小柴胡汤是《伤寒杂病论》中的一首经典方剂,是和解法的基础方,后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索,探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用,有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂,小柴胡汤亟需进一步的发扬与创新,以期更有效地应用于未来的临床实践。
Xiaochaihu Decoction,as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases,laid the foundation for reconciliation.It has a wide range of applications in the treatment of gynecological diseases.Through a literature search,this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application.This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain,bleeding,leucorrhea disease,tumors and other related diseases.Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea,pelvic inflammatory disease,menstrual irregularities,gynecological tumors,and perimenopausal syndrome through its role of soothing the liver and promoting bile flow,strengthening the spleen and stomach,and harmonizing and releasing the pivot.As a commonly used gynecological prescription in clinical practice,Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future.
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 探讨低浓度罗哌卡因行超声引导下髋关节囊周围神经(PENG)阻滞联合椎管内麻醉对衰弱患者髋关节手术的应用优势。方法 选择行髋关节手术的衰弱患者76例,随机分为两组,A 组(38例)行PENG阻滞联合椎管内麻醉,C 组(38例)行椎管内麻醉。比较两组入室(T0)、摆放体位时(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)静息和活动状态的数字等级评定量表(NRS)疼痛评分;术后非甾体抗炎药及阿片类药物补救次数;术后 6 h、24 h患侧股四头肌徒手肌力分级(MMT);首次下床活动时间、住院时间。结果 A组T1~T4时刻静息状态NRS疼痛评分分别为2(1,3)分、1(1,2)分、2(1,2)分、3(2,4)分均低于C组的5(4,7)分、4(3,5)分、5(3,6)分、4(2,6)分,比较差异有统计学意义(均P<0.001);A组T1~T4时刻活动状态NRS疼痛评分分别为5(4,7)分、3(2,4)分、4(3,5)分、6(4,7)分均低于C组的10(9,10)分、8(6,9)分、8(7,9)分、9(8,10)分,比较差异有统计学意义(均P<0.001)。A组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.01);C组在T1~T4时的静息状态NRS疼痛评分低于T0时的(均P<0.05);A组在T1~T4时的活动状态NRS疼痛评分均低于T0时的(均P<0.001);C组在T1、T2时的活动状态NRS疼痛评分均低于T0时的(均P<0.01)。A组术后非甾体抗炎药及额外阿片类药物补救次数为4(0,8)、2(0,3)次,均低于C组的15(7,19)、5(3,7)次,比较差异有统计学意义(均P<0.001)。两组术后 6 h和24 h患侧股四头肌MMT分级、首次下床活动时间和住院时间比较差异无统计学意义(P>0.05)。结论 低浓度罗哌卡因PENG阻滞可以有效减轻衰弱患者髋关节手术术后疼痛,不影响其术后下肢肌力。
Objective To explore the application advantages of low-concentration ropivacaine for ultrasound-guided pericapsular nerve group(PENG)block combined with spinal-epidural anesthesia in hip joint surgery for frail patients.Methods Seventy-six frail patients undergoing hip surgery were randomly divided into two groups:Group A(38 cases)received PENG block combined with intraspinal anesthesia,while Group C(38 cases)received only intraspinal anesthesia.The numerical rating scale(NRS)pain scores of resting and active states were compared between the two groups at the time of entering the room(T0),placing the position(T1),6 hours after surgery(T2),12 hours after surgery(T3),and 24 hours after surgery(T4).Postoperative non-steroidal drugs and opioids remedy times,muscle strength grading(MMT)of quadriceps femoris at 6 hours and 24 hours after operation,and the first time out of bed activity time,hospitalization time were also compared.Results The resting NRS pain scores at T1-T4 in Group A were 2(1,3),1(1,2),2(1,2)and 3(2,4),respectively,which were lower than 5(4,7),4(3,5),5(3,6)and 4(2,6)in Group C,and the difference was statistically significant(all P<0.001).The NRS pain scores at T1-T4 in Group A were 5(4,7),3(2,4),4(3,5)and 6(4,7),respectively,which were lower than 10(9,10),8(6,9),8(7,9)and 9(8,10)in Group C,and the difference was statistically significant(all P<0.001).The resting NRS pain score of Group A at T1-T4 was lower than that at T0(all P<0.01);the resting NRS pain score of Group C at T1-T4 was lower than that at T0(all P<0.05).The NRS pain scores at T1-T4 in Group A were lower than those at T0(all P<0.001);the NRS pain scores at T1 and T2 in Group C were lower than those at T0(all P<0.01).The number of postoperative non-steroidal drugs and additional opioids in group A(4[0,8],2[0,3])was lower than that in Group C(15[7,19],5[3,7]),and the difference was statistically significant(all P>0.001).There was no significant difference in the MMT grade of the affected quadriceps femoris at 6 h and 24 h after operation,the first time of getting out of bed and the number of days of hospitalization between the two groups(P>0.05).Conclusions Low concentration ropivacaine PENG block can effectively reduce the postoperative pain of hip joint surgery in frail patients without affecting the postoperative lower extremity muscle strength.
