目的   调查老年人照护服务需求现状并分析其影响因素，为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法，选取广州市某三甲医院212名老年人作为调查对象，采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养（1.96±0.90分）、心理慰藉（2.63±0.85分）、安宁服务（2.73±1.07分）的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素（P均＜0.05），可解释61.5%的变异量。结论   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征，构建供需匹配的多元化，多层次照护体系。

       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors，so as to provide a reference for the construction of a needs-oriented care service system for the elderly．Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale，Fried frailty scale and the self-designed elderly needs assessment questionnaire．Results  Elderly patients had higher demands for exercise，nutrition，psychological comfort and hospice services．The results of multivariate analysis showed that the influencing factors of care service demand included pension style，activities of daily living，number of hobbies，gender，frailty level，and having main caregivers（all P＜0.05），which could explain 61.5% of the variation．Conclusions  The care needs of elderly patients are affected by many factors．A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly．

       目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

      目的   探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素，为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法   采用便利抽样法，选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象，采用一般资料调查问卷、疼痛心理僵化量表（PIPS）、简易疾病感知问卷（BIPQ）、家庭功能问卷（APGAR）进行调查，采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果   本次研究共发放问卷152份，回收有效问卷150份，有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为（61.66±2.85）分，回避型经验维度得分为（45.52±1.97）分，认知融合维度得分为（19.74±1.59）分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示：肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系（P＜0.001），与家庭功能得分均呈负相关关系（P＜0.001）。多元线性回归结果显示：文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素（P＜0.05），可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论   肺癌伴癌性疼痛患者心理僵化处于较高水平，且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响，临床医护人员可从疾病感知、家庭支持等角度出发，采用认知干预、同伴支持等方法，加强对患者的健康教育，以缓解其对疾病的负性认知，从而缓解心理僵化，促进身心健康恢复。

       Objective  To explore the status and influencing factors of psychological  rigidity in patients with lung cancer and cancer pain，and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life．Methods  The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object．The general data questionnaire，Psychological Inflexibility in Pain Scale（PIPS），Brief Illness Perception Questionnaire（BIPQ），and family function questionnaire（APGAR）were used to investigate．Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain．Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain．Results  A total of 152 questionnaires were distributed in this study，and 150 valid questionnaires were recovered，with an effective recovery rate of 98.68 %．The total score of PIPS of 150 patients with lung cancer and cancer pain was（61.66±2.85），the score of avoidance experience dimension was（45.52±1.97），and the score of cognitive fusion dimension was（19.74±1.59）．There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels，family per capita monthly income，and pain degree（P＜0.05）．The  results of Pearson correlation analysis showed that the total score of PIPS，the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception（P＜0.001），and negatively correlated with the score of family function（P＜0.001）．The results of multiple linear regression showed that education level，family per capita monthly income，disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain（P＜0.05 ），which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain．Conclusions  The psychological rigidity of lung cancer patients with cancer pain is at a high level，and is affected by education level，family per capita monthly income，disease perception and family function．Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients，so as to alleviate their negative cognition of the disease，to alleviate the psychological rigidity and promote the recovery of physical and mental health．

       目的   探讨营养评估及炎症因子水平对非霍奇金淋巴瘤（NHL）患者化学治疗（化疗）后感染及平均住院日的影响。方法   回顾性分析接受R-CHOP治疗的NHL患者95例。通过受试者工作特征（ROC）曲线确定患者主观整体营养评估（PG-SGA）预测患者化疗后感染的界值。将患者分为PG-SGA＜4组与PG-SGA≥4组，比较两组间营养及炎症相关指标的差异。采用单因素与多因素回归分析NHL患者化疗后感染及平均住院日延长的危险因素。结果  ROC曲线显示PG-SGA为3.5时，约登指数最大，预测NHL患者化疗后感染灵敏度为92%，特异度为11.1%。PG-SGA≥4组患者平均年龄、国际预后指数（IPI）及Ann arbor Ⅲ~Ⅳ期比例均高于PG-SGA＜4组（P＜0.05）。与PG-SGA＜4组相比，PG-SGA≥4组患者白介素6（IL-6）及中性粒细胞与淋巴细胞比值（NLR）明显升高，且化疗后感染率及平均住院日≥5 d比例高于对照组（P＜0.05）；与对照组相比，PG-SGA＜4组患者前白蛋白、白蛋白和血红蛋白水平升高（P均＜0.05）。多因素回归分析显示，PG-SGA≥4及合并糖尿病是NHL患者化疗后感染率的独立危险因素（P均＜0.05）。白蛋白低于35 g/L及合并化疗后感染是NHL患者平均住院日延长的独立危险因素（P均＜0.05）。结论   基于PG-SGA的营养评估及炎症因子分析对NHL患者化疗后感染及平均住院日的预测具有临床指导意义。

