对比微创拔牙与传统拔牙在下颌阻生智齿治疗中的效果及并发症概率。方法:自2023年1月至2025年9月,选取110名下颌阻生智齿患者,采用随机数字列表法,将对象均衡地分为实验组(55人)与对照组(55人)。观察组行微创拔牙术(高速涡轮手机分牙+微创牙挺),对照组行传统拔牙术(骨凿劈冠+锤击增隙)。对比两组手术时间、术后疼痛程度、张口度及术中及术后并发症发生率。结果: 观察组施行手术的时间明显短于对照组[(25.38±5.47)min vs (31.65±6.83)min,P<0.001];术后24h及7d的VAS评分均低于对照组[(3.52±1.21)分 vs (5.87±1.56)分,(0.89±0.65)分 vs (1.95±0.91)分,均P<0.001],张口度大于对照组(均P<0.001)。观察组术中并发症总发生率(1.82%)显著低于对照组(14.55%)(P=0.009),术后并发症总发生率(3.64%)亦显著低于对照组(20.00%)(P=0.022)。结论:相较于常规拔牙方式,下颌阻生智齿的微创手术能显著减少治疗时间,减轻术后疼痛与张口受限,并显著降低术中及术后并发症风险,疗效与安全性俱佳,具备临床推广价值。
To compare the efficacy and complication rates of minimally invasive tooth extraction versus traditional extraction in treating impacted lower wisdom teeth. Methods: From January 2023 to September 2025,110 patients with impacted lower wisdom teeth were randomly assigned to an experimental group (55 cases) and a control group (55 cases) using a random number table. The experimental group underwent minimally invasive extraction (high-speed rotary mobile phone tooth splitting + minimally invasive tooth elevator), while the control group received traditional extraction (bone chisel splitting + hammer gap widening). The study compared operative time, postoperative pain (VAS score), mouth opening degree, and intraoperative/operative complications between the two groups. Results: The experimental group showed significantly shorter operative time [(25.38±5.47) min vs (31.65±6.83) min, P<0.001]. Postoperative VAS scores at 24h and 7d were significantly lower in the experimental group [(3.52±1.21) vs (5.87±1.56) points, (0.89±0.65) vs (1.95±0.91) points, both P<0.001], with greater mouth opening degree (P<0.001). The total intraoperative complication rate (1.82%) in the experimental group was significantly lower than the control group (14.55%) (P=0.009), and the postoperative complication rate (3.64%) was also significantly lower than the control group (20.00%) (P=0.022). Conclusion: Compared with traditional tooth extraction, minimally invasive tooth extraction can effectively shorten the operation time, reduce postoperative pain and limited mouth opening, and significantly reduce the risk of intraoperative and postoperative complications. The efficacy and safety are excellent, and it has the value of clinical promotion.
药物流产是终止早期妊娠的常用方法,但流产后仍易出现阴道持续出血、不全流产、盆腔感染及月经紊乱等并发症,影响患者生殖健康。生化汤作为中医经典方剂,具有活血化瘀、温经止痛、祛瘀生新之功效,在药物流产后并发症的临床治疗中应用广泛。本文通过梳理近年相关文献,从生化汤概述、药物流产及其并发症、生化汤的临床应用、作用机制及使用禁忌等方面进行系统综述,重点分析现有研究的局限性及争议性问题,并对未来研究方向提出展望,以为临床应用生化汤治疗药物流产后并发症提供理论依据与实践参考。?
