【摘要】目的：探讨超声骨刀与高速涡轮手机在颌骨囊肿患者外科手术中的应用效果及安全性。方法：研究选择2024年1月~2025年6月至我院行囊肿刮治术治疗的100例颌骨囊肿患者，通过隐藏信封法将入组患者随机列为常规组、试验组，每组50例。常规组术中应用高速涡轮手机去骨，试验组术中应用超声骨刀去骨，比较两组患者的手术情况，术后疼痛肿胀情况及住院期间并发症发生情况。术毕随访半年，比较两组患者神经损伤情况及骨愈合情况。结果：试验组的术中出血量、术后24h引流量、切骨精度偏差分别为（30.59±5.24）mL、（20.55±5.28）mL、（0.18±0.05）mm，均低于常规组[（40.19±7.33）mL、（30.46±6.45）mL、（0.59±0.12）mm]（t=7.534，8.407，22.301；P＜0.05）；手术耗时与常规组比较，差异无统计学意义（P＞0.05）。试验组术后24h、48h、72h的视觉模拟疼痛量表（VAS）评分，肿胀评分均低于常规组（t=4.403，3.354，12.986，4.610，2.911，14.888；P＜0.05）。试验组住院期间的并发症发生率4.00%（2/50）低于常规组18.00%（9/50）（x2=5.005；P＜0.05）。试验组随访第1个月、第3个月、第6个月的神经传导速度（NCV）均高于常规组，两点辨别觉（TPD）均低于常规组（t=4.598，5.784，6.322，3.194，3.595，3.501；P＜0.05）。截至随访结束时，试验组的成骨率分别为（75.27±8.14）%高于常规组（68.18±5.27）%]，骨缺损面积、创面愈合时间、骨吸收量分别为（55.29±5.42）%、（3.22±0.47）月、（1.25±0.36）mm，均低于常规组[（62.44±7.51）%、（5.08±1.33）月、（2.49±0.32）mm]（t=5.170，5.459，9.324，18.204；P＜0.05）。结论：与高速涡轮手机相比，超声骨刀可降低颌骨囊肿患者术中出血风险并实现精准去骨，在减轻术后疼痛、肿胀程度同时能一定程度减轻术后神经损伤，对促进患者骨愈合也有积极影响。

[Abstract]Objective:To explore the application effect and safety of ultrasound bone scalpel and high-speed turbine mobile phone in surgical procedures for patients with jaw cysts.Methods:A total of 100 patients with maxillary cysts who underwent curettage surgery in our hospital from January 2024 to June 2025 were selected for the study. The enrolled patients were randomly divided into a control group and an experimental group using the hidden envelope method, with 50 patients in each group. The conventional group used high-speed turbine mobile phones for bone removal during surgery, while the experimental group used ultrasonic bone knives for bone removal during surgery. The surgical conditions, postoperative pain and swelling, and incidence of complications during hospitalization were compared between the two groups of patients. Follow up for six months after surgery to compare the nerve damage and bone healing between the two groups of patients.Results:The intraoperative bleeding volume, postoperative 24-hour drainage volume, and bone cutting accuracy deviation of the experimental group were (30.59 ± 5.24) mL, (20.55 ± 5.28) mL, and (0.18 ± 0.05) mm, respectively, all lower than those of the control group [(40.19 ± 7.33) mL, (30.46 ± 6.45) mL, and (0.59 ± 0.12) mm] (t=7.534，8.407，22.301; P<0.05); The surgical time of the experimental group was similar to the control group (P>0.05). The VAS scores and swelling scores of the experimental group at 24, 48, and 72 hours after surgery were lower than the control group (t=4.403，3.354，12.986，4.610，2.911，14.888；; P<0.05). The incidence of complications during hospitalization in the experimental group was 4.00% (2/50) lower than the control group 18.00% (9/50) (x2=5.005; P<0.05).The NCV of the experimental group was higher than the control group at the1,3,6 months of follow-up, and TPD was lower than the control group (t=4.598，5.784，6.322，3.194，3.595，3.501; P<0.05). As of the end of follow-up, the osteogenic rate of the experimental group was (75.27 ± 8.14)% higher than the control group (68.18 ± 5.27)%. The bone defect area, wound healing time, and bone resorption were (55.29 ± 5.42)%, (3.22 ± 0.47) months, and (1.25 ± 0.36) mm, lower than the control group [(62.44 ± 7.51)%, (5.08 ± 1.33) months, and (2.49 ± 0.32) mm] (t=5.170，5.459，9.324，18.204; P<0.05).Conclusion:Compared with high-speed turbo phones, ultrasonic bone scalpel can reduce the risk of intraoperative bleeding in patients with jaw cysts and achieve precise bone removal. It can alleviate postoperative pain and swelling while greatly avoiding postoperative nerve damage, and has a positive impact on promoting bone healing in patients.