       Objective  To explore the effects of nutritional assessment and inflammatory factor levels on post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma（NHL）．Methods  A total of 95 NHL patients treated with the R-CHOP regimen were retrospectively analyzed．The  cut-off  value  of  Patient-Generated  Subjective Global Assessment （PG-SGA） for post-chemotherapy infection in NHL patients was evaluated by Receiver Operating Characteristic（ROC）curves．Patients were categorized into PG-SGA＜4 and PG-SGA≥4 groups and compared for differences of nutritional and inflammation-related factors．Univariate and multivariate logistic regression were used to analyze the risk factors for post-chemotherapy infection and length of hospital stay（LHS）．Results  The ROC curve showed that the Youden index was largest at PG-SGA of 3.5，which predicted post-chemotherapy infection in NHL patients with a sensitivity of 92% and a specificity of 11.1%．The mean age，International Prognostic Index（IPI），and Ann Arbor stage Ⅲ~IV proportion in patients with PG-SGA≥4 were higher compared with the control（P＜0.05）．Patients with PG-SGA≥4 had significantly higher interleukin-6 and neutrophil-to-lymphocyte ratio（NLR），and the infection rate and the proportion of LHS≥5 days after chemotherapy were higher than those in the control group（P＜0.05）．Patients in the PG-SGA＜4 group had significantly higher prealbumin，albumin，and hemoglobin levels compared to the PG-SGA≥4 group（P＜0.05）．Multifactorial logistic regression analysis revealed that PG-SGA≥4 and combined diabetes mellitus were independent risk factors for post-chemotherapy infection rate in NHL patients（both P＜0.05）．Albumin less than 35 g/L and combined post-chemotherapy infection were independent risk factors for prolonged LHS in NHL patients（both P＜0.05）．Conclusions  PG-SGA nutritional assessment and inflammatory factor analysis are clinically instructive in predicting post-chemotherapy infections and LHS in NHL patients．

目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为（48.58±6.34）分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素（F=30.872,P<0.001）,解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。

目的 分析广州某三甲医院脑梗死患者住院费用的变化以及影响因素,为有效减轻患者疾病经济负担提供参考依据。方法 提取广州某三甲医院2015—2022年出院诊断ICD-10前三位编码为I63的病案首页数据,并采用IBM SPSS 20.0软件对费用结构进行描述性统计分析,以多重线性回归分析患者住院费用的影响因素。结果 2015—2022年脑梗死患者的平均住院费用年均增长率为2.86%;费用结构以药品费为主,占比逐年下降,至2022年占比为27.74%,技术劳务性费用占比逐年增加,至2022年占比为47.41%;住院费用主要受医院感染情况、住院天数以及支付方式等因素影响（F=990.10,P<0.001）。结论 脑梗死患者的住院费用结构显著优化,但患者的疾病经济负担仍然较重,且费用受多种因素的综合影响。建议通过提高医疗质量与服务效能,并严格落实临床路径管理,减少不必要的检查以及耗材使用,以期最大程度地减轻患者的负担。

