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广州医药杂志服务号
论著

肺泡灌洗液靶向高通量测序在鹦鹉热衣原体肺炎中的应用价值

Application of bronchoalveolar lavage fluid targeted next-generation sequencing in Chlamydia psittaci pneumonia

:459-465
 
       目的 探究肺泡灌洗液靶向高通量测序(tNGS)在鹦鹉热衣原体肺炎中应用效果。方法 选取2021年5月—2025年3月我院收治的35例鹦鹉热衣原体肺炎患者进行研究,患者均接受肺泡灌洗液tNGS检测、肺泡灌洗液常规病原检测,以病原学为金标准,分析肺泡灌洗液tNGS对鹦鹉热衣原体肺炎的诊断效能。结果 金标准对鹦鹉热衣原体阳性检出35例,检出率100.00%,肺泡灌洗液tNGS阳性检出率高于传统病原检测,检测结果回报耗时短于肺泡灌洗液传统病原检测(P<0.05)。结论 鹦鹉热衣原体肺炎临床症状缺乏特异性,容易转为重症肺炎,肺泡灌洗液tNGS可提高鹦鹉热衣原体肺炎检出率且结果回报较快,采用四环素类、喹诺酮类抗生素有助于改善患者预后。
     Objective To investigate the application effect of targeted next-generation sequencing(tNGS)of bronchoalveolar lavage fluid(BALF)in Chlamydia psittaci pneumonia.Methods Thirty-five patients with Chlamydia psittaci pneumonia admitted to our hospital from May 2021 to March 2025 were selected for the study.All patients underwent BALF tNGS and conventional BALF pathogen detection.With etiology as the gold standard,the diagnostic efficacy of BALF tNGS for Chlamydia psittaci pneumonia was analyzed.Results The gold standard detected 35 cases of Chlamydia psittaci positive,with a detection rate of 100.00%.The positive detection rate of tNGS in alveolar lavage fluid was higher than that of traditional pathogen detection,and the results report time of tNGS was shorter than that of traditional pathogen detection(P<0.05).Conclusions Chlamydia psittaci pneumonia lacks specificity in clinical symptoms and is easy to turn into severe pneumonia,bronchoalveolar lavage fluid tNGS can improve the detection rate of Chlamydia psittaci pneumonia and the results return quickly,and the use of tetracyclines and quinolones antibiotics can help improve the prognosis of patients.

论著

基于肺康复的阻抗训练联合营养支持对老年COPD衰弱患者肌少症及运动耐量的影响

The impact of impedance training combined with nutritional support based on pulmonary rehabilitation on sarcopenia and exercise tolerance in elderly patients with COPD-related frailty

:594-599
 
       目的 探讨基于肺康复的阻抗训练联合营养支持对老年慢性阻塞性肺疾病(COPD)衰弱患者肌少症及运动耐量的影响。方法 将2024年1月—2025年5月收治的80例老年COPD衰弱合并肌少症患者,分为对照组、观察组,各40例。所有患者均采取常规药物治疗,对照组予以营养支持,观察组在对照组基础上增加基于肺康复的阻抗训练。比较两组治疗前、治疗3个月后肌少症改善情况,运动耐量,肺功能指标,衰弱状态及生活质量。结果 治疗3个月后,观察组骨骼肌指数、握力、股四头肌肌厚度均较治疗前提高,且与对照组相比,观察组更高(P<0.05);治疗3个月后,两组6 min步行距离、日常活动代谢当量均较治疗前提高,Borg量表评分降低,且与对照组相比,观察组改善幅度更大(P<0.05);治疗3个月后,两组第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、最大通气量(MVV)均较治疗前改善,且与对照组相比,观察组更优(P<0.05);治疗3个月后,两组Fried衰弱表型评分、COPD评估测试(CAT)总分、圣乔治呼吸问卷(SGRQ)总分均较治疗前降低,且与对照组相比,观察组更低(P<0.05)。结论 老年COPD衰弱合并肌少症患者采取基于肺康复的阻抗训练联合营养支持可改善其肌少症情况,提升运动耐量,并且提升患者肺功能水平,改善衰弱状态,提升生活质量。