【摘要】目的：探讨安全-行为双维度管理模式在儿童全麻舒适化口腔治疗中的应用效果。方法：选取2025年4月至2025年12月在本院接受全麻舒适化口腔治疗的80例患儿作为研究对象，根据围术期不同管理方式分为观察组和对照组，每组40例。对照组实施常规围术期管理，观察组实施安全-行为双维度管理模式。对比两组患儿牙科恐惧程度、治疗依从性、苏醒期躁动发生率及家属满意度。结果：术前检查、麻醉诱导、出院时观察组CFSS-DS评分均比对照组低（P＜0.05），FCS评分均比对照组高（P＜0.05）。与对照组苏醒期躁动发生率20.00%对比，观察组5.00%显著降低（P＜0.05）。与对照组家属满意度75.00%对比，观察组95.00%显著升高（P＜0.05）。结论：在儿童全麻舒适化口腔治疗中应用安全-行为双维度管理模式干预，可有效减轻患儿牙科恐惧程度，提高治疗依从性，减少苏醒期躁动发生，提升家属满意度，值得临床推广应用。

目的 比较横断疝囊与完全剥离疝囊在经腹腹膜前疝修补术（TAPP）在中老年单侧腹股沟疝中的临床价值。方法 回顾性选取2021年3月至2025年3月我院95例中老年单侧腹股沟疝，均采用TAPP治疗，根据疝囊具体处理策略分为横断组（横断疝囊，n＝65）和剥离组（完全剥离疝囊，n＝30）。比较两组手术指标、手术前后疼痛程度[疼痛数字评价量表（NRS）评分]、生活质量[生活质量综合评定问卷-74（GQOLI-74）]、并发症及术后12个月复发情况。结果 较剥离组，横断组手术、疝囊处理、卧床及住院时间缩短，腹股沟区积液及术中失血量减少（P＜0.05）；术后6 h、24 h、72 h横断组NRS评分较剥离组降低（P＜0.05）；术后3个月横断组GQOLI-74总分高于剥离组（P＜0.05）；两组并发症及复发率无显著差异（P＞0.05）。结论 在中老年单侧腹股沟疝TAPP中应用横断疝囊能优化手术流程，减轻疼痛程度，改善生活质量，且安全性、复发效果与完全剥离疝囊相当。

目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。

Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice．Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study．This led to the integration of a preliminary evaluation framework．Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project．Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals．This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023．Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application．Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%．Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process．Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors．This system holds considerable potential for widespread clinical adoption and application．

目的 对比分析钝性分离扩皮法与常规扩皮法对乳腺癌术后患者经外周静脉置入中心静脉导管（PICC）置管应用效果。方法 选取2022年4月—2024年4月在天津肿瘤医院空港医院接受治疗的120例乳腺癌术后PICC置管患者,依据随机数字表法进行分组处理。对照组60例给予常规扩皮法,观察组60例给予钝性分离扩皮法,对比两组患者扩皮结果。结果 观察组患者满意度为96.67%,对照组患者满意度为86.67%（χ²=3.927,P=0.048）;观察组患者的穿刺点血液浸湿面积分别为穿刺后即刻（0.87±0.14）cm²、1 d后（4.89±0.94）cm²以及3 d后（0.21±0.05）cm²,均低于对照组的（2.74±0.63）（9.89±2.04）（0.44±0.12）cm²,对比差异有统计学意义（t=22.444、17.243、13.704,P<0.05）;观察组患者一次性送鞘成功率为98.33%,对照组患者一次性送鞘成功率为88.33%,观察组高于对照组（χ²=4.821,P=0.028）;扩皮前两组患者的VAS评分无差异（P>0.05）,扩皮后两组患者的VAS评分均降低,且观察组（1.75±0.54）分低于对照组（3.89±1.22）分,对比差异有统计学意义（t=12.425,P<0.001）;观察组患者不良事件发生率为5.00%,对照组患者不良事件发生率为16.67%,观察组患者不良事件发生率低于对照组（χ²=4.227,P<0.05）。结论 钝性分离扩皮法能够降低穿刺点血液浸湿面积及不良事件发生率,提高一次性送鞘成功率,减轻患者疼痛感,提高患者满意度。