目的 分析基于快速康复外科(ERAS)理念的医护一体化全程护理在先天性巨结肠手术患儿中的护理效果。方法 回顾性选取我院97例HSCR手术患儿(2018年5月—2025年7月)作为研究对象,依照护理模式不同分为对照组(49例)、观察组(48例)。对照组采用常规护理干预,观察组在上述基础上采用基于ERAS理念的医护一体化全程护理。比较2组术后恢复情况、并发症发生率、疼痛程度[FLACC疼痛评分法(FLACC)]、家属照护能力[家属照顾者照顾能力测量表(FCTI)]、家属满意度。结果 干预后,观察组胃管拔除时间、尿管拔除时间、肛管拔除时间、经口进食时间、术后首次排便时间、术后排气时间、肠鸣音恢复时间与住院时长均显著短于对照组,FCTI得分显著低于对照组(P<0.05);干预后,观察组并发症发生率显著低于对照组,家属护理满意度高于对照组(P<0.05);术后3d、7d,观察组FLACC得分均显著低于对照组(P<0.05)。结论 基于ERAS理念的医护一体化全程护理可缓解HSCR手术患儿疼痛程度,提高家属照护能力,降低并发症发生率,促进术后恢复,提升家属满意度。
目的 探讨腔镜下双平面假体植入乳房重建术在乳腺癌患者乳房重建中的临床价值。方法 回顾性分析2023年1月至2025年1月于我院行手术治疗的126例乳腺癌患者病例资料,根据术中乳房重建方式分为两组,将采用胸肌前假体植入乳房重建的63例患者纳入对照组,采用腔镜下双平面假体植入乳房重建的63例患者纳入研究组。比较两组围手术期指标、患侧乳房体积、创面瘢痕[温哥华瘢痕量表(VSS)评分]、乳房美观度、生活质量[中文版乳腺癌患者生命质量测定量表(FACT-B)评分]及并发症情况。结果 研究组手术时间长于对照组,术中出血量高于对照组(P<0.05)。两组术后引流量、住院天数比较无显著差异(P>0.05);术后3个月研究组患侧乳房体积大于对照组,VSS评分低于对照组(P<0.05);研究组乳房美观度优良率95.24%高于对照组80.95%(P<0.05);术后3个月,研究组FACT-B总评分高于对照组(P<0.05);两组并发症总发生率比较无显著差异(P>0.05)。结论 乳腺癌患者采用腔镜下双平面假体植入乳房重建术虽在一定程度增加手术时间及术中出血量,但能改善乳房形态,提升美观满意度,改善患者生活质量,且不增加并发症风险。
目的 比较末端可弯曲负压吸引输尿管鞘(FANS-UAS)联合输尿管软镜与传统输尿管通路鞘(T-UAS)联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象,根据电脑随机法分为研究组、对照组,各60例。研究组采用FANS-UAS联合输尿管软镜治疗,对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表(VAS)评分]、炎症反应[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短,术中出血量较对照组降低,术后即刻、术后3d结石清除率较对照组显著升高(P<0.05);术后1d、3d研究组VAS评分较对照组降低(P<0.05);术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低(P<0.05);两组并发症总发生率比较无显著差异(P>0.05)。
结论 与T-UAS联合输尿管软镜相比,FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程,提升结石清除率,降低疼痛程度,减轻炎症反应,加快围术期恢复,安全性良好。
目的 比较末端可弯曲负压吸引输尿管鞘(FANS-UAS)联合输尿管软镜与传统输尿管通路鞘(T-UAS)联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象,根据电脑随机法分为研究组、对照组,各60例。研究组采用FANS-UAS联合输尿管软镜治疗,对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表(VAS)评分]、炎症反应[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短,术中出血量较对照组降低,术后即刻、术后3d结石清除率较对照组显著升高(P<0.05);术后1d、3d研究组VAS评分较对照组降低(P<0.05);术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低(P<0.05);两组并发症总发生率比较无显著差异(P>0.05)。
结论 与T-UAS联合输尿管软镜相比,FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程,提升结石清除率,降低疼痛程度,减轻炎症反应,加快围术期恢复,安全性良好。
目的 比较末端可弯曲负压吸引输尿管鞘(FANS-UAS)联合输尿管软镜与传统输尿管通路鞘(T-UAS)联合输尿管软镜治疗单侧上尿路结石的临床效果。方法 选取2023-05至2025-05我院120例单侧上尿路结石患者为研究对象,根据电脑随机法分为研究组、对照组,各60例。研究组采用FANS-UAS联合输尿管软镜治疗,对照组采用T-UAS联合输尿管软镜治疗。比较两组患者手术指标、结石清除效果、疼痛程度[视觉模拟量表(VAS)评分]、炎症反应[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]及并发症情况。结果 研究组手术时间、碎石时间、术后下床活动时间、住院时间较对照组缩短,术中出血量较对照组降低,术后即刻、术后3d结石清除率较对照组显著升高(P<0.05);术后1d、3d研究组VAS评分较对照组降低(P<0.05);术后1d、3d研究组血清CRP、IL-6、PCT水平较对照组降低(P<0.05);两组并发症总发生率比较无显著差异(P>0.05)。
结论 与T-UAS联合输尿管软镜相比,FANS-UAS联合输尿管软镜治疗单侧上尿路结石患者能优化流程,提升结石清除率,降低疼痛程度,减轻炎症反应,加快围术期恢复,安全性良好。
护理研究
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.