       Objective To explore the effects of impedance training based on pulmonary rehabilitation combined with nutritional support on sarcopenia and exercise tolerance in elderly patients with chronic obstructive pulmonary disease(COPD)and frailty.Methods Eighty elderly patients with COPD and frailty complicated by sarcopenia,admitted from January 2024 to May 2025,were selected as the study subjects and divided into a control group and an observation group,with 40 patients in each group.All patients received conventional drug therapy.The control group received nutritional support,while the observation group received additional impedance training based on pulmonary rehabilitation on top of the matched group’s treatment.The improvement of sarcopenia,exercise tolerance,pulmonary function index,weakness status and quality of life before and 3 months after treatment were compared between the two groups.Results After 3 months of treatment,the skeletal muscle index,grip strength and quadriceps thickness of the observation group increased compared with that before treatment,and compared with the control group,the observation group was higher(P<0.05).After 3 months of treatment,the 6 min walking distance and daily activity metabolic equivalent of both groups increased compared with that before treatment,and the Borg Scale score decreased.Compared with the control group,the improvement of the observation group was better(P<0.05).After 3 months of treatment,Forced Expiratory Volume in one second(FEV1),FEV1/Forced Vital Capacity(FVC)and Maximal Voluntary Ventilation(MVV)of both groups improved compared with that before treatment,and the observation group  was better than that of the control group(P<0.05).After 3 months of treatment,the Fried weakness phenotype score,COPD Assessment Test(CAT)total score and St. George’s Respiratory Questionnaire(SGRQ)total score of both groups were lower than that before treatment,and the observation group  was lower than that of the control group(P<0.05).Conclusions Impedance training based on pulmonary rehabilitation combined with nutritional support can improve sarcopenia,enhance exercise tolerance,and improve pulmonary function levels,frailty status,and quality of life in elderly patients with COPD and frailty complicated by sarcopenia.

论著

首发脑出血患者并发卒中相关性肺炎的风险预测模型构建及验证

Construction and validation of a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage

:472-480
 
       目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料,按照7︰3比例随机化分为训练列(293例)和验证队列(126例)。统计基于开发队列数据,采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素,并构建风险预测模型。基于开发队列和验证队列数据,采用校准曲线、受试者操作特征(ROC)曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎,发生率为26.97%。美国国立卫生研究院卒中量表(NIHSS)评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值(NPAR)、中性粒细胞计数与淋巴细胞计数比值(NLR)、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素(P<0.05)。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型,校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近;ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906(95%CI:0.867~0.937)、0.884(95%CI:0.815~0.934);决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。

      Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage(ICH)and validate the predictive performance of the model.Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022.They were randomly divided into a development cohort(293 cases)and a validation cohort(126 cases)according to a 7∶3 ratio.The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data,and a risk prediction model was constructed.Based on the development cohort data and validation cohort data,the predictive performance of the model was analyzed using calibration curves,receiver operating characteristic(ROC)curve,and decision curve analysis.Results Among 419 patients,113 developed stroke associated pneumonia,with a rate of 26.97%.The National Institutes of Health Stroke Scale(NIHSS)score,swallowing difficulties,initial hematoma volume,neutrophil percentage to albumin ratio(NPAR),neutrophil count to lymphocyte count ratio(NLR),surgical treatment,endotracheal intubation,and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH(P<0.05).Based on the above influencing factors,a risk prediction model for stroke associated pneumonia in patients with ICH was constructed.The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence.The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906(95%CI:0.867-0.937)and 0.884(95%CI:0.815-0.934),respectively.The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%,and the threshold probability of the validation cohort was between 2%-76%,the intervention using this model was more clinically valuable than all/no intervention.
Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score,swallowing difficulties,initial hematoma volume,NPAR,NLR,surgical treatment,tracheal intubation,and indwelling gastric tube has good predictive performance and clinical application value.

