cTnI与hs-CRP联合DSA在冠心病诊断中价值的对比研究

Comparative study on the value of cTnI and hs CRP combined with DSA in the diagnosis of coronary heart disease

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目的 探讨数字减影血管造影(DSA)在冠状动脉病变诊断中的应用价值,并评估血清学参数相对于DSA金标准的诊断效能。方法 本研究纳入100名确诊为冠心病的患者。病例组为100例DSA确诊的冠心病患者,对照组按1:1比例匹配100例同期接受DSA检查排除冠心病的患者。应用DSA技术分别评估冠心病的狭窄程度及部位等指征。回顾性收集并对比分析两组患者的各项血清学参数(cTnI、CK-MB、hs-CRP、LDL-C、TC),计算血清学指标诊断冠心病的效能,并进一步探究以上评估于入组患者性别亚组间的统计学差异。结果 病例组与对照组在性别、年龄、BMI等基线资料上均衡可比(P > 0.05)。以DSA为金标准,cTnI诊断冠心病的灵敏度为82.0%,特异度为85.0%;hs-CRP的灵敏度为85.0%,特异度为75.0%。 cTnI、hs-CRP水平随冠状动脉狭窄程度加重而显著升高(P < 0.05)。且以上冠心病评价指征于患者性别亚组间均无统计学差异( P <0.05)。结论 DSA技术可用于冠状动脉病变发生的部位、形态、数目等指征的明确评估,且于不同性别亚组间无统计学差异。血清学参数,尤其是cTnI和hs-CRP,对冠心病具有良好的辅助诊断价值,其水平与病变严重程度相关,可作为DSA检查前的有效筛查工具,为后续的治疗提供重要的参考依据。
Objective: To investigate the clinical value of digital subtraction angiography (DSA) in the diagnosis of coronary artery disease (CAD) and to evaluate the diagnostic performance of serological parameters relative to the DSA gold standard. Methods: A total of 100 patients with confirmed CAD were included in this study. The case group comprised 100 patients with CAD confirmed by DSA, while the control group consisted of 100 age- and sex-matched individuals who underwent DSA during the same period and were excluded from CAD. DSA was employed to assess the degree and location of coronary artery stenosis. Retrospective collection and comparative analysis of serological parameters (cTnI, CK-MB, hs-CRP, LDL-C, TC) were performed between the two groups. The diagnostic efficacy of these serological indicators for CAD was calculated, and subgroup analyses were conducted to explore potential sex-related differences. Results: The case and control groups were comparable in baseline characteristics such as sex, age, and BMI (P > 0.05). Using DSA as the gold standard, the sensitivity and specificity of cTnI for diagnosing CAD were 82.0% and 85.0%, respectively; hs-CRP demonstrated a sensitivity of 85.0% and specificity of 75.0%. Levels of cTnI and hs-CRP increased significantly with the severity of coronary stenosis (P < 0.05). No statistically significant differences were observed between male and female subgroups (P > 0.05). Conclusion: DSA provides definitive assessment of lesion location, morphology, and number in coronary artery disease, with no significant sex-related differences. Serological markers, particularly cTnI and hs-CRP, demonstrate good auxiliary diagnostic value for CAD. Their levels correlate with disease severity and may serve as effective screening tools prior to DSA, offering important reference value for subsequent clinical management.

2024年-2026年郑州人民医院急性下呼吸道感染患儿病原体检测及其流行病学特征分析

Analysis of Pathogen Detection and Epidemiological Characteristics in Children with Acute Lower Respiratory Tract Infections at Zhengzhou People’s Hospital, 2024–2026

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目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.

开窗减压联合二期刮治术在颌骨囊肿的治疗疗效观察

Observation on the therapeutic effect of fenestration decompression combined with two-stage curettage in the treatment of mandibular cysts