护理研究
目的 探讨标准化沟通(SBAR)模式交接班联合护理质量指标管理在胆管结石患者中的应用效果及护理质量、不良事件及并发症影响。方法 选取天津市人民医院2021年1月—2022年12月收治的80例胆管结石患者,应用抽签法分为观察组与对照组,每组各40例。所有患者均采取手术治疗,其中对照组患者实施常规护理,观察组患者在对照组基础上增加SBAR沟通模式交接班联合护理质量指标管理。对比两组患者的护理质量、护理不良事件发生率、护理满意度及术后并发症发生率。结果 观察组基础护理、护理态度、护理责任心、风险识别能力、风险防范能力护理质量评分高于对照组(P<0.05);两组注射、口服给药差错、换药、抽血差错、病例书写错误以及执行医嘱不及时等护理不良事件发生率对比差异无统计学意义(P>0.05),观察组患者护理满意度高于对照组(P<0.05);观察组患者压疮、感染、静脉血栓等并发症发生率均低于对照组(P<0.05)。结论 SBAR沟通模式交接班联合护理质量指标管理针对胆管结石患者应用效果显著,可改善临床护理质量,同时患者护理满意度较高,进一步降低患者术后并发症发生率。
Objective To investigate the application effect of SBAR communication mode shift combined with the management of care quality indicators on patients with bile duct stones and their influence on postoperative complications. Methods Eighty patients with bile duct stones admitted to our hospital from January 2021 to December 2022 were selected,and divided into observation group and control group by drawing lots,40 cases each.All the patients were treated by surgery,and the control group patients received routine care,and the observation group patients added the SBAR communication mode.The quality of care,incidence of adverse events,satisfaction with care and incidence of postoperative complications of the two groups were compared. Results The quality of care values of basic care,nursing care,nursing responsibility,risk identification and risk prevention in the observation group were significantly higher than in the control group(P<0.05).There was no difference in the incidence of nursing side effects such as injection and oral administration errors,dressing changes,blood sampling errors,case clerk errors and delayed execution of medical orders between the two groups(P>0.05).Patient satisfaction in the observation group was significantly higher than that in the control group(P<0.05).The incidence of complications such as pressure ulcers,infections and venous thrombosis in the observation group was significantly lower than that in the control group(P<0.05). Conclusions SBAR communication mode and combined nursing quality index management for patients with bile duct stones,which can improve the quality of clinical nursing and patient nursing satisfaction,and further reduce the incidence of postoperative complications in patients.
护理研究
目的 探讨风险防范护理干预对颅内动脉瘤介入术后患者血管并发症的应用。方法 选取天津市人民医院2020年6月—2023年10月收治的80例颅内动脉瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。所有患者均采取血管内介入栓塞术治疗,对照组患者实施常规护理,观察组患者在对照组基础上增加风险防范护理干预。对比两组患者干预前后负面情绪变化、术后并发症发生率、干预前后生活质量变化以及护理满意度。结果 干预后,两组焦虑、抑郁评分降低,观察组分别为(39.78±1.80)(44.73±3.78)分,低于对照组的(54.63±3.91)(49.23±4.14)分,对比差异有统计学意义(t=21.823、5.078,P<0.05);观察组术后并发症发生率低于对照组(7.50% vs 27.50%,χ2=5.541,P=0.019);干预后两组中文版明尼苏达心功能不全生命质量(MLHFQ)相关维度评分均升高,且观察组分别为(30.73±3.82](21.13±2.70)(27.08±4.28)分,高于对照组的(26.20±3.50)(17.20±2.79)(23.20±2.35)分,对比差异有统计学意义(t=5.530、6.389、5.021,P<0.05);观察组护理满意度高于对照组(92.50% vs 72.50%,χ2=5.541,P=0.019)。结论 颅内动脉瘤介入术后采取风险防范护理干预可改善患者焦虑、抑郁情绪,降低术后并发症,改善患者术后生活质量,患者护理满意度较高。
Objective To investigate the application effect of risk prevention nursing intervention on vascular complications in patients with intracranial aneurysms after interventional surgery.Methods Eighty patients with intracranial aneurysm admitted in Tianjin People’s Hospital from June 2020 to October 2023 were selected and divided into observation group and control group with 40 cases each.All the patients were treated with endovascular interventional embolization,the control group patients underwent routine care,and the observation group patients added risk prevention nursing intervention on the basis of the control group.The negative mood changes before and after the intervention,the incidence of postoperative complications,the quality of life before and after the intervention,and nursing satisfaction were compared between the two groups.Results After the intervention,the anxiety and depression scores in both groups decreased,and the observation group[(39.78±1.80)and (44.73±3.78)] scores were lower than the control group[(54.63±3.91)and(49.23±4.14)] scores,significantly(t=21.823,5.078,P<0.05).The postoperative complication rate was significantly lower than the control group(7.50% vs 27.50%,χ2=5.541,P=0.019).After the intervention,MLHFQ related dimension scores were increased in both groups,and the observation group(30.73±3.82,21.13±2.70 and 27.08±4.28)scores were higher than the control group(26.20±2.50,17.20±2.79 and 23.20±2.35)scores,statistically significant(t=5.530,6.389,5.021,P<0.05).The nursing satisfaction was higher than the control group(92.50% vs 72.50%,χ2=5.541,P=0.019).Conclusion sRisk prevention nursing intervention after intracranial aneurysm intervention can improve patient anxiety and depression,assist in reducing the incidence of postoperative complications,improve patient quality of life,and increase patient satisfaction with nursing.