目的 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经（PENG）阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例，随机分为两组，A 组（38例）行PENG阻滞联合椎管内麻醉，C 组（38例）行椎管内麻醉。比较两组入室（T0）、摆放体位时（T1）、术后6 h（T2）、术后12 h（T3）、术后24 h（T4）静息和活动状态的数字等级评定量表（NRS）疼痛评分；术后非甾体抗炎药及阿片类药物补救次数；术后 6 h、24 h患侧股四头肌徒手肌力分级（MMT）；首次下床活动时间、住院时间。结果 A组T1～T4时刻静息状态NRS疼痛评分分别为2（1，3）分、1（1，2）分、2（1，2）分、3（2，4）分均低于C组的5（4，7）分、4（3，5）分、5（3，6）分、4（2，6）分，比较差异有统计学意义（均P＜0.001）；A组T1～T4时刻活动状态NRS疼痛评分分别为5（4，7）分、3（2，4）分、4（3，5）分、6（4，7）分均低于C组的10（9，10）分、8（6，9）分、8（7，9）分、9（8，10）分，比较差异有统计学意义（均P＜0.001）。A组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.01）；C组在T1～T4时的静息状态NRS疼痛评分低于T0时的（均P＜0.05）；A组在T1～T4时的活动状态NRS疼痛评分均低于T0时的（均P＜0.001）；C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的（均P＜0.01）。A组术后非甾体抗炎药及额外阿片类药物补救次数为4（0，8）、2（0，3）次，均低于C组的15（7，19）、5（3，7）次，比较差异有统计学意义（均P＜0.001）。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义（P＞0.05）。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛，不影响其术后下肢肌力。

   Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group（PENG）block combined with spinal-epidural anesthesia in hip joint surgery for frail patients．Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups：Group A（38 cases）received PENG block combined with intraspinal anesthesia，while Group C（38 cases）received only intraspinal anesthesia．The numerical rating scale（NRS）pain scores of resting and active states were compared between the two groups at the time of entering the room（T0），placing the position（T1），6 hours after surgery（T2），12 hours after surgery（T3），and 24 hours after surgery（T4）．Postoperative non-steroidal drugs and opioids remedy times，muscle strength grading（MMT）of quadriceps femoris at 6 hours and 24 hours after operation，and the first time out of bed activity time，hospitalization time were also compared．Results The resting NRS pain scores at T1-T4 in Group A were 2（1，3），1（1，2），2（1，2）and 3（2，4），respectively，which were lower than 5（4，7），4（3，5），5（3，6）and 4（2，6）in Group C，and the difference was statistically significant（all P＜0.001）．The NRS pain scores at T1-T4 in Group A were 5（4，7），3（2，4），4（3，5）and 6（4，7），respectively，which were lower than 10（9，10），8（6，9），8（7，9）and 9（8，10）in Group C，and the difference was statistically significant（all P＜0.001）．The resting NRS pain score of Group A at T1-T4 was lower than that at T0（all P＜0.01）；the resting NRS pain score of Group C at T1-T4 was lower than that at T0（all P＜0.05）．The NRS pain scores at T1-T4 in Group A were lower than those at T0（all P＜0.001）；the NRS pain scores at T1 and T2 in Group C were lower than those at T0（all P＜0.01）．The number of postoperative non-steroidal drugs and additional opioids in group A（4［0，8］，2［0，3］）was lower than that in Group C（15［7，19］，5［3，7］），and the difference was statistically significant（all P＞0.001）．There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation，the first time of getting out of bed and the number of days of hospitalization between the two groups（P＞0.05）．Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength．

【摘要】目的：探讨器械护士术中分区精细化器械管理对心脏瓣膜置换术（HVR）手术效率及安全性的影响。方法：研究对象包括2024年6月~2026年5月至我院行HVR治疗的110例心脏瓣膜病（VHD）患者，以及同期参与手术的22名器械护士，采用随机数字表法将入组患者及护士分别列为常规组（55例患者、11名护士）、试验组（55例患者、11名护士），常规组内护士术中实施常规器械管理，试验组内护士术中实施分区精细化器械管理。比较两组患者的手术效率、围手术期安全事件，以及两组护士所参与手术的工作效率、术中器械管理情况。结果：在不同器械管理模式下，试验组内患者的主动脉阻断时间、体外循环时间、术中非必要等待时间、手术总耗时均低于常规组（t=8.817，5.730，20.609，9.632；P＜0.05）。试验组内患者的围手术期安全事件发生率9.09%（5/55）低于常规组25.45%（14/55）（x2=5.153；P＜0.05）。试验组内护士的器械摆台时间、器械传递反应时间、手术中断次数、器械整理时间、器械移交时间均低于常规组（t=3.347，6.505，5.971，3.795，5.838；P＜0.05）。试验组内护士的器械管理差错率低于常规组（x2=5.238；P＜0.05）。结论：器械护士术中分区精细化器械管理能提高HVR患者的手术效率并降低围手术期安全事件发生风险，对提高器械护士的器械管理质量、预防器械管理差错有积极影响

[Abstract]Objective:To explore the impact of refined intraoperative instrument management by operating room nurses on the efficiency and safety of HVR surgery.Methods:The study subjects included 110 patients with VHD who underwent HVR treatment at our hospital from June 2024 to May 2026, along with 22 instrument nurses who participated in the surgeries synchronously. Using the random number table method, the enrolled patients and nurses were divided into a control group (55 patients, 11 nurses) and an experimental group (55 patients, 11 nurses). Nurses in the conventional group implemented routine instrument management during surgery, while nurses in the experimental group implemented zoned and refined instrument management during surgery. The surgical efficiency, perioperative safety events of the two groups of patients, as well as the work efficiency and intraoperative instrument management of the surgeries participated by the nurses in the two groups were compared.Results:Under different instrument management modes, the aortic occlusion time, extracorporeal circulation time, intraoperative non-essential waiting time, and total surgical time of patients in the experimental group were all lower than the control group (t=8.817，5.730，20.609，9.632; P<0.05). The incidence of perioperative safety events in the experimental group was 9.09% (5/55) lower than that in the control group 25.45% (14/55) (x2=5.153; P<0.05). The instrument placement time, instrument delivery response time, number of surgical interruptions, instrument sorting time, and instrument handover time of nurses in the experimental group were lower than those in the control group (t=3.347，6.505，5.971，3.795，5.838; P<0.05). The error rate of nurses in the experimental group was lower than the control group (x2=5.238; P < 0.05).Conclusion:Refined intraoperative zone-specific instrument management by instrument nurses enhances surgical efficiency for HVR patients and reduces the risk of perioperative safety incidents, thereby positively impacting the quality of instrument care provided by nurses and preventing instrument-related adverse events.

目的：探讨基于超声实时引导的精准骶管阻滞联合喉罩全麻对阴式子宫切除手术患者术中应激反应及术后肠功能恢复的影响。方法：本研究采用前瞻性、单中心随机对照试验，选取2023年1月至2025年1月于我院择期行阴式子宫切除术的患者108例，随机分为对照组（n=54）和观察组（n=54）。对照组行单纯喉罩全身麻醉，观察组行超声实时引导精准骶管阻滞（0.25%罗哌卡因20 mL）联合喉罩全身麻醉。比较两组患者术中不同时间点血流动力学指标[平均动脉压（MAP）、心率（HR）]、应激反应指标[血清皮质醇（COR）、去甲肾上腺素（NE）、血糖（GLU）]、术后肠功能恢复指标（肠鸣音恢复时间、首次排便时间、首次排气时间）、术后疼痛视觉模拟评分（VAS）、术后镇痛泵有效按压次数、补救镇痛率及不良反应发生率。主要结局指标为术后24 h VAS评分，次要结局指标包括术中应激反应指标和术后肠功能恢复指标。结果：两组患者年龄、BMI、手术时间及术中出血量比较，差异均无统计学意义（P>0.05）。与T0时点比较，两组T1、T2、T3时点MAP、HR均升高，但观察组T1、T2、T3时点MAP、HR均低于对照组（P<0.05）。两组T1、T2、T3时点COR、NE、GLU水平均高于T0时点，但观察组T1、T2、T3时点COR、NE、GLU水平均低于对照组（P<0.05）。观察组术后肠鸣音恢复时间、首次排便时间及首次排气时间均短于对照组（P<0.05）。观察组术后2 h、6 h、12 h、24 h VAS评分均低于对照组（P<0.05），术后镇痛泵有效按压次数及补救镇痛率均低于对照组（P<0.05）。观察组术后恶心呕吐（PONV）发生率低于对照组（P<0.05），两组尿潴留发生率比较差异无统计学意义（P>0.05）。结论：基于超声实时引导的精准骶管阻滞联合喉罩全麻可有效减轻阴式子宫切除手术患者术中应激反应，维持血流动力学稳定，促进术后肠功能恢复，提高术后镇痛质量，且不增加不良反应发生率，值得临床推广应用。

Objective: To investigate the effects of ultrasoundguided realtime precise caudal block combined with laryngeal mask airway (LMA) general anesthesia on intraoperative stress response and postoperative bowel function recovery in patients undergoing vaginal hysterectomy. Methods: This prospective, singlecenter randomized controlled trial enrolled 108 patients who underwent elective vaginal hysterectomy in our hospital from January 2023 to January 2025. They were randomly divided into a control group (n=54) and an observation group (n=54). The control group received LMA general anesthesia alone, while the observation group received ultrasoundguided realtime precise caudal block (0.25% ropivacaine 20 mL) combined with LMA general anesthesia. The following parameters were compared between the two groups: hemodynamic variables [mean arterial pressure (MAP), heart rate (HR)] at different intraoperative time points, stress response indicators [serum cortisol (COR), norepinephrine (NE), blood glucose (GLU)], postoperative bowel function recovery indicators (time to bowel sound recovery, time to first defecation, time to first flatus), postoperative pain Visual Analog Scale (VAS) scores, effective pressing times of patientcontrolled analgesia (PCA) pump, rescue analgesia rate, and incidence of adverse reactions. The primary outcome was the 24 h postoperative VAS score; secondary outcomes included intraoperative stress response indicators and postoperative bowel function recovery indicators. Results: No significant differences were found between the two groups in age, BMI, operative time, or intraoperative blood loss (P>0.05). Compared with T0, MAP and HR at T1, T2 and T3 were increased in both groups, but the MAP and HR at T1, T2 and T3 in the observation group were significantly lower than those in the control group (P<0.05). Levels of COR, NE and GLU at T1, T2 and T3 were higher than those at T0 in both groups, but the levels in the observation group were significantly lower than those in the control group at the corresponding time points (P<0.05). The time to bowel sound recovery, time to first defecation and time to first flatus in the observation group were significantly shorter than those in the control group (P<0.05). The VAS scores at 2 h, 6 h, 12 h and 24 h postoperatively in the observation group were significantly lower than those in the control group (P<0.05); the effective pressing times of PCA pump and the rescue analgesia rate in the observation group were also significantly lower than those in the control group (P<0.05). The incidence of postoperative nausea and vomiting (PONV) in the observation group was significantly lower than that in the control group (P<0.05), whereas no significant difference was observed in the incidence of urinary retention between the two groups (P>0.05). Conclusion: Ultrasoundguided realtime precise caudal block combined with LMA general anesthesia can effectively alleviate intraoperative stress response, maintain hemodynamic stability, promote postoperative bowel function recovery, and improve postoperative analgesia quality in patients undergoing vaginal hysterectomy, without increasing the incidence of adverse reactions. Therefore, this combined anesthesia technique is worthy of clinical application.

【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.

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：探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法：选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者，按随机数字表法分为观察组和对照组，各50例。对照组采用常规麻醉方案维持麻醉，观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分（SAS）、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分（MMSE）]、围术期血流动力学指标[麻醉药物输注前（T0）、气管插管时（T1）、拔管后5min（T2）平均动脉压（MAP）、心率（HR）]及术后72h不良反应发生率。结果：观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组，苏醒时间、拔管时间低于对照组；观察组T0、T1、T2各时间点MAP、HR无显著差异（P>0.05）；对照组T1、T2时MAP、HR高于T0（P<0.05）；两组不良反应发生率无显著差异（P>0.05）。结论：利多卡因复合艾司氯胺酮应用于肺部手术，可提升患者苏醒质量、保护术后认知功能，维持围术期血流动力学稳定，且安全性良好。

Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.