Objective To analyze the structural changes and influencing factors of the hospitalization expenses for patients with cerebral infarction in a tertiary general hospital in Guangzhou,and provide a scientific basis for reducing economic burden of the patients．Methods The front page data of medical records with the main diagnosis of I63 were collected in the sample hospital．Descriptive statistics analysis of hospitalization expenses structure and multiple linear regression analysis of the influencing factors were carried out by SPSS 20.0．Results The annual growth rate of average hospitalization expenses of cerebral infarction patients from 2015 to 2022 in the sample hospital was 2.86% per year．The highest proportion of hospitalization expenses was medicine fee,the proportion of which declined year by year with a minimum 27.74% in 2022．The proportion of technical labor costs accelerated year by year with a maximum 47.41% in 2022．This study revealed the main factors influencing hospitalization expenses were hospital internal infection or not,length of stay,payment method and so on（F=990.10,P<0.001）．Conclusions The structure of hospitalization expenses for cerebral infarction patients was significantly optimized,but the economic burden of patients was still heavy affected by a combination of factors．In order to minimize the burden of patients,hospitals should improve medical quality and service efficiency and implement clinical pathway management strictly,to reduce unnecessary inspections and consumables．

目的 了解危重产妇代理决策者的决策困境现状及其影响因素。方法 选择2022年10月—2023年10月许昌市中心医院产科及ICU的262例危重产妇及其代理决策者作为研究对象。应用一般资料问卷、母婴健康素养问卷、决策困境量表、决策参与期待量表进行调查。结果 决策困境量表总分为（39.38±14.58）分,其中信息提供和价值观明确总分为（13.91±7.16）分、社会支持和决策有效性总分为（20.41±8.25）分、不确定性总分为（5.06±1.96）分。多元线性回归分析发现,性别、学历、决策时间和脑卒中防治知识总分对危重产妇代理决策者决策困境均有影响（P<0.05）。结论 危重产妇代理决策者存在决策困境,医护人员需要根据代理决策者的人口学特征、疾病防治知识以及患者疾病特征进行决策辅助,减轻其决策困境,提升决策质量。

Objective To understand the current situation and influencing factors of decision-making difficulties among surrogate decision-makers for critically ill puerpera．Methods A total of 262 critically ill puerpera and their surrogate decision-makers from the obstetrics and ICU of Xuchang Central Hospital from October 2022 to October 2023 were selected．A survey was conducted using the General Information Questionnaire,Maternal and Child Health Literacy Questionnaire,Decision Dilemma Scale,and Decision Participation Expectancy Scale．Results The total score of the Decision Dilemma Scale was（39.38±14.58）,with a total score of（13.91±7.16）for information provision and clear values,（20.41±8.25）for social support and decision effectiveness,and（5.06±1.96）for uncertainty．Multiple linear regression analysis found that gender,education level,decision time and total score of stroke prevention and control knowledge all have an impact on the decision-making difficulties of surrogate decision-makers in critically ill puerpera（P<0.05）．Conclusions There is a decision-making dilemma for the surrogate decision-makers of critically ill puerpera．Medical staff need to provide decision-making assistance based on the demographic characteristics,disease prevention and control knowledge,and patient disease characteristics of the surrogate decision-makers,in order to alleviate their decision-making difficulties and improve the quality of decision-making．