Objective To analyze the effect of blunt separating skin expansion and conventional skin expansion in PICC catheterization of patients after breast cancer surgery. Methods From April 2022 to April 2024,120 patients with postoperative PICC catheterization for breast cancer were selected and grouped according to the random number table method．Sixty patients in the control group received conventional skin expansion,and 60 patients in the observation group received blunt separation skin expansion,which the results of the two groups were compared．Results The patient satisfaction was 96.67% in the observation group,86.67% in the control group（χ²=3.927,P=0.048,P<0.05）．In the observation group,the blood immersion area after catheterization,after 1 d and 3 d were（0.87±0.14）,（4.89±0.94）,（0.21±0.05）cm²,lower than those of the control group [（2.74±0.63）（9.89±2.04）（0.44±0.12）cm²],the comparative difference was statistically significant（t=22.444,17.243,13.704,P<0.05）．The success rate of disposable sheath delivery in the observation group was 98.33%,which was higher than 88.33% in the control group（χ²=4.821,P=0.028<0.05）．There was no difference in VAS scores between the two groups before the intervention（P>0.05）,VAS scores decreased in both groups after the intervention,the score of the observation group（1.75±0.54）was lower than that of the control group（3.89±1.22）,the difference was statistically significant（t=12.425,P<0.001）．The incidence of adverse events in the observation group was 5.00%,and in the control group was 16.67%,which difference was significant（χ²=4.227,P<0.05）．Conclusions Blunt separating skin expansion can reduce the area of blood immersion and the incidence of adverse events,improve the success rate of disposable sheath delivery,reduce patient pain,improve patient satisfaction,and have significant clinical application value．

目的 探讨支气管镜灌洗用于儿童重症肺部感染合并肺实变的治疗效果及对CT特征、肺功能的影响。方法 选取2022年5月—2024年5月铜仁市人民医院收治的100例重症肺部感染合并肺实变患儿开展前瞻性研究,应用随机数表法分为对照组和观察组,每组各50例。对照组患儿采取常规治疗,观察组则采取常规治疗加支气管镜灌洗治疗。对比其临床疗效,治疗前后炎症因子、CT特征及肺功能变化。结果 观察组治疗总有效率高于对照组（P<0.05）;治疗后观察组患儿白细胞计数（10.36±2.52）×10⁹/L、白细胞介素-6（20.57±5.05）ng/L、C反应蛋白（13.12±2.64）mg/L、降钙素原（101.62±12.16）pg/L均低于对照组白细胞计数（13.25±3.32）×10⁹/L、白细胞介素-6（31.69±4.11）ng/L、C反应蛋白（16.16±4.44）mg/L、降钙素原（113.46±18.11）pg/L（P<0.05）;治疗后两组患儿胸腔积液、支气管壁增厚、空气支气管征、肺部实变、磨玻璃影等相关CT影像特征占比下降,且观察组低于对照组（P<0.05）;治疗后两组患儿呼气流量峰值水平均升高,观察组（90.67±18.45）L/s高于对照组（81.27±17.69）L/s,用力肺活量水平均更高,观察组（3.33±0.68）L高于对照组（2.68±0.25）L（P<0.05）。结论 针对儿童重症肺部感染合并肺实变,在常规治疗基础上增加支气管镜灌洗可提升临床疗效,减轻机体炎症反应,改善胸部CT各种表现及肺功能。

