论著

腹腔镜结直肠癌根治术患者术前静脉注射艾司氯胺酮的临床效果观察

Clinical observation of preoperative intravenous injection of esketamine in patients undergoing laparoscopic radical resection for colorectal cancer

:466-471
 
      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料,根据随机数字表法将患者分为两组:对照组40例,术前5 min予5 mL生理盐水;观察组40例,术前5 min予以0.25 mg/kg艾司氯胺酮(以生理盐水配置成5 mL)。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为(213.54±64.22)min、(240.67±81.26)min、(141.31±45.03)mL,与对照组的(210.43±65.71)min、(244.25±81.33)min、(137.64±42.75)mL比较,差异均无统计学意义(t=0.214、0.197、0.374,P均>0.05),而观察组丙泊酚、瑞芬太尼用量分别为(1 075.52±134.37)mg、(1 267.18±242.26)μg,虽然低于对照组的(1?126.64±150.21)mg、(1 352.50±295.14)μg,但差异也无统计学意义(t=1.604、1.413,P均>0.05);观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为(54.52±9.64)pg/mL、(40.08±7.75)pg/mL、(30.38±6.93)mg/L,均低于对照组的(77.31±10.86)pg/mL、(56.35±9.47)pg/mL、(43.73±7.61)mg/L(t=9.926、8.409、8.203,P均<0.05);术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为(51.92±4.41)分、(53.96±4.47)分、(3.59±1.14)分、(3.06±1.01)分、(2.89±0.91)分、(2.57±0.76)分,均低于对照组的(55.06±5.12)分、(57.21±5.19)分、(4.27±1.36)分、(3.68±1.18)分、(3.41±1.06)分、(2.96±0.92)分(t=2.939、3.001、2.423、2.525、2.329、2.067,P均<0.05),但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义(P>0.05);两组术后不良反应发生率也无显著差异(P<0.05)。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平,减轻术后疼痛,缓解术后负性情绪,且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer.Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed.The patients were divided into two groups according to the random number table method:40 cases in the control group were given 5 mL saline,five minutes before operation,40 cases in the observation group were treated with 0.25 mg / kg esketamine(in 5 mL saline)five minutes before operation.The perioperative indicators,inflammatory factors,negative emotions,pain and adverse reactions were compared between two groups.Results The operation time,anesthesia time and intraoperative blood loss of the observation group were(213.54±64.22)min,(240.67±81.26)min and(141.31±45.03)mL,respectively,which were not significantly different from those of the control group(210.43±65.71)min,(244.25±81.33)min and(137.64±42.75)mL(t=0.214,0.197,0.374,all P>0.05).The dosage of propofol and remifentanil in the observation group were(1 075.52±134.37)mg and(1 267.18±242.26)μg,respectively,which were lower than those in the control group of (1126.64±150.21)mg and(1352.50±295.14)μg,but the difference was not statistically significant(t=1.604,1.413,P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group at 24 h after operation were(54.52±9.64)pg / mL,(40.08±7.75)pg / mL and(30.38±6.93)mg / L,respectively,which were lower than those in the control group of (77.31±10.86)pg / ml,(56.35±9.47)pg / mL and 43.73±7.61)mg / L(t=9.926,8.409,8.203,all P<0.05).The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h,6 h,12 h and 24 h after operation were(51.92±4.41),(53.96±4.47),(3.59±1.14),(3.06±1.01),(2.89±0.91) and(2.57±0.76),respectively,which were lower than those of the control group(55.06±5.12),(57.21±5.19),(4.27±1.36),(3.68±1.18),(3.41±1.06) and(2.96±0.92)(t=2.939,3.001,2.423,2.525,2.329,2.067,P<0.05).However,no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively(P>0.05).Adverse event rates showed no significance in two groups(P>0.05).Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation,decrease pain,mitigate negative emotions,without increasing the incidence of postoperative adverse reactions.
论著

基于Caprini量表评估的干预模式联合充气加压泵预防慢性阻塞性肺疾病急性加重期患者静脉血栓的效果

Effect of intervention mode based on Caprini score combined with inflatable pump in preventing VTE in patients with AECOPD