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分析经开窗减压+二期刮治术治疗巨大型颌骨囊肿的效果。方法:回顾性采集100例巨大型颌骨囊肿的临床资料(2020年1月至2024年12月),按手术方法分组(传统刮治组、开窗减压+二期刮治术组),各50例,观察两组治疗有效率、炎症因子水平、并发症、华盛顿大学生活质量问卷(UW-QOL)评分及疾病复发情况。结果:总有效率比较,开窗减压+二期刮治术组(96.00%)比传统刮治组(82.00%)高(P<0.05);与传统刮治组比较,术后1周开窗减压+二期刮治术组白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平更低(P<0.05);开窗减压+二期刮治术组并发症总发生率为 6.00%,低于传统刮治组的22.00%(P<0.05);UW-QOL各维度(情绪、外貌、疼痛、咀嚼、味觉、唾液)评分比较,术后6个月开窗减压+二期刮治术组比传统刮治组高(P<0.05);开窗减压+二期刮治术组复发率(2.00%)比传统刮治组(16.00%)低(P<0.05)。结论:对巨大型颌骨囊肿患者开展开窗减压+二期刮治术,有利于抑制炎症反应,改善临床结局,提升生活质量。
To analyze the effect of fenestrated decompression + two-stage curettage in the treatment of giant mandibular cysts. Methods: The clinical data of 100 cases of giant jaw cysts (from January 2020 to December 2024) were retrospectively collected and divided into groups according to surgical methods (traditional curettage group, fenestrated decompression + two-stage curettage group), 50 cases in each group, and the treatment effectiveness, inflammatory factor levels, complications, University of Washington Quality of Life Questionnaire (UW-QOL) scores and disease recurrence were observed in the two groups. Results: Comparing the total effective rate, the window decompression + second-stage curettage group (96.00%) was higher than the traditional curettage group (82.00%) (P<0.05); compared with the traditional curettage group, the window decompression + second-stage curettage group 1 week after surgery The levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) in the surgery group were lower (P<0.05); the total incidence of complications in the window decompression + second-stage curettage group was 6.00%, lower than 22.00% in the traditional scaling group (P<0.05); comparison of UW-QOL scores in each dimension (emotion, appearance, pain, chewing, taste, saliva), window opening 6 months after surgery The decompression + two-stage curettage group was higher than the traditional curettage group (P<0.05); the recurrence rate of the window decompression + two-stage curettage group (2.00%) was lower than the traditional curettage group (16.00%) (P<0.05). Conclusion: Carrying out fenestration decompression + two-stage curettage for patients with giant jaw cysts can help suppress the inflammatory reaction, improve clinical outcomes, and enhance the quality of life.

呼吸性肌肉力量减低对I-IIIA期非小细胞肺癌术后预后的影响

Impact of Reduced Respiratory Muscle Strength on Postoperative Outcomes in Stage I–IIIA Non-Small Cell Lung Cancer

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【摘要】 目的 探讨基于峰值呼气流速(peak expiratory flow rate,PEFR)的呼吸性肌肉力量减低对I-IIIA期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后预后的影响。方法 回顾性分析我院2020年1月-2025年11月接受根治性手术切除的I-IIIA期NSCLC患者临床及影像资料,包括基于肺功能的PEFR(呼吸性肌肉力量指标)及胸部CT的胸肌质量指数(pectoralis muscle index, PMI)。分别采用Jonckheere-Terpstra检验、Spearman’s相关分析比较PEFR与PMI随年龄的变化规律及二者的相关性。低PEFR定义为小于PEFR的性别特异性下四分位数,进一步采用单、多因素Cox回归分析探讨PEFR及PMI对NSCLC患者术后结局的影响。结果 共纳入102例患者,中位年龄62岁(53-67岁),男性65例(63.7%),低低PEFR组24例(23.5%)。低PEFR组在年龄、FEVI、DLCO、FEV1/FVC、FVC、血清白蛋白及随访时间等方面均与正常组间存在显著差异(P<0.05)。在男、女性患者中,PEFR均表现为随年龄增长逐渐下降的趋势;且与PMI具有较好的相关性(r=0.25,P=0.001)。单因素及多因素Cox回归分析显示,低PEFR是影响NSCLC患者术后无进展生存期(progression free survival, PFS)的独立危险因素(HR=1.57,95%CI:1.03-2.39;P=0.036)结论 呼吸性肌肉力量减低是NSCLC患者术后PFS的独立危险因素,有望成为NSCLC术后复发的早期生物学标志物。
【Abstract】 Objective To investigate the impact of reduced respiratory muscle strength, assessed by peak expiratory flow rate (PEFR), on postoperative outcomes in patients with stage I-IIIA non-small cell lung cancer (NSCLC). Methods Clinical and imaging data of patients with stage I-IIIA NSCLC who underwent radical resection at our hospital from January 2020 to November 2025 were retrospectively analyzed, including PEFR (an indicator of respiratory muscle strength) based on pulmonary function tests and the pectoralis muscle index (PMI) derived from chest CT. The Jonckheere-Terpstra test and Spearman’s correlation analysis were used to evaluate age-related changes in PEFR and PMI and their correlation, respectively. Low PEFR was defined as values below the sex-specific lower quartile of PEFR. Univariate and multivariate Cox regression analyses were performed to assess the impact of PEFR and PMI on postoperative prognosis in NSCLC patients.Results A total of 102 patients were enrolled, with a median age of 62 years (range 53-67 years); 65 patients (63.7%) were male, and 24 (23.5%) were classified into the low PEFR group. The low PEFR group showed significant differences from the normal PEFR group in age, FEV1, DLCO, FEV1/FVC, FVC, serum albumin, and follow-up duration (all P < 0.05). In both male and female patients, PEFR progressively decreased with age and was positively correlated with PMI (r = 0.25, P = 0.001). Univariate and multivariate Cox regression analyses identified low PEFR as an independent risk factor for postoperative progression-free survival (PFS) in NSCLC patients (HR = 1.57, 95% CI: 1.03–2.39; P = 0.036).Conclusion Reduced respiratory muscle strength is an independent risk factor for postoperative PFS in NSCLC patients and may serve as an early biomarker for postoperative recurrence.