Objective To explore the therapeutic effects of bronchoalveolar lavage in children with severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function．Methods A prospective study was conducted on 100 children with severe pulmonary infection complicated with pulmonary consolidation in a hospital from May 2022 to May 2024．They were randomly divided into observation group and control group using a random number table method,50 cases in each group．The control group of children received routine treatment,and the observation group received conventional treatment plus bronchoalveolar lavage．Clinical efficacy,inflammatory factors,CT features,and alterations in pulmonary function before and after therapy were compared．Results The total effective rate of the observation group was higher than that of the control group（P<0.05）．After treatment,the white blood cell count（10.36±2.52）×10⁹/L,interleukin-6（20.57±5.05）ng/L,C-reactive protein（13.12±2.64）mg/L,and procalcitonin（101.62±12.16）pg/L in the observation group were all lower than those in the control group（13.25±3.32）×10⁹/L,interleukin-6（31.69±4.11）ng/L,C-reactive protein（16.16±4.44）mg/L,and procalcitonin（113.46±18.11）pg/L（P<0.05）．After treatment,the proportion of CT imaging features such as pleural effusion,bronchial wall thickening,air bronchogram sign,lung consolidation,ground glass opacities,decreased in both groups of children,and the observation group was lower than the control group（P<0.05）．After treatment,the peak levels of expiratory flow in both groups of children increased,with the observation group（90.67±18.45）L/s higher than the control group（81.27±17.69）L/s．The forced vital capacity levels were also higher,with the observation group（3.33±0.68）L higher than the control group（2.68±0.25）L（P<0.05）．Conclusions Adding bronchoalveolar lavage to routine treatment for children with severe pulmonary infection complicated with pulmonary consolidation can improve their clinical efficacy,alleviate inflammatory reactions,and improve various chest CT manifestations and lung function．

目的 探讨基于迷你临床演练评估（Mini-CEX）的可视化思维导图联合案例教学在全科住院医师规范化培训中的应用效果。方法 选取参加全科住院医师规范化培训的52例学员并分为试验组（n=26）和对照组（n=26）。对照组采取以案例讲授为主的传统教学模式,试验组采取基于Mini-CEX的可视化思维导图联合案例教学模式。对比两组Mini-CEX评分、考核成绩及教学满意度。结果 试验组Mini-CEX测评的问诊技巧、体格检查、临床判断、诊治能力、技能操作及整体表现得分均高于对照组（P<0.05）。试验组理论知识[（86.89±4.75）分 vs （82.96±4.87分）]、专业技能[（84.20±3.46）分 vs （70.18±4.93）分]及病历书写成绩[（80.64±5.26）分 vs （75.58±5.94）分]均高于对照组（t分别为2.678、13.685、2.764,P分别为0.009、<0.001、0.007）。试验组住院医师教学满意度高于对照组（P<0.05）。结论 基于Mini-CEX的可视化思维导图联合案例教学模式用于全科住院医师规范化培训,有助于提高教学效果及教学满意度。

Objective To evaluate the effect of visual mind mapping combined with case teaching based on mini-clinical evaluation exercise（Mini-CEX）for standardized training of general practitioners．Methods A total of 52 students who participated the standardized training of general practitioners were selected and divided into an experimental group（n=26）and a control group（n=26）．The control group adopted the traditional teaching mode based on case teaching and the experimental group adopted the visual mind mapping combined with case teaching based on Mini-CEX．The Mini-CEX score,assessment results and teaching satisfaction of two groups were compared．Results The interrogation skills,physical examination,clinical judgment,diagnosis and treatment ability,skill operation and overall performance of Mini-CEX in experimental group were higher than control group（P<0.05）．Theoretical knowledge score（[86.89±4.75] vs [82.96±4.87]）,professional skills score（[84.20±3.46] vs [70.18±4.93]）and medical record writing score（[80.64±5.26] vs [75.58±5.94]）of experimental groups were higher than control group（t=2.678,13.685,2.764,P=0.009,<0.001,0.007）．The teaching satisfaction of residents in experimental group was higher than control group（P<0.05）．Conclusions The visual mind mapping combined with case teaching based on Mini-CEX for standardized training of general practitioners is helpful to improve teaching effect and teaching satisfaction．