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.
【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.
【摘要】目的:探讨多元化健康宣教在幽门螺旋杆菌(Hp)感染碳13(13C)呼气试验筛查中的应用效果。方法:将2024年5月~2026年4月至我院体检科进行无痛胃肠镜检查后,结果提示Hp阳性的300例患者作为研究对象,开展前瞻性临床试验。经数字表法将入组患者随机列为常规组和试验组,每组150例。两组患者均行13C呼气试验,常规组检查前实施常规健康宣教,试验组检查前实施多元化健康宣教,比较两组患者的心理状态,准备情况,检查情况及整体满意度。结果:试验组的疾病不确定感(MUIS)评分、广泛性焦虑量表-7(GAD-7)评分均低于常规组(t=7.644,10.923;P<0.05)。试验组的药物停用依从率、饮食依从率、空腹依从率分别92.00%(138/150)、93.33%(140/150)、96.67%(145/150),均高于常规组[80.00%(120/150)、81.33%(122/150)、85.33%(128/150)](x2=8.970,9.763,11.762;P<0.05)。试验组的吹气一次成功率、肺泡气样本质量达标率、检查完成率、检查结果准确率分别为94.67%(142/150)、94.00%(141/150)、96.67%(145/150)、96.00%(144/150),均高于常规组[82.67%(124/150)、83.33%(125/150)、84.67%(127/150)、84.00%(126/150),](x2=10.748,8.492,12.763,12.000;P<0.05)。试验组的心理舒适、信息获取、检查流畅、结果可靠满意度评分均高于常规组(t=5.279,4.625,4.592,5.729;P<0.05)。结论:多元化健康宣教可改善Hp感染患者的心理状态,并优化13C呼气试验的准备情况、检查情况,对提升检查结果准确性及患者满意度均有积极影响
[Abstract]Objective:Exploring the application effect of diversified health education in screening for Hp infection with 13C breath test.Methods:A prospective clinical trial will be conducted on 300 patients who were found to be Hp positive after undergoing painless gastroscopy in our hospital from May 2024 to April 2026. The enrolled patients were randomly divided into a control group and an experimental group using a numerical table method, with 150 cases in each group. Both groups of patients underwent 13C breath tests. The routine group received routine health education before the examination, while the experimental group received diversified health education before the examination. The psychological status, preparation, examination results, and overall satisfaction of the two groups of patients were compared.Results:Compare to the control group,the experimental group had lower MUIS scores and GAD-7 scores (t=7.644,10.923; P<0.05). The medication discontinuation compliance rate, dietary compliance rate, and fasting compliance rate of the experimental group were 92.00% (138/150), 93.33% (140/150), and 96.67% (145/150), respectively, all higher than those of the conventional group [80.00% (120/150), 81.33% (122/150), 85.33% (128/150)] (x2=8.970,9.763,11.762; P<0.05). The success rate of one-time blowing, the quality compliance rate of alveolar gas samples, the completion rate of examination, and the accuracy of examination results in the experimental group were 94.67% (142/150), 94.00% (141/150), 96.67% (145/150), and 96.00% (144/150), respectively, which were higher than those in the conventional group [82.67% (124/150), 83.33% (125/150), 84.67% (127/150), 84.00% (126/150)] (x2=10.748,8.492,12.763,12.000; P<0.05). Compare to the control group,the experimental group had higher satisfaction scores of psychological comfort, information acquisition, smooth examination, and reliable results (t=5.279,4.625,4.592,5.729; P<0.05).Conclusion:Diversified health education can improve the psychological state of Hp infected patients, optimize the preparation and examination of 13C breath tests, and have a positive impact on improving the accuracy of examination results and patient satisfaction.