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.
论著

舒肝解郁胶囊联合体外反搏对冠心病介入术后患者焦虑抑郁疗效及心肺功能的影响

Effects of Shugan Jieyu Capsule combined with external counterpulsation on anxiety and cardiopulmonary function in patients with coronary artery disease after percutanous coronary intervention

:888-892
 
       目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者,随机分为对照组(43例)、舒肝解郁胶囊组(43例),均进行常规治疗及体外反搏治疗,舒肝解郁胶囊组加用舒肝解郁胶囊,测量并比较两组患者治疗前后心肺功能,评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数(LVEF)和最大摄氧量(VO2max)均显著高于对照组(P<0.05);治疗后舒肝解郁胶囊组汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05);舒肝解郁胶囊组总有效率高于对照组(P<0.05);治疗后舒肝解郁胶囊组生活质量综合评定问卷(GQOLI-74)各维度评分均显著高于对照组(P<0.05)。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著,可减轻患者负面情绪,改善其心肺功能及生活质量。

     Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention(PCI).Methods From January 2023 to January 2025,86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group(43 cases) and a Shugan Jieyu Capsule group(43 cases).All patients received conventional treatment and external counterpulsation.The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition.Cardiopulmonary function was measured and compared before and after treatment between the two groups,and anxiety and depression,clinical efficacy,and quality of life were evaluated.Results After treatment,the left ventricular ejection fraction(LVEF) and maximum oxygen uptake(VO2max) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).The Hamilton Anxiety Rating Scale(HAMA) and Hamilton Depression Rating Scale(HAMD) scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group(P<0.05).The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group(P<0.05).After treatment,the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74(GQOLI-74) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI,alleviating negative emotions and improving cardiopulmonary function and quality of life.

论著

ARIMA时间序列模型对耐碳青霉烯类肺炎克雷伯菌医院感染预测效果研究

Application of ARIMA model in prediction of incidence of carbapenem-resistant Klebsiella pneumoniae healthcare-associated infection

:864-870
 
       目的 探讨自回归求和时间序列模型(ARIMA)在耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染预测中的应用,为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率,应用SPSS 19.0建立ARIMA模型,利用该模型对2024年1—12月每月CRKP医院感染数据进行验证,以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合,建立最优模型ARIMA(1,1,1),模型拟合值与实际值较吻合,模型对CRKP医院感染率实际值与预测值吻合度较高,平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况,为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average(ARIMA)model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae(CRKP).Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected,and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model.Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024.The fitted value of the ARIMA(1,1,1)model was in good agreement with the actual value.The incidence of CRKP infection were in good agreement with the predicted value.The average relative errors were 5.40%.Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate,providing scientific guidance for the prevention and control of CRKP infection.

护理研究

肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理对疗效及气道重塑的影响

Effects of multidimensional enhanced nursing on the efficacy and airway remodeling in patients with pulmonary tuberculosis and type Ⅱ respiratory failure during nasal high-flow humidified oxygen therapy

:778-783
 
      目的 分析肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理的效果。方法 纳入2022年12月—2025年1月在河北省胸科医院进行经鼻高流量湿化氧疗的肺结核合并Ⅱ型呼吸衰竭患者294例,随机分为强化护理组(147例,多维度强化护理)、对照组(147例,常规护理),测量比较两组患者在护理前后气道重塑指标、肺功能指标、血气分析指标,进行疗效评估。结果 护理后强化护理组气道壁面积、气道壁厚度低于对照组,气道腔面积高于对照组(P<0.05);护理后强化护理组第1秒用力呼气容积、用力肺活量高于对照组(P<0.05);护理后强化护理组动脉血氧分压高于对照组,动脉血二氧化碳分压低于对照组(P<0.05);强化护理组总有效率高于对照组(P<0.05)。结论 肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间接受多维度强化护理可改善其气道重塑及肺功能,有利于血气分析指标恢复,应用效果显著。

       Objective To analyze the efficacy of multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy in patients with pulmonary tuberculosis and type Ⅱ respiratory failure.Methods A total of 294 patients with pulmonary tuberculosis and type Ⅱ respiratory failure who received nasal high-flow humidified oxygen therapy at Hebei Chest Hospital between December 2022 and January 2025 were enrolled and randomly divided into an enhanced nursing group(147 patients,receiving multidimensional enhanced nursing)and a control group(147 patients,receiving conventional nursing).Airway remodeling,pulmonary function,and blood gas analysis were measured and compared between the two groups before and after nursing,and the efficacy was evaluated.Results After nursing,the enhanced nursing group had lower airway wall area and airway wall thickness,and higher airway lumen area than the control group(P<0.05).The forced expiratory volume in 1 second and forced vital capacity in the enhanced nursing group were higher than those in the control group(P<0.05).The blood oxygen partial pressure(PaO2)in the enhanced nursing group was higher than that in the control group,and the carbon dioxide partial pressure(PaCO2)was lower than that in the control group(P<0.05).The total effective rate in the enhanced nursing group was higher than that in the control group(P<0.05).Conclusions Multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy can improve airway remodeling and lung function in patients with pulmonary tuberculosis and type Ⅱ respiratory failure,and is beneficial for the recovery of blood gas analysis indicators.The application effect is significant.
论著