目的 探讨多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓发生率的影响。方法 选择2021年1月—2022年10月我院收治的70例下肢骨折患者,随机分为联合组与常规组,每组各35例。常规组患者实施常规护理,联合组患者实施多学科整合护理路径联合手术室优质护理,对比两组患者护理效果。结果 联合组患者首次下床活动时间、术后视觉模拟量表（VAS）评分低于常规组（P<0.05）,二者住院时间以及引流管拔除时间比较差异无统计学意义（P>0.05）;经过护理干预后,两组的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）均延长,血浆纤维蛋白原（FIB）降低,联合组优于常规组（P<0.05）,且联合组下肢静脉血栓发生率低于常规组（0% vs 17.14%,P<0.05）;联合组患者护理满意度更高（P<0.05）;术后1个月两组患者日常生活活动能力（ADL）评分、Fugl-Meyer评分均升高,联合组高于常规组（P<0.05）。结论 多学科整合护理路径联合手术室优质护理可改善下肢骨折患者围术期指标和血液高凝状态,降低患者下肢静脉血栓发生率,提升护理满意度及患者远期日常生活能力、肢体运动功能。

Objective To explore the application effect of multidisciplinary integrated nursing path combined with high-quality nursing in operating room on patients with lower limb fracture and the effect on postoperative lower limb venous thrombosis．Methods From January 2021 to October 2022,70 patients with lower limb fracture admitted to our hospital were randomly divided into combination group and conventional group,with 35 cases in each group．Patients in the conventional group received routine nursing,and patients in the combined group received multidisciplinary integrated nursing path combined with high-quality nursing in the operating room．The nursing effect of the two groups was compared．Results The first time of getting out of bed in the combined group was earlier and postoperative VAS score was lower than those in the conventional group（P<0.05）,and the length of hospital stay and drainage tube removal time were not significantly different between the two groups（P>0.05）．After nursing intervention,the prothrombin time（PT）and activated partial thromboplastin time（APTT）of the two groups were prolonged,and the plasma fibrinogen（FIB）decreased,and the change range of the combined group was greater（P<0.05）．The incidence of venous thrombosis in the combined group was significantly lower than that in the conventional group（0.00% vs 17.14%,P<0.05）．The nursing satisfaction of patients in combination group was higher（P<0.05）．The activities of daily living score and Fugl-Meyer score of both groups increased one month after surgery,and the combined group was higher than the conventional group（P<0.05）．Conclusions Multidisciplinary integrated nursing path combined with high-quality nursing in operating room can improve perioperative indicators and blood hypercoagulability of patients with lower limb fractures,reduce the incidence of lower limb venous thrombosis,improve nursing satisfaction,long-term daily living ability and limb motor function of patients．

目的 探讨计划-实施-检查-处理（PDCA）循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）]、肺功能指标[第1秒用力呼气容积（FEV₁）、潮气量（VT）]、炎症免疫指标[单核细胞趋化蛋白-1（MCP-1）、可溶性髓系细胞触发受体-1（sTREM-1）、可溶性细胞间黏附分子-1（sICAM-1）]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义（P<0.05）。干预前,两组患儿PaO₂、SaO₂、PaCO₂、FEV₁、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义（P>0.05）;干预后,两组患儿上述指标水平均有不同程度变化（P<0.05）,观察组PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）、SaO₂（93.58±3.82% vs 86.30±4.21%）、FEV₁（2.66±0.46 L vs 1.97±0.34 L）、VT（11.92±1.89% vs 9.83±1.10%）水平均高于对照组,观察组PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）、MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）、sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）、sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）水平低于对照组,差异均有统计学意义（P<0.05）。观察组患儿家属满意度整体优于对照组（P<0.05）;观察组总满意率（97.5% vs 77.5%）高于对照组,差异有统计学意义（P<0.05）。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。

