本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题，IMB模型通过向患者提供科学的疾病知识，改变其疾病认知与态度，最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示，IMB模型可显著降低患者术后疼痛发生率，并提高患者参与治疗决策的程度，为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考，以便后期实施相关个性化干预措施，并提供相关理论依据。

       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy．The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge，and ultimately promotes their adoption and maintenance of healthy behaviors．It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy，the research background of this study，the current research status at home and abroad，as well as the future development trends and challenges．The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making．This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model，so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis．

目的 探讨入院时血清淀粉样蛋白A（SAA）、载脂蛋白A1（ApoA1）、C反应蛋白（CRP）水平联合检测对老年急性脑梗死（ACI）患者规范治疗后3个月内发生预后不良的早期预测效能。方法 前瞻性选取2023年1月～2025年1月于焦作市第五人民医院就诊的108例老年ACI患者作为ACI组，另选取同期健康志愿者108例作为对照组。比较两组血清SAA、ApoA1、CRP水平。老年ACI患者予以规范治疗，根据治疗后3个月内预后情况将其分为预后不良（46例）和预后良好（62例）亚组，比较不同预后ACI患者患者临床资料及入院时血清SAA、ApoA1、CRP水平；Logistic回归分析入院时血清SAA、ApoA1、CRP水平是否为老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素；ROC曲线分析入院时血清SAA、ApoA1、CRP水平联合检测对ACI患者预后不良的预测效能。结果 ACI组入院时血清SAA、CRP水平高于对照组，血清ApoA1水平低于对照组（P＜0.05）；预后不良亚组高血压占比、入院NIHSS评分、梗死体积、入院时血清SAA、CRP水平高于预后良好亚组，血清ApoA1水平低于预后良好亚组（P＜0.05）；剔除存在多重共线性指标高血压、入院NIHSS评分、梗死体积后，入院时血清SAA、ApoA1、CRP水平仍是老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素（P＜0.05）；入院时血清SAA、ApoA1、CRP水平联合预测ACI患者预后不良的AUC值为0.873，显高于各指标单独预测值0.738、0.768、0.749（P＜0.05）。结论 入院时血清SAA、ApoA1、CRP水平是老年ACI患者预后不良的独立影响因素，联合检测对预后不良具有较高的预测效能，可将其作为ACI患者血清敏感指标，协助临床医师早期制定针对性干预措施，减少ACI患者预后不良的发生。

【摘要】目的：探究淀粉样蛋白A（serum amyloid?A，SAA）、超敏C反应蛋白（high sensitivity C-reactive protein，hsCRP）、白细胞计数（white blood cell count，WBC）、SAA/hsCRP比值对儿童感染性疾病早期鉴别的临床价值。方法：选取2025年1月--2025年6月我院就诊的感染性疾病患儿296例进行研究，其中细菌感染组86例、病毒感染组180例，另选取同期30例健康体检儿童作为对照组。检测三组SAA、hsCRP、WBC水平，计算SAA/hsCRP比值情况，通过受试者工作特征（receiver operating characteristic curve，ROC）分析各指标单独及联合检测对细菌感染和病毒感染的诊断效能。结果：与对照组比较，细菌感染组和病毒感染组SAA、hsCRP、WBC、SAA/hsCRP比值更高（P<0.05）；与病毒感染组比较，细菌感染组SAA、hsCRP、WBC更高，SAA/hsCRP比值更低（P<0.05）。相关性分析显示，SAA 与 hsCRP、WBC 及 SAA/hsCRP 比值均呈正相关（r=0.417、0.473、0.324，均 P＜0.001）；hsCRP 与 WBC 呈正相关（r=0.408，P＜0.001），与 SAA/hsCRP 比值呈负相关（r=-0.402，P＜0.001）；SAA/hsCRP 比值与 WBC 呈负相关（r=-0.523，P＜0.001）。ROC 曲线分析结果显示，SAA、hsCRP、WBC 及 SAA/hsCRP 比值均可用于儿童细菌感染与病毒感染的鉴别诊断，其 AUC 分别为 0.810、0.879、0.893 和 0.893，联合检测的 AUC 为 0.997，灵敏度为98.80%，特异度为93.89%，诊断效能优于单项指标。结论：SAA、hsCRP、WBC、SAA/hsCRP比值在儿童细菌感染性疾病及病毒感染性疾病鉴别诊断中有一定价值，临床可联合检测上述指标水平以鉴别具体感染类型，为患儿诊断及预后评估提供依据。

