目的 分析基于叙事护理理论的心理干预在突发创伤下肢骨折患者中的应用价值。方法 选择南方医科大学深圳医院2023年4月—2023年10月收治的100例突发创伤下肢骨折患者,根据随机数字表法将患者分为研究组和对照组,各50例。对照组提供常规心理护理和健康教育,研究组在对照组的基础上增加基于叙事护理理论的心理干预。对比两情绪压力量表和创伤后成长情况、康复依从性。结果 研究组的情绪压力评分维度中抑郁和焦虑及压力评分明显低于对照组（P<0.05）;研究组的创伤相关评分维度中与他人的关系、新的可能性和个人力量、生活的欣赏和精神变化评分高于对照组,康复依从性高于对照组（P<0.05）。结论 基于叙事护理理论的心理干预,可缓解突发创伤下肢骨折患者的心理压力,提高康复依从性,促进早日康复。

Objective To analyze the application value of psychological intervention based on narrative nursing theory in patients with sudden traumatic lower extremity fracture．Methods A total of 100 patients with sudden traumatic lower extremity fracture admitted to Shenzhen Hospital of Southern Medical University from April 2023 to October 2023 were selected and divided into study group and control group with 50 cases in each group by random number table method．The control group received routine psychological nursing and health education,and the study group was added psychological intervention based on narrative nursing theory．The two emotional stress scales were compared with post-traumatic growth and rehabilitation compliance．Results The scores of depression,anxiety and stress in the study group were significantly lower than those in the control group（P<0.05）．The trauma-related scores of the study group were significantly higher than those of the control group in relation to others,new possibilities and personal strength,appreciation of life and spiritual changes,and the rehabilitation compliance was significantly higher than that of the control group（P<0.05）．Conclusions Psychological intervention based on narrative nursing theory can relieve psychological pressure of patients with sudden traumatic lower extremity fracture,improve rehabilitation compliance,and promote early recovery．

目的 探讨不同贫血类型患者铁蛋白水平、甲状腺功能检测结果对比分析。方法 前瞻性选取2018年11月—2021年11月我院收治的240例贫血患者作为研究对象。将患者分为小细胞低色素性贫血组（n=75）,正细胞性贫血组（n=100）和大细胞性贫血组（n=65）。检查患者甲状腺功能[甲状腺素（TSH）、游离三碘甲腺原氨酸（FT₃）、游离甲状腺素（FT₄）]和铁蛋白（SF）表达水平。采用Spearman检验进行相关性分析;采用Logistics回归模型进行回归分析。结果 3组患者红细胞（RBC）、血红蛋白（Hb）、平均红细胞容积（MCV）、红细胞平均血红蛋白浓度（MCHC）、平均红细胞血红蛋白含量（MCH）、血清肌酐（Scr）间存在差异（P<0.05）;大细胞性贫血组TSH、FT₃和SF低于正细胞性贫血组和小细胞低色素性贫血组（P<0.05）,而FT₄高于正细胞性贫血组和小细胞低色素性贫血组（P<0.05）;贫血类型与TSH、FT₄、FT₃和SF呈正相关（P<0.05）;多因素Logistics回归分析结果显示,TSH、FT₄、FT₃和SF在3个模型中均为独立危险因素（P<0.05）。结论 不同贫血类型患者间甲状腺功能和铁蛋白表达水平存在显著差异,大细胞性贫血组TSH、FT₃和SF低于正细胞性贫血组和小细胞低色素性贫血组,而FT₄更高,甲状腺功能指标和铁蛋白均是各种类型贫血发生的危险因素。

Objective To explore the comparative analysis of ferritin level and thyroid function detection results in patients with different types of anemia．Methods A total of 240 anemia patients admitted to our hospital from November 2018 to November 2021 were prospectively selected as research objects．The patients were divided into microcytic hypochromic anemia group（n=75）,normocytic anemia group（n=100）,and macrocytic anemia group（n=65）．The expression levels of thyroid function[thyroxine（TSH）,free triiodothyronine（FT₃）,free thyroxine（FT₄）]and ferritin（SF）were examined．Correlation analysis was performed by Sperman test．The logistic regression model was adopted for regression analysis．Results There were significant differences in red blood cell,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin concentration,mean corpuscular hemoglobin content and serum creatinine among three groups（P<0.05）．TSH,FT₃ and SF in macrocytic anemia group were significantly lower than those in normocytic anemia group and microcytic hypochromic anemia group（P<0.05）,while FT₄ was significantly higher than that in normocytic anemia group and microcytic hypochromic anemia group（P<0.05）．The type of anemia was positively correlated with TSH,FT₄,FT₃ and SF（P<0.05）．The results of multi-factor logistics regression analysis showed that TSH,FT₄,FT₃ and SF were independent risk factors in the three models（P<0.05）．Conclusions There were significant differences in thyroid function and ferritin expression levels among patients with different types of anemia．Macrocytic anemia group TSH,FT₃ and SF were lower than those in normocytic anemia group and microcytic hypochromic anemia group,while FT₄ was higher．Both thyroid function indexes and ferritin were risk factors for various types of anemia．