目的 探究本体感觉神经肌肉促进疗法（PNF）技术与居家远程康复治疗对缺血性脑卒中患者凝血功能、平衡状态的影响。方法 选择2023年1月—2024年1月在宁乡市中医医院择期治疗的60例缺血性脑卒中患者为研究对象。按照患者选择的治疗方案进行分组, 观察组接受PNF技术联合居家远程康复指导治疗, 对照组接受常规居家远程康复指导治疗。记录疗效、凝血功能、神经功能缺损症状。结果 凝血功能方面,观察组治疗后活化部分凝血酶时间（APTT）、凝血酶原时间（PT）高于治疗前, 二聚体（D-D）、纤维蛋白原（FIB）低于治疗前,组间比较差异有统计学意义（P<0.05）。与对照组相比, 观察组的APTT、PT、D-D、FIB指标相近,组间比较差异无统计意义（P>0.05）。治疗后, 观察组平衡功能（BBS）评分比治疗前高, 组间比较差异有统计学意义（P<0.05）。观察组BBS评分、FMA评分、肌力等级更高, 组间比较差异有统计学意义（P<0.05）。结论 PNF技术+居家远程康复指导治疗可作为缺血性脑卒中患者治疗的有效手段。联合治疗后凝血功能、平衡状态、肢体功能状况、肌力明显改善, 可见联合治疗对于减轻患者病情尤为明显。

Objective To explore the effects of proprioceptive neuromuscular facilitation（PNF）and home-based remote rehabilitation on coagulation function and balance function in patients with ischemic stroke．Methods From January 2023 to January 2024, 60 patients with ischemic stroke were selected from our hospital．The patients were divided into two groups according to the treatment plan chosen by themselves．The patients in the observation group received PNF technology combined with home-based remote rehabilitation guidance, while the patients in the control group received routine home-based remote rehabilitation guidance．The curative effect, coagulation function and neurological deficit were recorded．Results After treatment, activated partial thrombin time（APTT）and prothrombin time（PT）were significantly higher, D-dimer（D-D）and fibrinogen（FIB）were significantly lower in the observation group than those before treatment（P<0.05）．Compared with the control group, the APTT, PT, D-D and FIB of the observation group were similar, and there was no significant difference between the two groups（P>0.05）．After treatment, the Berg Balance Scale score of the observation group was higher than that before treatment, and there was significant difference between the two groups（P<0.05）．The Berg Balance Scale score, Fugl-Meyer Assessment score and muscle strength grade of observation group were higher than those of control group（P<0.05）．Conclusions PNF combined with home-based remote rehabilitation can be used as an effective method for the treatment of patients with ischemic stroke．The coagulation function, balance, extremity function and muscle strength were significantly improved after combined treatment, which indicated that the combined treatment was especially effective in relieving the patients’ symptoms．

目的 探讨与分析全面护理联合细节干预在创伤骨科手术质量及康复中应用价值。方法 选择2022年1月—2023年1月在福建省立医院骨科进行创伤骨科手术患者120例为研究对象,用随机数字表法分组,分为常规组、联合组,各纳入60例患者。前者进行常规护理,后者在前者基础上开展全面护理联合细节干预,对两组患者术后恢复情况进行观察比较。结果 在围术期指标方面,联合组手术时间、术中出血量、术后首次下床活动时间、术后住院时间与常规组相比减少（P<0.05）。联合组术后1 d、术后3 d、术后7 d、术后14 d的疼痛VAS评分与常规组相比减少（P<0.05）。联合组术后14 d的护理总满意度为100.00%,常规组为83.33%,联合组与常规组相比明显提高（P<0.05）。联合组术后14 d的社会关系、心理关系、生理关系等生活质量评分均高于常规组（P<0.05）。结论 全面护理联合细节干预在创伤骨科手术患者的应用促进患者康复,能持续缓解患者的疼痛状况,提高患者的护理满意度与生活质量。