目的 探讨密室逃脱教学法运用于急诊护理教学查房的效果。方法 选取2024年6月—2025年6月在本院急诊科的新入职护士76人作为研究对象,按随机数字表法将所有护士分为对照组和观察组(n均=38)。对照组采用传统模式护理教学查房,观察组采用密室逃脱教学法教学查房。培训后对两组护士采用理论及操作技能考核、批判性思维能力量表-中文版进行考核,并调查两组护士对两种教学模式的满意度。结果 与对照组比较,观察组的理论知识成绩及操作技能成绩明显提升(P<0.05);另外,观察组的批判性思维能力量表-中文版得分比对照组明显提升(P<0.05)。观察组的非常满意、比较满意例数(率)及总满意度均比对照组明显增加(P<0.05)。结论 密室逃脱教学法可有效提高急诊护理教学查房效果,值得在临床教学实践中进一步推广。
Objective: To investigate the effectiveness of the escape room teaching method in emergency nursing teaching rounds. Methods: A total of 76 newly hired nurses in the Emergency Department of our hospital between June 2024 and June 2025 were selected as study subjects. Using a random number table, all nurses were divided into a control group and an observation group (n = 38 each). The control group underwent traditional nursing teaching rounds, while the observation group participated in teaching rounds using the escape room teaching method. After training, both groups were assessed using theoretical and practical skill examinations, as well as the Critical Thinking Skills Scale (Chinese Version), and their satisfaction with the two teaching models was surveyed. Results: Compared with the control group, the observation group showed significant improvements in theoretical knowledge and practical skill scores (P < 0.05); Additionally, the scores on the Critical Thinking Skills Scale (Chinese Version) in the observation group were significantly higher than those in the control group (P < 0.05). The number (and rate) of nurses in the observation group who reported being “very satisfied” or “fairly satisfied,” as well as the overall satisfaction rate, were significantly higher than those in the control group (P < 0.05). Conclusion: The escape room teaching method can effectively enhance the effectiveness of emergency nursing teaching rounds and is worthy of further promotion in clinical teaching practice.