慢性阻塞性肺疾病居家管理小程序开发与评价

Development and evaluation of a home management mini program for chronic obstructive pulmonary disease

:747-755
 
      目的 开发一款针对慢性阻塞性肺疾病(COPD)患者居家症状管理的微信小程序,并全面评价其可用性,旨在为患者提供智能化、个性化的居家管理工具。方法 首先采用半结构化访谈分析患者及照顾者的核心需求。随后,组建多学科团队,基于需求分析结果开发了名为“呼吸哨兵”的微信小程序,包含5大功能模块。开发完成后,通过纳入10名测试者的内部测试,采用整体评估可用性问卷(PSSUQ)进行初步评估与迭代优化。最终,纳入52例COPD患者进行为期1个月的用户测试,采用系统可用性量表(SUS)及开放式问卷评价其最终可用性。结果 成功开发了“呼吸哨兵”微信小程序,包括用户登录、症状管理、健康日志、健康教育、沟通互动五大模块。内部测试后,针对PSSUQ评分高于基准值的4个题项进行了优化,关键指标如任务完成效率评分从3.50分降至2.90分。最终用户测试显示,小程序的SUS总分均值为(76.15±6.58)分,处于“良好”水平。此外,81%的用户表示愿意继续使用并推荐给其他病友。结论 “呼吸哨兵”小程序内容与功能设计针对性强,整体可用性良好,能够满足COPD患者居家康复管理的核心需求。

      Objective To develop a WeChat mini program for home-based symptom management for patients with chronic obstructive pulmonary disease(COPD)and to evaluate its usability.Methods Semi-structured interviews were used to analyze the needs of patients and caregivers.A multidisciplinary team was formed to develop the “The Breath Sentinel” mini program with five functional modules.Initially,an internal test involving 10 users was conducted using the Post-Study System Usability Questionnaire(PSSUQ)for iterative optimization.Following this,52 COPD patients were recruited for a one-month user test,and the System Usability Scale(SUS)along with an open-ended questionnaire were used for the final usability evaluation.Results We successfully developed “The Breath Sentinel” WeChat mini program.Internal testing led to targeted optimizations,improving key metrics such as the task efficiency score from 3.50 to 2.90.The final user test with 52 users showed that the mean SUS score was(76.15±6.58),indicating “good” usability.Furthermore,81% of users expressed their willingness to continue using and recommend the mini program.Conclusions The content and functions of “The Breath Sentinel” mini program are well-targeted and comprehensive.It demonstrates good usability and can meet the home rehabilitation management needs of COPD patients.
综述

肺癌患者术后肺功能预测模型的研究进展

Research progress on predictive models of postoperative lung function in patients with lung cancer

:717-723
 
       肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种,手术是其主要治疗手段。然而,肺切除手术常引起肺功能下降,影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前,研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型,用于评估肺癌患者术后肺功能变化。然而,现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素,并对现有预测模型进行总结与评价,以期为患者术前评估、手术方案选择及术后管理提供参考,进而为改善治疗效果与患者生活质量提供理论依据。

       Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world,and surgery is the main treatment.However,pneumonectomy is often accompanied by the loss of lung function,which seriously affects the recovery of lung function and the  quality of life.Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans,reducing the risk of complications and improving the prognosis of patients.At present,researchers have developed a variety of predictive models that combine clinical indicators,imaging parameters,and biomarkers to evaluate postoperative lung function changes in patients with lung cancer.However,there are still many challenges in the accuracy,specificity,standardization and clinical promotion of existing models.This paper systematically reviews the influencing factors of lung function after lung cancer surgery,and summarizes and evaluates the existing prediction models,in order to provide a reference for preoperative evaluation,surgical plan selection and postoperative management of patients,and then provide theoretical basis for improving treatment effect and quality of life of patients.

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