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。

目的 探究麦默通（Mammotome）微创旋切术加置引流对乳腺良性肿物患者术后疼痛、炎性应激指标及并发症的影响。方法 选取本院2020年1月—2022年1月收治的100例乳腺良性肿物患者,简单随机法进行分组,每位患者赋予1位随机数,1~51号为实验组,采用Mammotome微创旋切术加置引流,52~100号为对照组,实施Mammotome微创旋切术。对比2组治疗效果、围术期指标、术前及术后1 d、3 d疼痛程度（NRS评分）、术前及术后3 d炎性应激指标及并发症情况。结果 2组病灶清除率（100.00%、97.96%）、并发症发生率（3.92%、16.32%）间无差异（P>0.05）;相较于对照组,实验组手术时间较长,残腔积液较少,住院时间较短（P<0.05）;术后1 d、3 d实验组NRS评分低于对照组（P<0.05）;术后3 d 2组C反应蛋白、白介素-6、白介素-1β、降钙素原水平较术前上升,且实验组上升幅度小于对照组（P<0.05）。结论 Mammotome微创旋切术加置引流治疗乳腺良性肿物能减少残腔积液,降低炎症反应程度,有助于术后切口愈合,缓解术后疼痛,且不增加并发症风险。

Objective To investigate the effect of Mammotome minimally invasive excision with drainage on postoperative pain,inflammatory stress indexes and complications in patients with benign breast tumors．Methods A total of 100 patients with benign breast tumors admitted to our hospital from January 2020 to January 2022 were selected and grouped by simple random method,each patient was assigned a random number．Patients No.1 to No.51 were included in the experimental group,treated with Mammotome minimally invasive excision with drainage．Patients No.52 to No.100 were included in the control group,treated with Mammotome minimally invasive excision．The treatment effect,perioperative indicators,pain level（NRS score）and inflammatory stress indexes before and 1st and 3rd days after operation and complications were compared between the two groups．Results There were no significant differences in the lesion clearance rate（100.00% vs 97.96%）and the complication rate（3.92% vs 16.32%）between the two groups（P>0.05）．Compared with the control group,the experimental group had longer operation time,less residual cavity liquid and shorter hospital stay（P<0.05）．The NRS score of the experimental group was lower than that of the control group at 1st and 3rd days after operation（P<0.05）．On the third day after operation,the levels of C-reactive protein,interleukin- 6,interleukin-1β and procalcitonin in the two groups were increased compared with those before operation,and the increase in the experimental group was smaller than that in the observation group（P<0.05）．Conclusions Mammotome minimally invasive excision with drainage in the treatment of benign breast tumors can reduce residual cavity fluid accumulation,reduce the degree of inflammatory response,help postoperative incision healing,relieve postoperative pain,and without increasing the risk of complications．

目的 对比不同血管通路运用于血液透析中的透析充分性及并发症发生率分析。方法 选取我院2018年5月—2020年10月收治的其中60例血液透析患者作为研究对象,根据患者不同血管通路分为3组,甲组30例,采取自体动静脉内瘘为通路方式,乙组15例,采取聚四氟乙烯移植血管内瘘为通路方式;丙组15例,采取带隧道和涤纶套的透析导管为通路方式。观察并记录3组患者透析后的血红蛋白、高密度脂蛋白、总胆固醇、C反应蛋白、血浆清蛋白、低密度脂蛋白、尿素清除指数、甘油三酯、尿素降低率水平,并对患者随访10个月,观察3组患者血管通路并发症(感染及血栓栓塞)的发生情况。结果 透析后3组患者血红蛋白、总胆固醇、高密度脂蛋白、甘油三酯、血浆清蛋白、C反应蛋白、低密度脂蛋白、尿素清除指数、尿素清除率比较,差异无统计学意义(P>0.05)。甲组的感染和血栓栓塞发生率低于乙组和丙组,而乙组的感染率又低于丙组,差异有统计学意义(P<0.05)。结论 自体动静脉内瘘可以做为血液透析治疗中血管通路的首选方式,若患者自体血管条件有限,可考虑建立移植血管内瘘来保证透析的充分性,降低并发症发生率,提高患者透析安全性及生活质量。

Objective To compare the dialysis adequacy and complication incidence of different vascular access in hemodialysis. Methods A total of 60 hemodialysis patients treated in our hospital from May 2018 to October 2020 were selected as the research objects. They were divided into three groups according to different vascular access. Thirty patients in group A took autologous arteriovenous fistula (AVF) as the access, and 15 patients in group B took polytetrafluoroethylene graft (arteriovenous grafts,AVG) as the access, 15 cases in group C were treated with dialysis catheter with tunnel and polyester sleeve (tunnel-cuffed catheter,TCC). The levels of hemoglobin, high density lipoprotein, total cholesterol, C-reactive protein, plasma albumin, low density lipoprotein, urea clearance index, triglyceride and urea reduction ratio (URR) were observed and recorded. The patients were followed up for 10 months to observe the incidence of vascular access complications (infection and thromboembolism) in the three groups. Results There was no significant difference in hemoglobin, total cholesterol, high density lipoprotein, triglyceride, plasma albumin, C-reactive protein, low density lipoprotein, urea clearance index and URR among the three groups after dialysis (P>0.05). The incidence of infection and thromboembolism in group A was lower than that in group B and group C, while the infection rate in group B was lower than that in group C, the differences were statistically significant (P<0.05). Conclusions AVF can be used as the preferred way of vascular access in hemodialysis treatment. If the patient's autologous vascular conditions are limited, it can be considered to establish transplanted vascular fistula (AVG) to ensure the adequacy of dialysis, reduce the incidence of complications and improve the dialysis safety and quality of life of patients.