目的 探讨导言-目标-前测-对照-后测-总结（BOPPPS）教学模式在基层护理培训中的应用效果。方法 采用类实验研究方法,将2021年5月—2021年12月参加培训的96名护士设为对照组,使用传统教学模式,将2022年1月—2022年12月参加培训的325名护士设为研究组,使用BOPPPS教学模式。对两组学员的教学效果通过理论、操作考核及问卷调查进行比较。结果 对照组学员理论知识、技能操作以及培训满意度均高于对照组,差异均有统计学意义（均P<0.05）。结论 BOPPPS教学模式在基层护理实训课中具有重要意义,可提高学员理论和技能操作能力,提升学员满意度。

Objective To explore the application effect of BOPPPS teaching mode in nursing primary training. Methods Adopting class experimental research method,96 nurses who participated in the training from May 2021 to December 2021 were the control group,using the traditional teaching method．The 325 nurses who participated in the training from January 2022 to December 2022 were set up as a study group using the BOPPPS teaching model．The teaching effectiveness of the two groups of nurses was compared through theoretical and operative examinations and questionnaires. Results The theoretical knowledge,skill operation and training satisfaction of the trainees in the experimental group were higher than those in the control group,and the differences were statistically significant（P<0.05）. Conclusions BOPPPS teaching mode is of great significance in nursing primary practical training course,which can improve the theory and skill operation ability of trainees and enhance the satisfaction of trainees．

目的 分析以信息-动机-行为技巧（IMB）模型为基础延续护理平台在帕金森病患者中的应用效果。方法 纳入河南省人民医院在2019年1月至2022年1月期收治的帕金森病患者96例进行研究,将其依据随机数表法分为对照组和观察组,均为48例,对照组均给予常规护理干预,观察组均给予以IMB模型为基础延续护理平台干预。比较两组主要照顾者干预前24 h（T0）和完成干预24 h（T1）内的心理状态评分、自我效能、希望水平、运动能力、肌张力、认知功能,并评估T1时刻的Barthel指数。结果 观察组患者T1时的汉密尔顿焦虑量表（HAMA）（16.64±2.57）分、汉密尔顿抑郁量表（HAMD）（16.38±1.69）分均低于对照组（20.65±1.68）（19.57±2.65）分（t=10.116、5.407,P<0.001）,观察组患者T1时的自我效能（7.24±1.48）分、希望水平（44.51±4.07分）均高于对照组（6.02±1.74）（38.95±4.54）分（t=3.357、3.311,P<0.001）,观察组患者T1时的运动能力评分（43.62±4.01）分高于对照组（39.17±5.25）分（t=4.715,P<0.001）,肌张力评分（0.72±0.21）分低于对照组（1.13±0.52）分（t=5.118,P<0.001）,观察组患者T1时刻的Barthel指数评估依靠帮助完成率（6.25%）、部分完成率（10.42%）低于对照组（25.00%）、（27.08%）（χ²=6.353、5.263,P<0.05）,观察组患者T1时刻的命名能力（3.46±0.51）、延迟回忆（3.78±0.21）分、语言能力（3.29±0.48）分、注意力评分（3.95±0.10）分均高于对照组（2.91±0.98 ）（3.21±0.96）（2.87±0.82）（3.76±0.05）分（t=3.698、3.675、3.846、4.305,P<0.001）。结论 以IMB模型为基础延续护理平台干预能够改善帕金森病患者的负性情绪,提升自我效能、希望水平,改善运动能力、肌张力、日常生活能力、认知水平。