Phaco+房角分离术与Phaco+小梁切除术对APACG合并白内障患者的治疗效果对比分析:一项回顾性研究

Comparative analysis of phacoemulsification combined with goniosynechialysis versus phacoemulsification combined with trabeculectomy in patients with APACG complicated with cataract: a retrospective study

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目的 比较白内障超声乳化吸除术(Phaco)+房角分离术与Phaco+小梁切除术治疗急性原发性闭角型青光眼(APACG)合并白内障的临床价值。方法 回顾性分析2022年1月至2025年1月我院200例APACG合并白内障患者临床资料,根据手术方式分为小梁切除组(Phaco+小梁切除术)与房角分离组(Phaco+房角分离术),每组100例(200眼)。比较两组眼压、视力[最佳矫正视力(BCVA)]、中央前房深度、视盘血流密度[整体视盘血流密度(wiVD)、视盘内血流密度(diVD)]、生活质量[视功能相关生活质量量表-25(NEI-VFQ-25)]及并发症情况。结论 术后1周、1个月、3个月,房角分离组眼压低于小梁切除组,BCVA、中央前房深度大于小梁切除组,wiVD、diVD高于小梁切除组(P<0.05);术后1个月,房角分离组NEI-VFQ-25评分高于小梁切除组(P<0.05),术后3月两组NEI-VFQ-25评分比较无显著差异(P>0.05);房角分离组并发症总发生率(6.50%)低于小梁切除组(13.00%)(P<0.05)。结论 与Phaco+小梁切除术相比,Phaco+房角分离术治疗APACG合并白内障患者能有效控制眼压,增加前房深度,改善视盘血流循环,恢复患者视力,提高生活质量,减少并发症发生率。
Objective To compare the clinical efficacy of phacoemulsification (Phaco) combined with goniosynechialysis and phacoemulsification combined with trabeculectomy in the treatment of acute primary angle-closure glaucoma (APACG) complicated with cataract. Methods The clinical data of 200 patients with APACG complicated with cataract treated in our hospital from January 2022 to January 2025 were retrospectively analyzed. According to surgical procedures, the patients were divided into trabeculectomy group (Phaco combined with trabeculectomy) and goniosynechialysis group (Phaco combined with goniosynechialysis), with 100 patients (200 eyes) in each group. Intraocular pressure, visual acuity [best corrected visual acuity (BCVA)], central anterior chamber depth, optic disc vessel density [whole-image optic disc vessel density (wiVD), disc-inside vessel density (diVD)], quality of life [25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)] and complications were compared between the two groups. Results At 1 week, 1 month and 3 months after surgery, the goniosynechialysis group had lower intraocular pressure, better BCVA, deeper central anterior chamber depth, and higher wiVD and diVD than the trabeculectomy group (P<0.05). One month postoperatively, the NEI-VFQ-25 score of the goniosynechialysis group was significantly higher than that of the trabeculectomy group (P<0.05), while no significant difference was observed between the two groups at 3 months after surgery (P>0.05). The overall incidence of complications in the goniosynechialysis group was 6.50%, which was lower than 13.00% in the trabeculectomy group (P<0.05). Conclusion Compared with phacoemulsification combined with trabeculectomy, phacoemulsification combined with goniosynechialysis can effectively control intraocular pressure, increase anterior chamber depth, improve optic disc blood circulation, restore visual acuity, enhance quality of life and reduce the incidence of complications in patients with APACG complicated with cataract.

利多卡因联合艾司氯胺酮对肺部手术患者苏醒质量及术后认知功能的影响

Effects of lidocaine combined with esketamine on recovery quality and postoperative cognitive function in patients undergoing lung surgery

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目的:探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法:选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者,按随机数字表法分为观察组和对照组,各50例。对照组采用常规麻醉方案维持麻醉,观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分(SAS)、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分(MMSE)]、围术期血流动力学指标[麻醉药物输注前(T0)、气管插管时(T1)、拔管后5min(T2)平均动脉压(MAP)、心率(HR)]及术后72h不良反应发生率。结果:观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组,苏醒时间、拔管时间低于对照组;观察组T0、T1、T2各时间点MAP、HR无显著差异(P>0.05);对照组T1、T2时MAP、HR高于T0(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论:利多卡因复合艾司氯胺酮应用于肺部手术,可提升患者苏醒质量、保护术后认知功能,维持围术期血流动力学稳定,且安全性良好。
Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative diagnostic value of 99mTc-MIBI SPECT/CT dual-phase imaging and ultrasound in preoperative localization of secondary hyperparathyroidism

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目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

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目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.
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