【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 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练（ACBT）在非小细胞肺癌（NSCLC）化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者，采用随机数字表法将所有研究对象分为联合组和常规组，每组49例。常规组给予常规干预，联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后，两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组（P<0.05）；联合组FVC、FEV1、MVV及6MWT均显著高于常规组（P＜0.05）；干预前两组6MWT组间对比差异无统计学意义（P>0.05），干预4周、6周、8周、12周后，两组6MWT均较干预前增加，且联合组远于常规组（P<0.05）；干预12周后，两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升，且联合组高于常规组（P<0.05）。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能，提高生活质量和运动耐力。
Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.
目的：探讨填髓益精法联合环孢素A治疗再生障碍性贫血（AA）的临床疗效，及其对骨髓造血功能、免疫功能及生活质量的影响。方法：选取2021年1月—2026年1月收治的AA患者65例，随机分为对照组（21例）、中药组（23例）、综合组（21例）。对照组予环孢素A口服；中药组在对照组基础上加用填髓益精方口服；综合组在中药组基础上联合督灸、艾灸、耳针治疗。连续治疗24周，观察三组临床疗效、血常规、免疫指标、生活质量及不良反应。结果：对照组、中药组、综合组总有效率分别为76.19%、86.96%、85.71%，中药组与综合组均显著高于对照组（P<0.05）。治疗后，三组红细胞、血红蛋白、血小板均较治疗前升高（P<0.05），IL?2水平下降，CD3?、CD4?、CD4?/CD8?升高，中药组与综合组改善优于对照组（P<0.05）。生活质量评分综合组改善最优，三组不良反应发生率差异无统计学意义（P>0.05）。结论：填髓益精法联合环孢素A可有效提高AA临床疗效，改善骨髓造血与免疫功能，提升生活质量，安全性良好，值得临床推广。
Objective To investigate the clinical efficacy of traditional Chinese medicine (TCM) method of tonifying marrow and nourishing essence combined with cyclosporine A in the treatment of aplastic anemia (AA)， and its effects on bone marrow hematopoiesis， immune function and quality of life. Methods A total of 65 patients with AA admitted from July 2014 to January 2024 were randomly divided into control group (21 cases)， TCM group (23 cases) and comprehensive group (21 cases). The control group was treated with oral cyclosporine A; the TCM group was additionally given Tonifying Marrow and Nourishing Essence Decoction; the comprehensive group was further combined with governor vessel moxibustion， moxibustion and ear acupuncture on the basis of the TCM group. All patients were treated for 24 weeks. The clinical efficacy， blood routine， immune indexes， quality of life and adverse reactions were observed. Results The total effective rates of the control group， TCM group and comprehensive group were 76.19%， 86.96% and 85.71%， respectively. The TCM group and comprehensive group were significantly higher than the control group (P<0.05). After treatment， red blood cells， hemoglobin and platelets in the three groups were increased compared with those before treatment (P<0.05)， the levels of IL?2 were decreased， and CD3?， CD4? and CD4?/CD8? were increased. The improvements in the TCM group and comprehensive group were better than those in the control group (P<0.05). The quality of life score of the comprehensive group was the best， and there was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion TCM method of tonifying marrow and nourishing essence combined with cyclosporine A can effectively improve the clinical efficacy of AA， ameliorate bone marrow hematopoiesis and immune function， and improve quality of life with good safety， which is worthy of clinical promotion.
意识障碍（Disorders of Consciousness, DoC）是颅脑损伤、脑卒中、缺血缺氧性脑病等严重脑损伤后的常见并发症，其康复治疗是神经科学领域的重大挑战。重复经颅磁刺激（Repetitive Transcranial Magnetic Stimulation, rTMS）作为一种无创神经调控技术，通过调节皮层兴奋性、促进神经可塑性及改善脑血流灌注，在DoC治疗中展现出独特优势。本文系统梳理近年研究，从作用机制、临床证据及未来方向等方面进行综述，旨在为临床精准治疗提供理论依据。
背景：经动脉穿刺行冠状动脉介入治疗（PCI）是心血管疾病常见的诊疗手段，但术后常并发术侧上肢肿胀、血肿等并发症，影响患者康复进程。传统护理方法如硫酸镁湿敷效果有限，探索安全有效的中医外治方案具有重要临床意义。目的：探讨芒硝与大黄中药热奄包对经动脉介入术后肿胀的临床疗效及护理要点。方法：总结芒硝与大黄的药理作用，阐述热奄包的制备方法、应用时机、操作流程及注意事项，结合63例PCI术后患者的临床观察数据进行分析。结果：中药热奄包干预组在术后肿胀消退时间、疼痛评分（VAS）、臂围变化及患者舒适度（GCQ）方面均显著优于常规护理组（P<0.05）。结论：芒硝与大黄中药热奄包能有效促进经动脉介入术后肿胀消退，减轻疼痛，提高患者舒适度，操作简便安全，值得临床推广使用。
【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：探讨粒细胞集落刺激因子（G CSF）宫腔灌注联合宫腔粘连冷刀分离术治疗薄型子宫内膜的临床效果。方法：选取2023年9月—2025年9月间在桐乡市妇幼保健院妇科因薄型子宫内膜住院并行手术治疗的患者101例，按治疗方式不同，分为对照组（56例）与治疗组（45例）。对照组采用宫腔镜下宫腔粘连冷刀分离术治疗，治疗组采取G-CSF宫腔灌注联合宫腔粘连冷刀分离术的方式治疗。比较两组手术前后的子宫内膜厚度情况、性激素指标水平、子宫动脉血流参数、术后临床妊娠情况。结果：治疗组子宫内膜厚度、子宫内膜厚度改善值、LH、E2、AMH、PSV、EDV、临床妊娠率均高于对照组，RI、PI低于对照组（P＜0.05）。结论：G-CSF宫腔灌注联合宫腔粘连冷刀分离术在治疗薄型子宫内膜中可取得令人满意的效果，能通过改善子宫的血流，促进子宫内膜的生长，而且还可提升性激素水平，对促进术后妊娠率的上升有积极的作用。
目的 探讨密室逃脱教学法运用于急诊护理教学查房的效果。方法 选取2024年6月—2025年6月在本院急诊科的新入职护士76人作为研究对象,按随机数字表法将所有护士分为对照组和观察组（n均=38）。对照组采用传统模式护理教学查房,观察组采用密室逃脱教学法教学查房。培训后对两组护士采用理论及操作技能考核、批判性思维能力量表-中文版进行考核，并调查两组护士对两种教学模式的满意度。结果 与对照组比较，观察组的理论知识成绩及操作技能成绩明显提升（P＜0.05）；另外，观察组的批判性思维能力量表-中文版得分比对照组明显提升（P＜0.05）。观察组的非常满意、比较满意例数（率）及总满意度均比对照组明显增加（P＜0.05）。结论 密室逃脱教学法可有效提高急诊护理教学查房效果，值得在临床教学实践中进一步推广。
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。
2-8℃低温干预结合金银花口腔喷雾在甲状腺术后气管拔管患者中的应用研究