Objective To analyze the application effect of the information motivation behavioral skills（IMB）model as a continuous care platform in Parkinson's patients. Methods A study was conducted on 96 Parkinson's patients enrolled in our hospital from January 2019 to January 2022．They were divided into a control group and an observation group based on a random number table method,with 48 patients in each group．The control group received routine nursing intervention,while the observation group received continuous nursing platform intervention based on the IMB model．The psychological state scores,self-efficacy,hope level,motor ability,muscle tone,cognitive function of the two main caregivers 24 hours before intervention（T0）and 24 hours after completion of intervention（T1）,and evaluate the Barthel index at T1 time were compared. Results The Hamilton Anxiety Scale（HAMA）[（16.64±2.57）points] and Hamilton Depression Scale（HAMD）[（16.38±1.69 points）scores] of patients in the observation group at T1 were lower than those in the control group [（20.65±1.68）points,（19.57±2.65）points]（t=10.116,5.407,P<0.001）．The self-efficacy of patients in the observation group at T1 was（7.24±1.48）points．The hope level [（44.51±4.07）points] was higher than that of the control group [（6.02±1.74）points,（38.95±4.54）points]（t=3.357,3.311,P<0.001）．The motor ability score at T1 time in the observation group [（43.62±4.01）points] was higher than that in the control group [（39.17±5.25）points]（t=4.715,P<0.001）,and the muscle tone score [（0.72±0.21）points] was lower than that in the control group [（1.13±0.52）points]（t=5.118,P<0.001）．The Barthel index evaluation of patients in the observation group at T1 time relied on help completion rate（6.25%）and partial completion rate（10.42%）,which were lower than those in the control group（25.00%）and（27.08%）（χ²=6.353,5.263,P=0.012,0.022）．The naming ability [（3.46±0.51）points],delayed recall [（3.78±0.21）points],language ability [（3.29±0.48）points],attention scores [（3.95±0.10）points] were higher than the control group [（2.91±0.98）points,（3.21±0.96）points,（2.87±0.82）points,（3.76±0.05）points]（t=3.698,3.675,3.846,4.305,P=<0.001,<0.001,<0.001）. Conclusions Continuing nursing platform intervention based on the IMB model can improve the negative emotions,self-efficacy,hope level,motor ability,muscle tone,daily living ability,and cognitive level of Parkinson's patients．

目的 探讨2型糖尿病（T2DM）睡眠障碍患者使用经颅微电流刺激（CES）联合自我穴位按摩干预的效果。方法 使用随机数表法将南昌大学第二附属医院2022年6月—2023年1月收治的T2DM合并睡眠障碍患者100例分为两组,每组各50例。对照组采用CES干预,基于此,观察组加用自我穴位按摩,比较两组临床疗效、睡眠质量及血糖水平。结果 与对照组干预总有效率80.00%（40/50）比较,观察组干预总有效率96.00%（48/50）更高（χ²=6.061,P=0.014）;两组干预后匹兹堡睡眠质量指数（PSQI）中入睡时间、睡眠效率、催眠药物、睡眠障碍、睡眠时间、主观睡眠质量、日间功能障碍及总分均降低,且观察组[（0.95±0.28）分、（1.05±0.24）分、（0.55±0.14）分、（0.67±0.20）分、（0.92±0.21）分、（0.82±0.20）分、（0.65±0.18）分、（5.61±1.10）分]均低于对照组[（1.42±0.33）分、（1.30±0.33）分、（1.40±0.26）分、（1.14±0.27）分、（1.31±0.30）分、（1.32±0.37）分、（1.22±0.27）分、（9.11±1.26）分]（t=7.679、4.332、20.354、9.891、7.531、8.406、12.421、14.797,均P<0.001）;两组干预后餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA_1c）及空腹血糖（FBG）水平均降低,且观察组2 hPG[（6.14±0.68）mmol/L]、HbA_1c[（3.45±0.37）%]、FBG[（5.52±0.48）mmol/L]低于对照组[（7.12±1.25）mmol/L、（4.30±0.34）%、（6.58±0.67）mmol/L]（t=4.870、11.961、9.094,均P<0.001）。结论 对T2DM合并睡眠障碍患者使用CES联合自我穴位按摩干预效果满意,可有效提高患者的睡眠质量,调节血糖水平。