目的 探讨电子计算机断层扫描（CT）增强碘对比剂急性不良反应发生及影响因素分析。方法 选取天津市肿瘤医院空港医院2020年10月—2023年10月收治的100例行CT增强出现碘对比剂急性不良反应的患者进行回顾性分析,将其分为观察组,另选取同期在我院行CT增强检查未发生不良反应的100例患者作为对照组。分析观察组患者碘对比剂急性不良反应情况,对比两组患者临床资料及碘对比剂注射情况,以急性不良反应作为因变量（发生急性不良反应=1,未发生急性不良反应=0）纳入Logistic回归模型,分析CT增强碘对比剂急性不良反应发生的独立影响因素。结果 100例发生碘对比剂急性不良反应的患者中轻度65例（65.00%）,中度34例（34.00%）,重度1例（1.00%）;观察组与对照组性别、年龄、体质指数（BMI）、高血压史、糖尿病史、心功能不全史、甲状腺功能亢进史、冠状动脉粥样硬化性心脏病史、碘对比剂使用史、食物过敏史对比差异无统计学意义（P>0.05）,观察组与对照组哮喘史（9.00% vs 2.00%）、肾功能不全史（13.00% vs 3.00%）、碘对比剂不良反应发生史（21.00 % vs 2.00%）、花粉过敏史（12.00% vs 4.00%）、药物过敏史（26.00% vs 7.00%）及其他过敏史（10.00 % vs 2.00%）,对比差异有统计学意义（χ²=4.710,P=0.030;χ²=6.790,P=0.009;χ²=17.740,P<0.001;χ²=4.350,P=0.037;χ²=13.100,P<0.001;χ²=5.670,P=0.017）;观察组与对照组碘对比剂剂量对比差异无统计学意义（P>0.05）,观察组与对照组碘对比剂注射速度（<3 mL/min为55.00% vs 69.00%;≥3 mL/min为45.00% vs 31.00%）、碘对比剂类型（碘克沙醇为34.00% vs 34.00%,碘佛醇为47.00% vs 30.00%,碘海醇为19.00% vs 36.00%）对比差异有统计学意义（χ²=4.160,P=0.041;χ²=9.010,P=0.011）;肾功能不全史、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度为发生碘对比剂急性不良反应的影响因素（P<0.05）。结论 CT增强碘对比剂急性不良反应多以轻度为主,且以往合并肾功能不全、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度过高可能为碘对比剂不良反应发生的影响因素。

Objective To explore the occurrence and influencing factors of acute adverse reactions of iodine contrast agents in enhanced computed tomography（CT）. Methods A retrospective analysis was conducted on 100 patients admitted to our hospital from October 2020 to October 2023 who experienced acute adverse reactions to iodine contrast agents during CT enhancement．They were divided into an observation group and another 100 patients who underwent CT enhancement examination in our hospital during the same period without any adverse reactions were selected as the control group．The acute adverse reactions of iodine contrast agent in the observation group of patients were analyzed,the clinical data and injection of iodine contrast agent between the two groups of patients were compared,and include acute adverse reactions as the dependent variable（occurrence of acute adverse reactions=1,absence of acute adverse reactions=0）was used in the Logistic regression model to analyze the independent influencing factors of acute adverse reactions of CT enhanced iodine contrast agent．Results Among the 100 patients who experienced acute adverse reactions to iodine contrast agents,65 were mild reactions,accounting for 65.00%,34 cases had were moderate reactions,accounting for 34.00%,and one cases had severe reactions,accounting for 1.00%．There was no significant difference between the observation group and the control group in gender,age,body mass index（BMI）,history of hypertension,diabetes,heart dysfunction,hyperthyroidism,coronary heart disease,use of iodine contrast agent,and food allergy（P>0.05）．The history of asthma（9.00% vs 2.00%）,renal insufficiency（13.00% vs 3.00%）,adverse reactions of iodine contrast（21.00 % vs 2.00%）,pollen allergy（12.00% vs 4.00%）,drug allergy（26.00% vs 7.00%）and other allergies（10.00 % vs 2.00%）were significantly different（χ²=4.710,P=0.030;χ²=6.790,P=0.009;χ²=17.740,P<0.001;χ²=4.350,P=0.037;χ²=13.100,P<0.001;χ²=5.670,P=0.017）．There was no significant difference in the dosage of iodine contrast agent between the observation group and the control group（P>0.05）．The injection rate of iodine contrast agent between the observation group and the control group（< 3 mL/min was 55.00% vs 69.00%;≥3 mL/min was 45.00% vs 31.00%）,and the types of iodoxanol （iodoxanol[34.00% vs 34.00%],iodoxanol[47.00% vs 30.00%],iodohexanol[19.00% vs 36.00%]） were significantly different（χ²=4.160,P=0.041;χ²=9.010,P=0.011）．History of renal insufficiency,adverse reactions to iodine contrast agents,drug allergies,other allergies,and injection speed of iodine contrast agents were independent risk factors for the occurrence of acute adverse reactions to iodine contrast agents（P<0.05）．Conclusions Acute adverse reactions to iodinated contrast agents in CT enhancement are mostly mild．Previous history of renal insufficiency,history of adverse reactions to iodinated contrast agents,history of drug allergies,other allergic histories,and high injection speed of iodinated contrast agents may be influencing factors for the occurrence of adverse reactions to iodinated contrast agents．