Objective To explore the application effect of Plan-Do-Check-Action（PDCA）circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation．Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study．Based on the random number table method,they were divided into two groups,with 40 cases in each group．The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention．The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure（PaO₂）,arterial oxygen saturation（SaO₂）,arterial partial pressure of carbon dioxide（PaCO₂）],lung function indicators [（forced expiratory volume in 1 second,FEV₁）,tidal volume（VT）],and inflammatory immune indicators [monocyte chemotactic protein-1（MCP-1）,soluble myeloid cell trigger receptor-1（sTREM-1）,soluble intercellular adhesion molecule-1（sICAM-1）] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared．Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Before intervention,there was no statistically significant difference in the levels of PaO₂,SaO₂,PaCO₂,FEV₁,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children（P>0.05）．After intervention,the levels of the above indicators in both groups of children showed varying degrees of change（P<0.05）．The levels of PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）,SaO₂（93.58±3.82% vs 86.30±4.21%）,FEV₁（2.66±0.46 L vs 1.97±0.34 L）,VT（11.92±1.89% vs 9.83±1.10%）in the observation group were higher than those in the control group．The levels of PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）,MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）,sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）and sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）in the observation group were lower than those of the control group,with statistically significant differences（P<0.05）．The overall satisfaction of the observation group was better than that of the control group（P<0.05）,the total family members’ satisfaction rate of the observation group was higher than that of the control group（97.5% vs 77.5%）,with a statistically significant difference（P<0.05）．Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction．

目的 探究纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗根管治疗（RCT）后后牙楔状缺损（WSD）的效果。方法 选取2019年8月—2022年8月在新乡市口腔医院治疗的300例（300牙）RCT后后牙WSD患者,按随机数字表法分成A组（n=150）、B组（n=150）。A组接受纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗,B组接受金属烤瓷冠（PFM）联合金属桩核（MPC）修复治疗。对比2组修复成功率、修复效果、修复前后牙周健康指标[牙龈指数（GI）、菌斑指数（PLI）、牙周探诊深度（PD）]、龈沟液炎性因子[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）]水平。结果 A组修复成功率为97.33%（146/150）,高于B组的87.33%（131/150）（P<0.05）;A组边缘密合性、表面质地、颜色匹配均优于B组（P<0.05）;修复6个月后A组GI、PLI、PD较B组低（P<0.05）;修复1个月后A组龈沟液TNF-α、IL-6水平较B组低,IL-10水平较B组高（P<0.05）。结论 与PFM联合MPC修复治疗RCT后后牙WSD患者相比,应用纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗更有助于提升修复成功率及修复效果,改善牙周健康,且对组织产生创伤更小。

Objective To investigate the restorations outcome of fibre post + composite resin + zirconia porcelain crown for patients with wedge-shaped defects（WSD）in posterior teeth after root canal therapy（RCT）．Methods A total of 300 patients（300 teeth）with posterior WSD after RCT in our hospital（from August 2019 to August 2022）were selected and divided into group A（n=150）and group B（n=150）according to random number table method．Group A received composite resin + zirconia porcelain crown + fiber post repair treatment,while group B received porcelain fused to metal（PFM）+ metal post core（MPC）repair treatment．The success rate of repair,the effect of repair,the periodontal health indicators before and after repair[gingival index（GI）,plaque index（PLI）,periodontal probing depth（PD）],and the levels of gingival creval fluid inflammatory factors[interleukin-6（IL-6）,IL-10,tumor necrosis factor-α（TNF-α）] were compared between the two groups．Results The success rate of repair in group A was 97.33%（146/150）,higher than 87.33%（131/150）of group B（P<0.05）．The edge tightness,surface texture and color matching of group A were better than those of group B（P<0.05）．After 6 months of repair,GI,PLI and PD in group A were lower than those in group B（P<0.05）．After one month of repair,the contents of TNF-α and IL-6 in gingival crevicular fluid of group A were lower than those of group B,and the contents of IL-10 were higher than those of group B（P<0.05）．Conclusions Compared with PFM+MPC in the treatment of posterior WSD patients after RCT,the application of composite resin + zirconia porcelain crown + fiber post repair is more helpful to improve the success rate and effect of repair,improve periodontal health,and cause less tissue trauma．