【摘要】目的：探讨不同剂量右美托咪定对老年骨科手术患者术后谵妄的预防作用。方法：回顾性选取2022年11月至2025年11月本院收治的116例老年骨折手术患者为研究对象，根据右美托咪定维持剂量不同分为0.2μg/(kg·h)的小剂量组（58例）和0.4μg/(kg·h)的大剂量组（58例）。比较两组不同时间点[麻醉诱导前（T0）、麻醉诱导后30 min（T1）、术闭即刻（T2）]的血压（收缩压、舒张压）、心率、应激反应指标[皮质醇（COR）、肾上腺素（E）、去甲肾上腺素（NE）]；采用简易智力状态检查量表（MMSE）评估两组患者术前、术后12 h、术后24 h、术后48 h的认知功能水平；统计两组患者术后谵妄及围术期不良反应发生情况。结果：小剂量组T1、T2时收缩压、舒张压和心率均高于大剂量组（P<0.05）。小剂量组T1、T2时COR、E和NE均低于大剂量组（P<0.05）。小剂量组术后12h、术后24h、术后48h的MMSE评分均高于大剂量组（P<0.05）。小剂量组术后谵妄发生率8.62%（5/58）显著低于大剂量组22.41%（13/58）（χ2=4.209，P=0.040）。小剂量组不良反应总发生率12.07%（7/58）与大剂量组20.69%（12/58）对比无显著差异（P>0.05）。结论：与0.4μg/(kg·h)的大剂量右美托咪定相比，0.2μg/(kg·h)的小剂量在老年骨科手术麻醉中应用效果更佳，能有效维持血流动力学稳定、减轻应激反应、保护认知功能，对术后谵妄具有更好的预防作用，且安全性良好，值得在临床推广应用。

探讨将 Root Cause Analysis（RCA）质量管理模式与心理资本理论相结合应用于手术核查团队，对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名，按手术间编号分为对照组与实验组，各 40 名。对照组实施常规手术核查流程；实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后，比较两组沟通中断发生率、核查流程执行质量、沟通效率，以及心理资本量表（PCQ-24）和团队协作量表（T-TPQ）得分。结果 实验组沟通中断发生率显著低于对照组（P＜0.05），核查流程执行质量和沟通效率均显著优于对照组（P＜0.001）。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组（均 P＜0.001）。结论 将 RCA 流程分析与心理资本理论干预相结合，可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平，具有良好的临床应用价值与推广潜力。

To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P＜0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P＜0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P＜0.001), as were T-TPQ total and subscale scores (P＜0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

探讨将 Root Cause Analysis（RCA）质量管理模式与心理资本理论相结合应用于手术核查团队，对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名，按手术间编号分为对照组与实验组，各 40 名。对照组实施常规手术核查流程；实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后，比较两组沟通中断发生率、核查流程执行质量、沟通效率，以及心理资本量表（PCQ-24）和团队协作量表（T-TPQ）得分。结果 实验组沟通中断发生率显著低于对照组（P＜0.05），核查流程执行质量和沟通效率均显著优于对照组（P＜0.001）。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组（均 P＜0.001）。结论 将 RCA 流程分析与心理资本理论干预相结合，可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平，具有良好的临床应用价值与推广潜力。

To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P＜0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P＜0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P＜0.001), as were T-TPQ total and subscale scores (P＜0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

目的 探讨将 Root Cause Analysis（RCA）质量管理模式与心理资本理论相结合应用于手术核查团队，对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名，按手术间编号分为对照组与实验组，各 40 名。对照组实施常规手术核查流程；实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后，比较两组沟通中断发生率、核查流程执行质量、沟通效率，以及心理资本量表（PCQ-24）和团队协作量表（T-TPQ）得分。结果 实验组沟通中断发生率显著低于对照组（P＜0.05），核查流程执行质量和沟通效率均显著优于对照组（P＜0.001）。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组（均 P＜0.001）。结论 将 RCA 流程分析与心理资本理论干预相结合，可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平，具有良好的临床应用价值与推广潜力。

To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P＜0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P＜0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P＜0.001), as were T-TPQ total and subscale scores (P＜0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.