目的 探讨慢性阻塞性肺疾病（COPD）住院患者口腔功能状态现状及影响因素。方法 采用便利抽样法,选择2022年9月—2023年7月在深圳市龙岗区某三甲医院呼吸内科、胸外科的老年COPD住院患者191例作为研究对象。使用一般资料调查表、日常生活自理能力评估量表（BADL）、反复唾液吞咽试验（RSST）、改良版呼吸困难量表（mMRC）、改良版Beck口腔评分量表进行调查及评估。采用单因素分析老年COPD住院患者口腔功能状态的影响因素,采用Logistic回归分析老年COPD住院患者口腔功能状态的影响因素。结果 191例老年COPD患者中,入院时、住院第3天（D3）、住院第5天（D5）、出院的Beck口腔评分分别为（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）分,比较差异无统计学意义（P>0.05）。单因素分析结果显示,COPD患者在D3、D5、出院时,Beck口腔功能状态的影响因素有：年龄、性别、婚姻状况、牙齿缺失情况、抽烟史以及生活自理能力影响,差异具有统计学意义（P<0.05）。二元Logistic回归分析结果显示,年龄、吸烟状况、牙齿缺失数量、生活自理能力是COPD住院患者口腔功能状态的影响因素（P<0.05）。结论 老年COPD患者口腔卫生状况较差,且受到年龄、吸烟情况、牙齿缺失、生活自理能力的影响,应采取针对性预防和干预策略,改善老年COPD住院患者的口腔卫生状况,以降低COPD患者发生并发症的风险。

Objective To investigate the status quo and influencing factors of oral function in hospitalized patients of chronic obstructive pulmonary disease（COPD）．Methods A total of 191 patients with COPD who were hospitalized in the Respiratory Department and Thoracic Surgery Department of a hospital in Longgang,Shenzhen from September 2022 to July 2023 were selected by convenience sampling．The general data questionnaire,the Barthel index of activity of daily living（BADL） the repetitive saliva swallowing test（RSST）,modified Medical Research Council Dyspnea Scale（mMRC）,the Modified Beck Oral Assessment Scale（BOAS）were used for investigation and evaluation．Single factor analysis was used to analyze the influencing factors of oral function status in elderly COPD patients,and logistic regression was used to analyze the independent risk factors affecting oral function status in elderly COPD patients．Results Among 191 elderly patients with COPD,the BOAS scores were（10.79±2.51）,（10.91±2.82）,（11.21±2.30）,（10.83±2.55）at admission,the 3rd day,the 5th day and discharged day,respectively,with no statistical significance．The results of univariate analysis indicated that the independent risk factors of Beck oral function status in COPD patients at D3,D5 and discharge were gender,age,marital status,tooth loss,smoking history and Barthel index score,and the differences were statistically significant（P <0.05）．Binary logistic regression analysis indicated that age,smoking status,tooth loss and Barthel index score were independent risk factors for oral function status in hospitalized patients with COPD（P<0.05）．Conclusions Elderly patients with COPD have poor oral health status,which is affected by patient's age,smoking history,tooth loss and self-care ability．Targeted prevention and intervention strategies should be adopted to improve the oral health status of hospitalized patients with COPD,so as to reduce the COPD patient's risk of complications．

目的 探讨全身麻醉（全麻）髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为（56.35±5.86）分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室（AICU）住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素（P<0.05）。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。

Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia．Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected．The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated．The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed．Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was（56.35±5.86）,with a moderate level．Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia（P<0.05）．Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles．