目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组（30例,常规治疗+四子散中药封包药熨）与对照组（30例,常规治疗）。比较两组治疗前后疼痛评分（NRS-11）、肿胀程度评分、C反应蛋白（CRP）、白细胞介素-6（IL-6）水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义（P>0.05）; 治疗1周后,观察组疼痛评分为（2.11±0.48）分、肿胀程度为（0.35±0.43）度、CRP为（12.23±3.12）mg/L、IL-6为（16.03±4.01）ng/L,均低于对照组的（3.54±0.56）分、（1.04±0.58）度、（24.31±4.51）mg/L、（23.19±6.75）ng/L,差异有统计学意义（P<0.001）。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。

       Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery．Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group（30 cases, conventional treatment+Sizi power pack hot compress）and control group（30 cases, conventional treatment）． The pain score（NRS-11）, swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups．Results There was no significant difference in pain and swelling scores between the two groups before treatment（P>0.05）．After 1 week of treatment, the pain score（2.11±0.48）, swelling score（0.35±0.43）, CRP（12.23±3.12 mg/L）, IL-6（16.03±4.01 ng/L）levels in the observation group were significantly lower than those in the control group（3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L）, and the difference was statistically significant（P<0.001）．There were no adverse events in the observation group or the control group．Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety．

      目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题：多重躯体症状负担持续存在（术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感）; 负性心理情绪困扰（病耻感、疾病不确定感与复发恐惧）; 心理调适过程（诊断冲击与认知失调、角色适应与主动应对）; 创伤后成长与健康行为转变（生命意义感提升、健康促进行为强化）; 强烈的康复信息支持需求（自我保健知识需求、结构化康复锻炼指导需求）。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。

       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions．Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer．Colaizzi's 7-step analysis method was used to summarize and extract themes．Results Five themes and 12 sub-themes were summarized：Persistent burden of multiple physical symptoms（postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue）; negative emotional experiences（stigma of illness, illness uncertainty and fear of recurrence）; psychological adjustment processes（diagnostic shock and denial, role acceptance and active coping）; post-traumatic growth and health behavior transformation（enhanced sense of meaning in life, strengthened health-promoting behaviors）; strong demand for rehabilitation information support（self-care knowledge, rehabilitation exercise knowledge）．Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life．

       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象，采用随机数字表法将患者分为A、B组，B组56例患者采取治疗性沟通干预，A组66例患者采用认知行为疗法联合治疗性沟通干预，两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异，对比两组干预依从性。结果   干预后，两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326，P＜0.05）；干预后，两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622，P＜0.05）；干预后，两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794，P＜0.05）；A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ ² =8.782，P＜0.05）。结论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想，能够明显改善患者负性情绪，提高心理弹性及对疾病康复的希望水平，有效提升依从性。

       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods  Prospectively，122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method，and 56 patients in group B were treated with therapeutic communication，66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication，and both groups were continuously intervened for 2 months．The  scores of Self-Rating Anxiety Scale（SAS），Self-Rating Depression Scale（SDS），Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results  After treatment，the SAS and SDS scores of the two groups were decreased，and the scores of group A was lower than that of group B（t=12.096，10.326，P＜0.05）after the intervention，the scores of the CD-RISC scale of the two groups were improved，and the score of group A was higher than that of group B（t=18.483，12.060，13.622，P＜0.05）．After intervention，the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B（t=11.289，11.568，12.527，13.794，P＜0.05）．The total compliance rate of patients in group A was 96.97%（64/66），which was significantly higher than 80.36%（45/56）in group B（χ ² =8.782，P＜0.05）．Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients，which can significantly improve patients’ negative emotions，psychological resilience and hope for disease recovery，and also therapy compliance．