目的:探讨早期康复治疗对中青年脑卒中患者肢体运动功能恢复等影响。方法：从我院选取中青年脑卒中患者90例作为实验对象，分为实验组和观察组各45例，两组同时接受相同常规治疗并给予早期康复介入，并对其进行患侧上肢和下肢功能评定量表（ Fugl-Meyer, FMMS），以及患者日常生活活动能力（Modified Barthel Index,MBI）评定。实验组给予进一步强化康复运动治疗，以加速提高患者康复速率；2周结束时对实验组和观察组再次进行评估，比较2组患者治疗前后组内和组间治疗疗效。结果：早期康复2周后，实验组FMMS量表上肢评分为(29.82±15.43)分，观察组上肢评分为(21.33±11.98)分，组间存在统计学差异（P=0.005）。实验组FMMS量表下肢评分为(21.18±8.97)分，观察组下肢评分为(15.40±7.40)分，实验组得分高于观察组且两组间存在显著统计学差异（P=0.002）；随访1个月后实验组上下肢功能呈持续改善趋势，且两组间差异具有显著统计学意义。实验组MBI量表评分为(35.56±18.93)分，高于对照组（28.56±14.68）分，但未见统计学意义；1个月后两组间差异具有显著统计学意义（P＜0.001）。结论：研究表明，早期康复治疗对改善中青年脑卒中患者肢体功能和日常生活活动能力具有显著康复效果。

Objective:Exploring the impact of early rehabilitation therapy on the recovery of limb motor function and other aspects in young and middle-aged stroke patients. Methods: Ninety young and middle-aged stroke patients were selected from our hospital as experimental subjects and divided into two groups, namely the experimental group and the observation group, with 45 cases in each group. Both groups received the same conventional treatment and early rehabilitation intervention simultaneously, and were evaluated using the Fugl-Meyer Motor Scale (FMMS) for the affected upper and lower limbs, as well as the Modified Barthel Index (MBI) for activities of daily living. The experimental group received further intensive rehabilitation exercise therapy to accelerate the rehabilitation rate. At the end of 2 weeks, both groups were reassessed, and the therapeutic effects within and between the two groups before and after treatment were compared. Results: After 2 weeks of early rehabilitation, the FMMS upper limb score in the experimental group was (29.36±15.27) points, while that in the observation group was (25.18±11.99) points, with no statistically significant difference observed between the groups. The FMMS lower limb score in the experimental group was (20.93±8.93) points, higher than that in the observation group (15.40±7.40) points, with a significant statistical difference between the two groups (P=0.002). The MBI score in the experimental group was (33.22±15.96) points, higher than that in the control group (28.56±14.68) points, but no statistical significance was observed. Conclusions: Our study indicates that early rehabilitation therapy has certain effects on upper limb function and activities of daily living in patients, particularly demonstrating significant rehabilitation effects in improving lower limb functional recovery in young and middle-aged stroke patients.

摘要 目的 分析固定（FB）和活动平台（MB）单髁置换术（UKA）在膝关节内侧间室骨关节炎早期阶段的临床效果与影像学差异，以指导临床假体选择。 方法 本研究回顾性纳入41例确诊为单侧膝关节内侧间室骨关节炎的患者，按照假体类型分为两组：FB组（20例，使用春立XG假体）和MB组（21例，使用春立XK假体）。分别在术前、术后及随访终点统计膝关节屈伸活动范围（ROM）、VAS 疼痛评分、美国特种外科医院膝关节评分（HSS ）；测量并比较股胫角（FTA）、胫骨假体内外翻角（TCVA）、胫骨假体后倾角（TCPSA）；记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善（P均<0.0001）；末次随访时固定平台组 VAS 评分显著低于活动平台组（P<0.05），而两组间的ROM、HSS 评分无统计学差异（均 P>0.05）。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围，组间均无统计学差异（均 P>0.05）。固定平台组手术时间更短（P<0.05），两组均无严重并发症，假体生存率均为 100%。 结论 活动平台与固定平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能，下肢力线恢复效果相当；固定平台假体在疼痛控制与手术便捷性方面更具优势，临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术；活动平台假体；固定平台假体；骨关节炎；并发症

Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications

目的 探讨固定平台（FB）与活动平台（MB）单髁置换术（UKA）治疗膝关节内侧间室骨关节炎（OA）的早期临床疗效及影像学差异，为临床假体选择提供依据。 方法 回顾性分析41 例单侧膝关节内侧间室骨关节炎患者临床资料，其中 FB 组 20例（采用春立XG假体），MB 组 21 例（采用春立XK假体）。比较两组患者术前、术后和末次随访的膝关节活动度（ROM）、疼痛视觉模拟评分（VAS）、美国特种外科医院膝关节评分（HSS）；测量并比较股胫角（FTA）、胫骨假体内外翻角（TCVA）、胫骨假体后倾角（TCPSA）；记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善（P均<0.0001）；末次随访时固定平台组 VAS 评分显著低于活动平台组（P<0.05），ROM、HSS 评分两组差异无统计学意义（均 P>0.05）。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围，组间差异均无统计学意义（均 P>0.05）。固定平台组手术时间更短（P<0.05），两组均无严重并发症，假体生存率均为 100%。 结论 固定平台与活动平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能，下肢力线恢复效果相当；固定平台假体在疼痛控制与手术便捷性方面更具优势，临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术；活动平台假体；固定平台假体；骨关节炎；并发症

Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications

摘要：目的：探讨早期床上抗阻训练联合情绪释放技术应用于肝癌介入术后患者效果。 方法：选取中国医学科学院肿瘤医院96例肝癌介入治疗患者，于2024年3月-2025年4月间收治，随机分为两组。两组患者均给予常规肝癌介入术后管理，对照组给予早期床上抗阻训练，观察组在此基础上联合使用情绪释放技术，两组患者均连续干预2周。比较两组术后康复指标[术后首次排便时间、术后肠鸣音恢复时间、术后住院时长、术后首次排气时间]，干预前后应激指标[皮质醇(Cor )、促肾上腺皮质激素(ACTH)、醛固酮（ALD）]、情绪指标[疾病进展恐惧量表（FoP-Q-SF）、心理痛苦温度计（DT）、正负性情绪状态量表（PANAS）]及生活质量[肝癌患者生命质量测定量表（QOL-LC）]。 结果：干预前两组各指标相比无差别（P>0.05）。与对照组相比，观察组干预后Cor、ACTH、ALD、FoP-Q-SF、DT、PANAS消极情绪部分水平较低，PANAS积极情绪部分、QOL-LC各项评分水平较高（P<0.05）。两组中，观察组首次排气排便时间、肠鸣音恢复时间较早，术后住院时长较短（P<0.05）。 结论：早期床上抗阻训练联合情绪释放技术应用于肝癌介入术术后患者效果良好，可促进患者术后胃肠道功能恢复，减轻机体应激反应，缓解患者疾病恐惧及负性情绪，提升患者生活质量。

摘要：目的：探讨早期床上抗阻训练联合情绪释放技术应用于肝癌介入术后患者效果。 方法：选取中国医学科学院肿瘤医院96例肝癌介入治疗患者，于2024年3月-2025年4月间收治，随机分为两组。两组患者均给予常规肝癌介入术后管理，对照组给予早期床上抗阻训练，观察组在此基础上联合使用情绪释放技术，两组患者均连续干预2周。比较两组术后康复指标[术后首次排便时间、术后肠鸣音恢复时间、术后住院时长、术后首次排气时间]，干预前后应激指标[皮质醇(Cor )、促肾上腺皮质激素(ACTH)、醛固酮（ALD）]、情绪指标[疾病进展恐惧量表（FoP-Q-SF）、心理痛苦温度计（DT）、正负性情绪状态量表（PANAS）]及生活质量[肝癌患者生命质量测定量表（QOL-LC）]。 结果：干预前两组各指标相比无差别（P>0.05）。与对照组相比，观察组干预后Cor、ACTH、ALD、FoP-Q-SF、DT、PANAS消极情绪部分水平较低，PANAS积极情绪部分、QOL-LC各项评分水平较高（P<0.05）。两组中，观察组首次排气排便时间、肠鸣音恢复时间较早，术后住院时长较短（P<0.05）。 结论：早期床上抗阻训练联合情绪释放技术应用于肝癌介入术术后患者效果良好，可促进患者术后胃肠道功能恢复，减轻机体应激反应，缓解患者疾病恐惧及负性情绪，提升患者生活质量。