目的 探讨BOPPPS[（导引（B）,目标（O）,课前测试（P）,参与式学习（P）,课后测试（P）,总结（S）]模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法 选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士,随机分为对照组和干预组,每组45名护士。对照组采用传统授课模式进行教学培训;干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果 干预组的综合理论成绩为（80.74±6.87）分、单项技能成绩为（92.13±2.26）分,相较于对照组均提高（P<0.05）。干预组对创伤急救课程的总体满意度：非常同意23例、同意20例,比例均高于对照组（P<0.05）。干预组的创伤急救救护综合能力如病情评估预判能力,优秀26例、良好15例;护理计划分析实施能力,优秀25例、良好13例;团队协作与资源管理能力,优秀27例、良好15例;情景感知与应变能力,优秀30例、良好11例;综合救护能力,优秀36例、良好5例。显著优于对照组（P<0.05）。结论 BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力,且取得了较高的满意度,值得进一步推广应用。

Objective To explore the application effect of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model．Methods A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group（n=45） and intervention group（n=45）．The control group was trained by traditional teaching mode．The intervention group was trained by BOPPPS modular teaching combined with simulation exercise．After the training,the comprehensive theory of trauma first aid,individual skills,comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed．Results The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group（P<0.05）．The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group（P<0.05）．The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group（P<0.05）．Conclusions The combination of modular teaching and simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergency department,and has obtained a high degree of satisfaction,which is worthy of further popularization and application．

目的 探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法 对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果 CT增强延迟扫描显示观察组患者分叶征（12.50% vs 53.57%）、内部空泡征数量（6.25% vs 39.29%）低于对照组（χ²=26.560、24.680,P<0.05）,观察组患者边缘毛刺（56.25% vs 17.86%）、胸部凹陷征（59.38% vs 14.29%）、高于对照组（χ²=43.330、64.600,P<0.05）;82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%（79/82）,与病理诊断结果100.00%对比差异无统计学意义（χ²=3.060,P=0.080）;82例非小细胞肺癌平均CT增强值为（39.14±7.31）,不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义（P>0.05）,不同病理类型[腺癌（43.75±7.15）vs 鳞癌（34.74±6.12）]、细胞分化程度[中、低分化（45.71±7.21）vs 高分化（32.81±5.11）]、临床分期[Ⅰ期（31.03±2.12）vs Ⅱ期（36.61±3.13）vs Ⅲa期（46.32±6.83）]患者、淋巴结转移[是（42.75±4.21）vs 否（35.77±8.13）]CT增强值对比差异有统计学意义（t/F=5.243、8.804、84.828、4.378,P<0.05）;Spearman相关分析结果显示：病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05）。结论 CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。

Objective To explore the application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer（NSCLC）．Methods A retrospective analysis was conducted on 82 patients with NSCLC who underwent surgical treatment in a hospital from May 2021 to May 2024．They were included into an observation group and another 82 patients with benign lung tumors were included in the control group．The preoperative CT enhanced delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC．And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC．Results CT enhanced delayed scanning showed that the number of lobular（12.50% vs 53.57%）and internal vacuolar signs（6.25% vs 39.29%）in the observation group was significantly lower than that in the control group（χ²=26.560,24.680,P<0.05）,while the edge spicules（56.25% vs 17.86%）and chest depression signs（59.38% vs 14.29%）in the observation group were significantly higher than that in the control group（χ²=43.330,64.600,P<0.05）．A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%（79/82）,with no significant difference from the pathological diagnosis result of 100.00%（χ²=3.060,P=0.080）．The average CT enhancement value of 82 NSCLC cases was（39.14±7.31）．There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration（P>0.05）．Patients with different pathological types [adenocarcinoma（43.75±7.15）vs squamous cell carcinoma（34.74±6.12）],degree of cell differentiation [moderate,and low differentiation（45.7±7.21）vs high differentiation（32.81±5.11）],clinical stage [I（31.03±2.12）vs II（36.61±3.13）vs IIIa（46.32±6.83）] and lymph node metastasis [yes（42.75±4.21）,vs no（35.77±8.13）] CT enhancement had significant difference（t/F=5.243,8.804,84.828,4.378,P<0.05）．The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008）．Conclusions CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC．Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients．