       目的   探讨基于手术风险模型（RoSCo）评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法   选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者，应用随机数字表法将其分为观察组与对照组，各40例。80例患者均实施腹腔镜肾部分切除术，对照组实施常规干预与术后早期下床活动干预，观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平，疼痛程度与睡眠质量，并发症发生率及生活质量。结果   观察组首次下床活动（19.30±4.17）h、排气（22.03±4.15）h、排便时间（29.93±5.58）h及术后住院时间（5.35±1.33）h短于对照组［（25.08±5.11）、（29.38±5.75）（34.20±5.98）（7.35±2.38）］h，对比差异有统计学意义（t=-5.540、-6.557、-3.308、-4.637，P＜0.05）；手术后，观察组视觉模拟量表（VAS）评分（3.93±0.92）分、PSQI评分（9.13±1.64）分高于对照组［（5.38±1.25）、（12.23±2.40）］分，对比差异有统计学意义（t=-5.902、-6.747，P＜0.05）；观察组并发症发生率7.50%低于对照组27.50%（χ ² =5.541，P=0.019）；手术后观察组SF-36评分相关维度［生理职能（84.45±9.74）、总体健康（60.75±10.65）、躯体疼痛（65.65±8.60）、生理功能（72.98±9.22）、活力（71.95±6.93）、社会功能（75.38±8.33）、精神健康（75.63±8.02）、情感职能（65.43±9.70）］分值高于对照组［生理职能（69.98±10.09）、总体健康（53.58±7.96）、躯体疼痛（58.83±9.35）、生理功能（65.68±7.58）、活力（62.83±12.80）、社会功能（68.98±10.99）、精神健康（71.58±9.69）、情感职能（57.90±6.86）］分值，对比差异有统计学意义（t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004，P＜0.05）。结论   针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复，辅助减轻术后疼痛程度，提升睡眠质量，降低并发症发生率，进一步提升患者生活质量。

      Objective  To explore the application effect of early mobilization timing  based on the Risk of  Surgical Complication（RoSCo）scoring system in renal tumor patients after surgery．Methods  From June 2021 to June 2024，80 patients with renal tumors admitted to the hospital were selected as the research subjects．They were  randomly divided into an observation group and a control group using a random number table method，with 40 patients in each group．All patients underwent laparoscopic partial nephrectomy．The control group received routine care and early postoperative mobilization intervention，while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system．The postoperative rehabilitation level，pain level and sleep quality，incidence of complications，and quality of life between two groups were compared．Results  The first time getting out of bed，exhaust，defecation and postoperative hospitalization time in observation group（［19.30±4.17］h，［22.03±4.15］h，［29.93±5.58］h，［5.35±1.33］h） were shorter than those in control group（［25.08±5.11］h，［29.38±5.75］h，［34.20±5.98］h，［7.35±2.38］h），the  differences  were  statistically significant（t=-5.540，-6.557，-3.308，-4.637，all P＜0.05）．After operation，VAS score（3.93±0.92）and PSQI score（9.13±1.64）in the observation group were higher than those in the control group（［5.38±1.25］and［12.23±2.40］），and the differences were statistically significant（t=-5.902，-6.747，both P＜0.05）．The complication  rate of the observation group （7.50%） was lower than that of the control group（χ ² =5.541，P=0.019）．After operation，SF-36 scores in the observation group were physiological function（84.45±9.74），general health（60.75±10.65），physical pain（65.65±8.60），physiological function（72.98±9.22），vitality（71.95±6.93），social function（75.38±8.33），spiritual health（75.63±8.02）and emotional function（65.43±9.70），which were higher than those of the control group（physiological function［69.98±10.09］，general health［53.58±7.96］，physical pain［58.83±9.35］，physiological function［65.68±7.58］and vitality［62.83±12.80］，social function［68.98±10.99］，mental health［71.58±9.69］，emotional function［57.90±6.86］），and the differences were statistically significant（t=6.530，3.414，3.398，3.870，3.966，2.936，2.037，4.004，all P＜0.05）．Conclusions  Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery，assist in reducing postoperative pain，improve sleep quality，reduce the incidence of complications，and further enhance the quality of life of patients with renal tumors．

目的 研究胸腰椎骨质疏松性椎体压缩性骨折（OVCF）经皮椎体成形术（PVP）后腰背部疼痛缓解情况与骨水泥弥散分布的相关性。方法 选取2021年1月—2023年12月金沙县中医医院和毕节市第三人民医院185例因骨质疏松症导致的胸腰椎OVCF行PVP后的患者,根据术后胸腰椎正侧位X线片显示的骨水泥分布情况分为两组：骨水泥分布充分组（n=101例）和骨水泥分布不良组（n=84）, 两组均行PVP, 均行双侧穿刺入路。统计分析两组患者术前、术后及术后1周、3个月、6个月视觉模拟评分（VAS）、患者起床时间等情况。结果 185例患者术后随访半年, 骨水泥分布充分组101例, 骨水泥分布不良组84 例, 两组术后VAS评分均较前缓解（P<0.05）, 术后及术后1周、3个月、6个月的随访中分布充分组VAS评分分别为（7.17±0.76）（2.11±1.04）（1.4±0.78）（0.36±0.58）（0.05±0.22）分, 优于分布不良组（7.14±0.79）（2.37±0.79）（1.89±0.82）（0.68±0.76）（0.25±0.62）分（P<0.05）。结论 骨水泥的分布在一定程度上决定了PVP后患者腰背部残余痛的程度。尤其是骨水泥在椎体内均匀分布时, 可降低术后腰背疼痛的发生率。

Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty（PVP）of thoracolumbar osteoporotic vertebral compression fracture（OVCF）．Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City．Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation, they were divided into the group with adequate bone cement distribution（n=101 cases）and the group with poor bone cement distribution（n=84）．Both groups underwent PVP and bilateral puncture approaches．The Visual Analogue Scale（VAS）scores of the two groups of patients before the operation, after the operation, 1 week, 3 months, and 6 months after the operation, as well as the leaving bed time of the patients,were statistically analyzed．Results A total of 185 patients were followed up for half a year after the operation．There were 101 cases in the group with adequate bone cement distribution, and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients（P>0.05）, and the postoperative VAS scores of both groups were decreased compared with those before operation（P<0.05）．The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week, 3 months, and 6 months after the operation were（7.17±0.76）,（2.11±1.04）,（1.4±0.78）,（0.36±0.58） ,and（0.05±0.22）, respectively,better than the poor distribution group （7.14±0.79）,（2.37±0.79）,（1.89±0.82）,（0.68±0.76）,（0.25±0.62）, P<0.05．Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP．Especially when the bone cement is evenly distributed within the vertebral body, the incidence of postoperative low back pain can be reduced．

目的 评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法 检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果 纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR（95%CI）=537.70（4.18,124 511.88）、0（0,0.52）,P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR（95%CI）=8.55（1.40,73.35）,P<0.05];其余比较差异无统计学意义（P>0.05）。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论 综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。

Objective To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer．Methods PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively．Related randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation．The network Meta analysis was performed using ADDIS 1.16.5 softwares．Results A total of 18 articles and 1596 patients were inciuded．The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR（95%CI）=537.70（4.18,124 511.88）,0（0,0.52）,P<0.05]．In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR（95%CI）=8.55（1.40,73.35）,P<0.05],the others were not statistically different（P>0.05）．Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness．Conclusions Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is recommended considering the early post-operative activities of laryngeal cancer patients．

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．

腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。

In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain．This pain not only impacts the patient's postoperative experience,but can also worsen the body's internal environment and hinder recovery．Visceral pain originates from internal organs and tissues．It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs．In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals．At present,there are multiple clinical treatment options available for postoperative pain management．However,clinicians must overcome the challenge of controlling postoperative visceral pain．This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements．

目的 探讨多学科整合护理路径联合手术室优质护理对下肢骨折的应用效果及对术后下肢静脉血栓发生率的影响。方法 选择2021年1月—2022年10月我院收治的70例下肢骨折患者,随机分为联合组与常规组,每组各35例。常规组患者实施常规护理,联合组患者实施多学科整合护理路径联合手术室优质护理,对比两组患者护理效果。结果 联合组患者首次下床活动时间、术后视觉模拟量表（VAS）评分低于常规组（P<0.05）,二者住院时间以及引流管拔除时间比较差异无统计学意义（P>0.05）;经过护理干预后,两组的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）均延长,血浆纤维蛋白原（FIB）降低,联合组优于常规组（P<0.05）,且联合组下肢静脉血栓发生率低于常规组（0% vs 17.14%,P<0.05）;联合组患者护理满意度更高（P<0.05）;术后1个月两组患者日常生活活动能力（ADL）评分、Fugl-Meyer评分均升高,联合组高于常规组（P<0.05）。结论 多学科整合护理路径联合手术室优质护理可改善下肢骨折患者围术期指标和血液高凝状态,降低患者下肢静脉血栓发生率,提升护理满意度及患者远期日常生活能力、肢体运动功能。