目的 探讨基于括约肌保护的置管中药冲洗对高位复杂性肛瘘术后中早期肛门功能恢复与生活质量改善的临床效果。方法 采用回顾性研究方法，收集2025年1月-2025年12月太原市中医院肛肠科收治的85例高位复杂性肛瘘患者，按治疗方式分为研究组（42例，括约肌保护置管+中药冲洗术）和对照组（43例，括约肌保护置管+复方黄柏液）。比较两组患者术前1天（T0）及术后3天（T1）、1周（T2）、2周（T3）、3周（T4）的肛门括约肌功能（Wexner量表）、创面愈合质量（REEDA量表、创面愈合时间）、生活质量（SF-36量表），并统计术后3周内并发症发生率及术后3个月（T5）肛瘘复发情况。结果 术前两组各项评估指标差异均无统计学意义（P>0.05）；术后各时间点，研究组Wexner量表评分、REEDA量表评分均显著低于对照组，SF-36量表评分显著高于对照组，创面愈合时间显著短于对照组，差异均有统计学意义（P<0.05）；术后3周内研究组总并发症发生率（7.14%）低于对照组（16.28%）P>0.05），随访3个月，研究组肛瘘复发率、mVSS、肛门坠胀VAS评分、肠液渗漏分级低于对照组，差异有统计学意义（P<0.05）。结论 基于括约肌保护的置管中药冲洗可有效改善高位复杂性肛瘘患者术后中早期肛门括约肌功能，缩短创面愈合时间、提升创面愈合质量，改善患者生活质量，且安全性良好。

       目的  探讨胸部肿瘤患者手术后早期排痰的效果，降低肺部并发症的发生率。方法  选择2024年6月—2025年7月在本院进行胸部肿瘤切除的60例术后患者作为研究对象。采用非同期回顾对照设计，以不同时间段病例分组，分为对照组（n＝30）和观察组（n＝30）。两组胸部手术后患者均给予常规围术期护理，观察组胸部手术后患者增加早期排痰护理。统计两组排痰效果［咳痰难度、血氧饱和度（SPO₂）］变化、疼痛评分，并统计两组肺部相关并发症及住院时间进行比较。结果  观察组患者术后的SPO₂水平高于对照组（P＜0.05），咳痰难度评分低于对照组患者（P＜0.05）。干预后第B、C时间点观察组患者的疼痛评分均低于对照组（P＜0.05）。观察组住院时间短于对照组（P＜0.05），胸部并发症总发生率低于对照组（P＜0.05），满意度高于对照组（P＜0.05）。结论  胸部肿瘤术后早期排痰有助于促进术后患者排痰，减少肺部相关发症，缩短住院时间。

       Objective  To investigate the efficacy of early expectoration management in reducing pulmonary complications for patients following thoracic tumor surgery．Methods  Sixty patients undergoing thoracic tumor  resection at our hospital between 2024 and 2025 were enrolled．A non-concurrent retrospective control design was adopted．Cases were grouped according to different time periods，divided into a control group（n=30）and an observation group（n=30）．The control group  received  standard perioperative care，while the observation group received additional early expectoration nursing interventions．Outcome measures included expectoration efficacy（assessed by cough difficulty score and oxygen saturation［SpO₂］），pain scores，incidence of pulmonary complications，and hospital stay duration．Results  Postoperative SpO₂ levels were higher in the observation group than in the control group （P＜0.05），while cough difficulty scores were significantly lower（P＜0.05）．At time points B and C after the intervention，the pain scores of patients in the observation group were lower than those in the control group（P＜0.05）．The observation group demonstrated a significantly shorter hospital stay（P＜0.05），a lower overall incidence of thoracic complications（P＜0.05），and higher patient satisfaction  than the control group（P＜0.05）．Conclusions  Implementing early expectoration protocols after thoracic tumor surgery facilitates sputum clearance can reduce pulmonary complications，and shorten hospitalization time．