目的 探究强化肢体沟通联合心理引导在肱骨髁上骨折患儿围术期照护中的应用。方法 选取2023年1月—2024年1月河南省儿童医院收治的84例肱骨髁上骨折患儿为研究对象。根据随机数字表法分为常规组和干预组, 每组各42例。对照组采用常规护理, 干预组采用强化肢体沟通联合心理引导的护理。比较两组肘关节功能疗效、疼痛程度、康复锻炼依从性、生活质量等。结果 两组优良率比较差异无统计学意义(P>0.05); 干预后,两组视觉模拟评分法(VAS)评分和儿童疼痛行为量表(FLACC)评分均降低,且干预组低于常规组(P<0.05); 干预组康复锻炼依从性为97.62%高于常规组的76.19%(P<0.05); 干预后, 两组生活质量均升高,且干预组高于常规组(P<0.05)。结论 强化肢体沟通联合心理引导对肱骨髁上骨折患儿护理效果显著, 可降低患者的疼痛程度,提高康复锻炼依从性,提高生活质量。
Objective To explore the application of strengthening physical communication combined with psychological guidance in perioperative care of children with supracondylar fracture of humerus.Methods From January 2023 to January 2024, 84 children with supracondylar fracture of humerus in Henan Children's Hospital were selected as the research objects.By the random number table method, these patients were evenly divided into the routine group and the observation group, with 42 patients each.The routine group received standard nursing care, while the observation group was provided with enhanced nursing interventions that incorporated physical communication and psychological guidance.A comparative analysis was conducted between the two groups in terms of elbow joint function recovery, pain intensity levels, compliance to rehabilitation exercises, and overall quality of life improvements.Results No statistically significant difference was observed in the proportion of excellent and good outcomes between the two groups(P>0.05).Following the implementation of the interventions, both the Visual Analog Scale(VAS)score and the Faces, Legs, Activity, Cry, Consolability(FLACC)score decreased in both groups,with the observation group demonstrating a more pronounced reduction compared to the routine group(P<0.05).The compliance rate for rehabilitation exercises in the observation group was notably higher, reaching 97.62%, in contrast to 76.19% of the routine group,with difference being statistically significant(P<0.05).Post-intervention, an improvement in the quality of life was noted in both groups,however,the observation group exhibited a superior increase compared to the routine group, with this superiority being statistically significant(P<0.05).Conclusions Strengthening physical communication combined with psychological guidance has obvious nursing effect on children with supracondylar fracture of humerus, which can reduce the pain degree of patients, improve the compliance of rehabilitation exercise and the quality of life.
目的 探讨一种保护型的上肢约束衣在儿童洗胃中的应用。方法 自制并获得实用新型专利“一种保护型的上肢约束衣”,包括背单和两条前襟连接单,三条可调节性约束带,以及下肢延伸固定。选取2023年1月—2023年12月在我院急诊科因急性中毒施行洗胃的患儿为研究对象,依据住院时间,将2023年1月—2023年6月收治患儿为对照组(58例),将2023年7月一2023年12月收治患儿为观察组(58例)。观察组使用本研究发明的保护型上肢约束衣进行约束,对照组则采用传统的约束方法。对两组患儿的洗胃时间、协助人员数量和重复置管次数进行了记录和比较。结果 观察组协助洗胃人数、洗胃时间、重复置管次数分别为1.00(1.00,1.00)人、28.00(26.00,32.00)min、0.00(0.00,0.00)次,均低于对照组的3.00(3.00,3.00)人、32.00(29.00,35.25)min、0.00(0.00,0.00)次,差异有统计学意义(P<0.05)。结论 儿童洗胃中应用保护型上肢约束衣,能显著减少协助洗胃人数和重复置管次数,缩短洗胃时间,提高了洗胃效率。
Objective To explore the application of a protective upper extremity restraint in gastric lavage in children.Methods A new patent for“A protective upper extremity restraint garment” was designed,which includes a back sheet and two front-flap connecting sheets,three adjustable restraint bands,and an extension fixation of lower extremity.From January 2023 to December 2023,children who underwent acute gastric lavage due to accidental ingestion in the emergency department of a hospital were selected as the research subjects,according to the admission date,the control group(58 cases)was selected from January 2023 to June 2023,and the observation group(58 cases)was selected from July 2023 to December 2023.The observation group was restrained by the protective upper extremity restraint garment,while the control group was restrained by the traditional restraint method.The time of gastric lavage,the number of assistants and the times of repeated intubation were recorded and compared between the two groups.Results The gastric lavage assistance,lavage time,and number of repeated intubations in the observation group were 1.00[1.00,1.00]person,28.00[26.00,32.00]min,and 0.00[0.00,0.00]times,lower than in the control group(3.00[3.00,3.00]person,32.00[29.00,35.25]min,0.00[0.00,0.00]times),the differences were statistically significant(P<0.05).Conclusions The application of a protective upper extremity restraint suit during pediatric gastric lavage significantly reduces the number of required assistants,decreases repeated intubation attempts,shortens lavage time,and enhances procedural efficiency.
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.