:507-512
 
      目的 观察慢性阻塞性肺疾病急性加重期(AECOPD)患者应用基于Caprini量表评估的干预模式联合充气加压泵(IPC)预防静脉血栓(VTE)的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象,经随机数表法分为对照组41例予以VTE常规干预,观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓(VTE)发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组(P<0.05)。干预前,两组AECOPD患者凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体水平比较差异无统计学意义(P>0.05);干预后,两组患者TT、PT、APTT、D-二聚体水平均降低,观察组较低(P<0.05)。干预前,两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义(P>0.05);干预后,两组患者平均流速、血流峰速均升高,观察组高于对照组(P<0.05);阻力指数均降低,观察组低于对照组(P<0.05)。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率,改善凝血指标与股静脉血流速。
   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression(IPC)in preventing venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group(41 cases)and an observation group(41 cases)using a random number table.The control group received routine VTE prevention,while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care.The extremity conditions,occurrence of VTE,coagulation parameters,and femoral venous blood flow velocity were compared between the two groups.Results The rates of extremity swelling,extremity pain,and VTE incidence in the observation group were lower than those in the control group(P<0.05).Before the intervention,there were no statistically significant differences in thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),or D?dimer levels between the two groups(P>0.05).After the intervention,TT,PT,APTT,and D?dimer levels decreased in both groups,with lower values in the observation group(P<0.05).Before the intervention,there were no statistically significant differences in mean flow velocity,peak flow velocity,or resistance index between the two groups(P>0.05).After the intervention,mean flow velocity and peak flow velocity increased in both groups,with higher values in the observation group(P<0.05),while the resistance index decreased,with a lower value in the observation group(P<0.05).Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling,extremity pain,and VTE incidence,and improve  coagulation parameters and femoral venous blood flow velocity.
论著

尼达尼布联合格隆溴铵治疗合并肺纤维化的慢性阻塞性肺疾病患者的效果及对肺功能影响

Efficacy and effect on pulmonary function of nintanib combined with glycopyrrolate in the treatment of chronic obstructive pulmonary disease with pulmonary fibrosis

:513-519
 
      目的 合并肺纤维化的慢性阻塞性肺疾病(COPD)是COPD的特殊亚型,患者兼具气流受限与肺组织纤维化病理特征,临床症状更严重、肺功能下降更快,且现有单一治疗方案难以同时改善气流受限与纤维化进展,预后较差。基于此,本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响,为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者,采用前瞻性随机对照研究设计,应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗,对照组48例采取尼达尼布治疗,试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后,比较治疗前后症状评分、肺功能、纤维化指标、炎症指标,并分析两组治疗安全性。结果 治疗后,两组CAT评分、mMRC评分及VAS降低(P<0.05);且与对照组比较,试验组CAT评分、mMRC评分及咳嗽VAS评分较低(P<0.05)。治疗后,两组FVC、FEV1、DLCO及FEV1/FVC比值均较治疗前改善(P<0.05);且与对照组比较,试验组FVC、FEV1、DLCO及FEV1/FVC比值较优(P<0.05)。治疗后,两组血清KL-6、SP-D水平及CT纤维化评分均降低(P<0.05);且与对照组比较,试验组血清KL-6、SP-D水平及CT纤维化评分较低(P<0.05)。治疗后,两组血清IL-6、TNF-α及TGF-β1水平降低(P<0.05);且与对照组比较,试验组血清IL-6、TNF-α及TGF-β1水平较低(P<0.05)。试验组总不良反应发生率为8.33%(4/48),对照组为10.42%(5/48),两组比较差异无统计学意义(P>0.05)。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好,可减轻患者临床症状,改善肺功能与肺纤维化,降低机体炎症反应,安全性较高。

   Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease(COPD)patients with associated pulmonary fibrosis and its impact on lung function,providing a basis for optimizing clinical treatment strategies.Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected,and divided into experimental group and control group using a random number table method.Using a prospective randomized controlled study design,all patients received conventional treatment,with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide.After 24 weeks of treatment in both groups,the symptom scores,lung function,fibrosis indicators,and inflammation indicators were compared before and post-treatment,and the drug safety of the two groups was analyzed.Results Post-treatment,CAT score,mMRC score and VAS decreased in both groups(P<0.05).Compared with the control group,CAT score,mMRC score and cough VAS score were lower in the experimental group(P<0.05).Post-treatment,FVC,FEV1,DLCO and FEV1/FVC ratio of both groups improved compared with that before treatment(P<0.05).Compared with the control group,FVC,FEV1,DLCO and FEV1/FVC ratio of the experimental group were better(P<0.05).Post-treatment,serum KL-6,SP-D levels and CT fibrosis scores of both groups decreased(P<0.05).Compared with the control group,serum KL-6,SP-D levels and CT fibrosis scores of the experimental group were lower(P<0.05).Post-treatment,serum IL-6,TNF-α and TGF-β1 levels in both groups decreased(P<0.05).Compared with the control group,serum IL-6,TNF-α and TGF-β1 levels in the experimental group were lower(P<0.05).The incidence of total adverse reactions in the experimental group was 8.33%(4/48),and that in the control group was 10.42%(5/48).There was no difference between the two groups(P>0.05).Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis,which can alleviate its clinical symptoms,improve lung function and pulmonary fibrosis,reduce the body’s inflammatory response,which is relatively safe.