Objective To explore the application effect of multidisciplinary integrated nursing path combined with high-quality nursing in operating room on patients with lower limb fracture and the effect on postoperative lower limb venous thrombosis．Methods From January 2021 to October 2022,70 patients with lower limb fracture admitted to our hospital were randomly divided into combination group and conventional group,with 35 cases in each group．Patients in the conventional group received routine nursing,and patients in the combined group received multidisciplinary integrated nursing path combined with high-quality nursing in the operating room．The nursing effect of the two groups was compared．Results The first time of getting out of bed in the combined group was earlier and postoperative VAS score was lower than those in the conventional group（P<0.05）,and the length of hospital stay and drainage tube removal time were not significantly different between the two groups（P>0.05）．After nursing intervention,the prothrombin time（PT）and activated partial thromboplastin time（APTT）of the two groups were prolonged,and the plasma fibrinogen（FIB）decreased,and the change range of the combined group was greater（P<0.05）．The incidence of venous thrombosis in the combined group was significantly lower than that in the conventional group（0.00% vs 17.14%,P<0.05）．The nursing satisfaction of patients in combination group was higher（P<0.05）．The activities of daily living score and Fugl-Meyer score of both groups increased one month after surgery,and the combined group was higher than the conventional group（P<0.05）．Conclusions Multidisciplinary integrated nursing path combined with high-quality nursing in operating room can improve perioperative indicators and blood hypercoagulability of patients with lower limb fractures,reduce the incidence of lower limb venous thrombosis,improve nursing satisfaction,long-term daily living ability and limb motor function of patients．

目的 探讨积极综合护理措施对早期宫颈癌术后患者性功能、抑郁和主观幸福感的影响。方法 对我院收治的84例50岁以下宫颈癌患者的临床资料进行回顾性分析,将行常规护理的43例患者作为对照组、行综合护理的41例患者作为治疗组,治疗组除了常规护理内容,还采用幸福理论框架模型下（PERMA模型）的性健康管理多学科团队干预方案。分别在干预前、干预后3个月、干预后6个月采用女性性功能指数、抑郁自评量表评分和幸福感指数,对性功能指数、抑郁评分和幸福指数进行评估。结果 与对照组相比,治疗组干预3个月及6个月患者的性功能改善（F=91.08,P<0.001）。干预3个月及6个月后,治疗组抑郁评分低于对照组（F=1 092.59,P<0.001）,幸福感改善指数高于对照组（F=107.90,P<0.001）。Spearman相关分析结果显示,女性性功能指数同抑郁自评量表得分呈负相关（r_s=-0.918,P<0.001）,同幸福感指数得分呈正相关（r_s=0.844,P<0.001）。结论 综合护理在性功能、抑郁和主观幸福感方面均有明显改善。通过PERMA模式下性健康管理的多学科团队干预方案,可以提高患者的性生活质量,降低患者的抑郁程度,及改善患者的主观幸福感。

Objective To explore the effects of active and comprehensive care measures on sexual function,depression and subjective well-being of patients after early cervical cancer surgery．Methods The clinical data of 84 cervical cancer patients（under 50 years old）admitted to our hospital were retrospectively analyzed．There were 43 cases with conventional care in control group and 41 cases with comprehensive care group in treatment group．Besides the conventional care components,the comprehensive care group also adopted a multidisciplinary team intervention program for sexual health management under the framework model of well-being theory（PERMA model）．We used the female sexual function index,depression self-rating scale score and happiness index to assess the sexual function index,depression score and happiness index before,3 months and 6 months after the intervention,respectively．Results In comparison with the control group,the patients in the treatment group had a significant improvement in sexual function at 3 and 6 months of intervention（F=91.08,P<0.001）．After 3 and 6 months of intervention,the depression score was significantly lower in the comprehensive care group than in the control group（F=1 092.59,P<0.001）,and the happiness improvement index was significantly higher than in the control group（F=107.90,P<0.001）．Spearman’s correlation analysis showed that the female sexual function index was negatively correlated with the depression self-rating scale score（r_s=-0.918,P<0.001）and positively correlated with the well-being index（r_s=0.844,P<0.001）．Conclusions The comprehensive care group showed significant improvements in sexual function,depression,and subjective well-being．A multidisciplinary team intervention program for sexual health management under the PERMA model can improve the quality of patients’ sexual life,reduce their depression,and improve their subjective well-being．