malignant tumor receiving chemotherapy. Including 355 cases of breast cancer,89 cases of colorectal cancer,80 cases of leukemia,67 cases of cervical carcinoma,46 cases of ovarian cancer,39 cases of lymphoma,38 cases of gastric cancer,30 cases of lung cancer and 18 cases of liver cancer. Leukemia and ovarian cancer is the most common malignant tumor in young female between 15 to 25 years old. The cases of malignant tumor receiving chemotherapy increased with increasing age. Conclusion Breast cancer is the most common malignant tumor in young female receiving chemotherapy, followed by colorectal cancer, leukemia, and cervical carcinoma. It is very important to conserve young women's ovary function and fertility function.

目的 研究分析牙髓血管再生术治疗年轻恒牙的临床应用疗效。方法 选取本院2012年1月—2013年12月间年轻恒牙牙髓血管再生治疗的60例患者为研究对象,按随机数方式分成两组,每组30例。对照组患者应用根尖诱导成形手术治疗,观察组患者应用牙髓血管再生术进行治疗,统计比较两组患者术后VAS评分及临床疗效。结果 观察组患者治疗总有效率为93.3%,相较于对照组患者的90.0%差异无统计学意义(P＞0.05);治疗前,两组患者VAS疼痛等级评分差异无统计学意义(P＞0.05);治疗后,患者VAS评分降低明显,且观察组显著低于对照组,差异有统计学意义(P＜0.05)。结论 临床中应用内封氢氧化钙糊剂血管再生术在年轻恒牙治疗中具有较好的应用效果,提高有效率,减轻疼痛,值得临床中应用与推广。

目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.