桑白皮汤加减辅助常规西药对痰热郁肺型保留比率的肺功能减损患者治疗效果的多维度指标评价

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目的 探讨桑白皮汤加减辅助常规西药治疗痰热郁肺型保留比率的肺功能减损(PRISm)患者的治疗效果,并分析其对中医证候积分、肺功能、气道阻力、免疫功能的影响。方法 选取2024年6月~2025年6月于本院诊治的88例PRISm患者为研究对象,按照随机数字表法将其分为对照组(常规西药治疗)、研究组(桑白皮汤加减联合常规西药治疗),各44例。比较两组临床疗效、不良反应及治疗前后中医证候积分、慢阻肺评估测试(CAT)量表、改良版英国医学研究委员会呼吸困难问卷(mMRC)、吸入支气管扩张剂后检测肺功能、肺弥散功能[一氧化碳弥散量占预计值百分比(DLCO%pred)、残气量/肺总量(RV/TLC)]、气道阻力[抗阻指数(R5-20)、共振频率(Fres)、呼吸总阻抗(Zrs)]、炎症指标[白细胞介素-6(IL-6)、可溶性细胞间黏附分子-1(sICAM-1)、单核细胞趋化蛋白-1(MCP-1)、嗜酸性粒细胞(EOS)、肿瘤坏死因子-α(TNF-α)]、气道重塑[基质金属蛋白酶-2(MMP-2)、缺氧诱导因子-1α(HIF-1α)、转化生长因子-β1(TGF-β1)、碱性成纤维细胞生长因子(bFGF)]、T淋巴细胞亚群水平。结果 研究组总有效率高于对照组(P<0.05);治疗后,与对照组比较,研究组中医证候积分、CAT评分、mMRC评分级RV/TLC降低,FEV1、FEV1/FVC、FEV1%pred、VC%pred、DLCO%pred升高(P<0.05);治疗后,与对照组比较,研究组R5-20、Fres、Zrs降低(P<0.05);治疗后,与对照组比较,研究组血清IL-6、sICAM-1、MCP-1、EOS、TNF-α及MMP-2、HIF-1α、TGF-β1、bFGF水平降低(P<0.05);治疗后,与对照组比较,研究组CD3+、CD4+、CD4+/CD8+水平升高(P<0.05);两组不良反应比较无明显差异(P>0.05)。结论 桑白皮汤加减辅助常规西药治疗PRISm患者的疗效显著,可改善临床症状、肺功能,提高生活质量,降低气道阻力,并可减轻炎症反应,缓解气道重塑,增强机体免疫功能,且具有一定安全性。

超声骨刀与高速涡轮手机在颌骨囊肿外科手术中的应用效果及安全性研究

Research on the Application Effect and Safety of Ultrasonic Bone Knife and High speed Turbine Mobile Phone in Jaw Cyst Surgery

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【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.

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应用于非小细胞肺癌化疗患者的效果分析

Effect Analysis of Nutrition Management Based on E-Coach Health Management Model Combined with Active Cycle of Breathing Technique in Patients Undergoing Chemotherapy for Non-Small Cell Lung Cancer

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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.

应用芒硝与大黄中药热奄包在经动脉介入术后肢体肿胀护理中的效果研究

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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。

安全 - 行为双维度管理模式在儿童全麻口腔舒适化治疗中的应用效果

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【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。

横断疝囊与完全剥离疝囊在中老年单侧腹股沟疝患者TAPP中应用效果的回顾性对比分析

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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。

季德胜蛇药片不同用药方式结合阿昔洛韦治疗带状疱疹的效果及安全性比较

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目的:对比季德胜蛇药片不同用药方式分别与阿昔洛韦结合,在带状疱疹治疗中的价值。方法: 将74例于我院诊治带状疱疹患者随机分为外涂组(37例,季德胜蛇药片外涂结合阿昔洛韦治疗)与口服组(37例,季德胜蛇药片口服结合阿昔洛韦治疗)。对治疗7天后两组的症状程度、病情转归时间、整体疗效及用药安全性展开对比。结果:治疗后,外涂组VAS评分、皮损评分均低于口服组(P<0.05);治疗后,外涂组止疱时间、疼痛减轻时间、结痂时间均短于口服组(P<0.05);外涂组97.30%的总有效率较口服组的83.78%高(P<0.05);外涂组5.41%的药物副反应发生率较口服组的21.62%低(P<0.05)。结论:在带状疱疹治疗中,季德胜蛇药片外涂结合阿昔洛韦治疗,相比于季德胜蛇药片口服结合阿昔洛韦治疗,可获得更好整体疗效,患者症状改善更明显,病情转归更快,用药安全性更高。
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