目的 探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法 抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度（CRAMS）评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果 观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义（χ²=2.222,P=0.136）;观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组[（23.64±5.69）、（52.27±12.60）min],差异有统计学意义（t=10.349、8.928,P<0.05）;观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义（χ²=0.346,P=0.556）;治疗后两组患者的CRAMS评分均升高,且观察组（9.87±2.62）分高于对照组（8.60±2.98）分,差异有统计学意义（t=2.024,P=0.046）;观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组（χ²=3.914,P=0.048）。结论 本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。

Objective To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans after ambulance return to the hospital for corresponding injury treatment,the observation group received CRAMS scores at the treatment site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis,corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared,and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant（χ²=2.222,P=0.136）．The time to diagnosis（13.56±2.36）min,time to the operating room（30.42±8.99）min were shorter than that in the control group[（23.64±5.69）,（52.27±12.60）min],with significant difference（t=10.349,8.928,P<0.05）．The consistency between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ²=0.346,P=0.556）．After treatment,the CRAMS scores of both groups of patients increased,the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024,P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%,while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ²=3.914,P=0.048）．Conclusions This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces,aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward,which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．

目的本文聚焦DeepSeek这一国产人工智能技术,结合护理临床实践,系统探讨其在护理场景中的应用潜力、现存问题及应对策略。方法检索国内外相关文献,与现有通用人工智能技术对比,进行综述,并提出思考和建议。结果预计DeepSeek在护理文书自动化、个性化护理方案生成、临床决策支持、护理质控及教育培训等提供适配应用路径,针对性的服务和解决方案等。结论DeepSeek可通过多模态技术整合与跨平台互补策略,推动护理服务向智能化、精准化方向发展,为缓解护理人力短缺、优化资源分配提供新思路。

ObjectiveThis study focuses on DeepSeek,a domestic artificial intelligence technology,systematically exploring its application potential,existing issues,and targeted strategies in nursing clinical scenarios through integration with practical nursing care contexts．MethodsRelevant literatures from both domestic and international sources were collected,compared with existing Artificial General Intelligence（AGI）technologies,to conduct a review,and propose reflections and recommendations．ResultsThrough literature review and technical comparisons,the results proposed specific application paths for DeepSeek in scenarios such as automated nursing documentation,personalized care plan generation,clinical decision support,quality control,and education．It further addressed issues including data privacy,ethical risks,and technical limitations．ConclusionsThe findings suggest that DeepSeek can integrate multimodal technologies and cross-platform complementary strategies to promote intelligent and precise nursing services,offering innovative solutions to alleviate nursing shortages and optimize resource allocation．

传统的结肠镜检查质量评估方式具有主观性强、费时费力等缺点。近年来,人工智能（AI）技术在结肠镜检查质量控制方面展现出客观性、即时性、全面性等优势,具有广阔的应用前景。文章全面探讨了AI在结肠镜检查质量控制中的多个应用场景,包括评估肠道准备质量、记录退镜时间、息肉识别和分类、预测早期结直肠癌浸润深度等方面,并通过具体的研究案例和数据分析了AI技术的有效性和优势。AI技术有望在提升结肠镜检查质量、促进结直肠癌的早诊早治方面发挥更加重要的作用,但面对技术、伦理及法规等多方面的挑战,未来需要持续努力,不断优化算法,加强跨学科合作,推动AI技术在医疗领域的健康、快速发展。

Traditional colonoscopy quality assessment methods have strong subjectivity and are time-consuming．In recent years,artificial intelligence technology has shown objectivity,timeliness,and comprehensiveness in colonoscopy quality control,with broad application prospects．This article comprehensively explores multiple application scenarios of AI in colonoscopy quality control,encompassing assessments of bowel preparation quality,recording of withdrawal times,polyp identification and classification,and prediction of early colorectal cancer invasion depth．Through specific research cases and data analysis,the effectiveness and advantages of AI technology are elucidated．AI technology is expected to play an increasingly significant role in enhancing the quality of colonoscopy and promoting early diagnosis and treatment of colorectal cancer．However,facing challenges from technology,ethics,regulations,and other aspects,continued efforts are needed in the future to continuously optimize algorithms,strengthen interdisciplinary collaboration,and promote the healthy and rapid development of AI technology in the medical field．

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．