Objective To explore and analyze the application value of comprehensive nursing combined with detailed intervention in the quality and rehabilitation of orthopedic trauma surgery．Methods From January 2022 to January 2023,120 cases of patients who underwent trauma orthopedic surgery in the Department of Orthopedic Surgery of Fujian Provincial Hospital were selected as the research subjects．And the randomized numerical table method was taken to operate in groups,which were divided into the conventional group and the combined group,and 60 patients were included in each group．The former group recieved conventional nursing care,and the latter group recieved comprehensive nursing care combined with detail intervention on its basis to observe and compare the postoperative recovery of patients in the two groups．Results In terms of perioperative indicators,the operation time,intraoperative bleeding,time to first postoperative bed movement and postoperative hospitalization time were significantly reduced in the combined group compared with the conventional group（P<0.05）．The pain VAS scores of the combination group were significantly reduced compared to the conventional group at 1 day,3 days,7 days and 14 days after surgery（P<0.05）．The total satisfaction rate of postoperative care in the combination group at 14 days was 100.00%,while in the conventional group it was 83.33%．The combination group showed there were significant improvements compared to the conventional group（P<0.05）．The social,psychological and physiological quality of life scores of the combination group were significantly higher than those of the conventional group 14 days after surgery（P<0.05）．Conclusions The application of comprehensive nursing combined with detailed intervention in orthopedic trauma surgery patients can promote their recovery,continuously alleviate their pain status and improve their nursing satisfaction and quality of life．

目的 探讨导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用效果。方法 选取2020年6月—2023年6月周口市中心医院收治的106例肺癌患者,应用随机数字表法分为观察组（n=53）与对照组（n=53）。患者均采取胸腔镜肺癌切除术治疗,对照组实施常规的术前、术中及术后相关围术期护理,观察组在常规围术期护理基础上增加导航护士主导的三级质控护理。对比两组住院时间、术后并发症和护理前后世界卫生组织生活质量-100量表（WHOQOL-100）及癌因性疲乏程度（PFS）,最后对比两组的护理满意度。结果 观察组首次排气时间、首次下床时间、术后疼痛视觉模拟量表（VAS）评分、术后住院时间均优于对照组（P<0.05）;观察组并发症发生率低于对照组（P<0.05）;干预后两组WHOQOL-100评分升高、PFS评分降低,观察组均优于对照组（P<0.05）;观察组护理满意度高于对照组（P<0.05）。结论 对胸腔镜肺癌切除术患者,采取导航护士主导的三级质控管理的加速康复护理,可促进患者术后肠胃功能恢复,缩短住院时间,减轻术后疼痛感与减少并发症,在改善患者癌因性症状的同时,提升其生活质量,提高患者护理满意度。

Objective To explore the application effect of three-level quality control led by navigation nurses in accelerating rehabilitation of patients undergoing thoracoscopic lung cancer resection．Methods A total of 106 lung cancer patients admitted to our hospital from June 2020 to June 2023 were selected and randomly divided into an observation group（n=53）and a control group（n=53）using a random number table method．All patients were treated with thoracoscopic lung cancer resection,while the control group received routine preoperative,intraoperative and postoperative perioperative care,the observation group received a three-level quality control nursing led by navigation nurses in addition to routine perioperative care．The length of hospitalization,postoperative complications,WHOQOL-100 and PFS before and after care,and the nursing satisfaction of the two groups were compared．Results The observation group had significantly shorter first exhaust time,first time out of bed,postoperative visual analogue scale（VAS）score and postoperative hospital stay compared to the control group（P<0.05）．The incidence of complications in the observation group was lower than that in the control group（P<0.05）．After intervention,the WHOQOL-100 scores of both groups increased,and the observation group was higher than the control group．The PFS score decreased,and the observation group was lower than the control group（P<0.05）．The nursing satisfaction of the observation group was significantly higher than that of the control group（P<0.05）．Conclusions Adopting a three-level quality control management led by navigation nurses to accelerate rehabilitation care for patients undergoing thoracoscopic lung cancer resection can promote postoperative recovery of gastrointestinal function,reduce hospitalization time,reduce postoperative pain and complications,improve cancer related symptoms,improve their quality of life and increase patients nursing satisfaction．

目的 评估医院-社区-家庭一体化康复护理模式对慢性创面患者生活质量及创面愈合的潜在影响。方法 选择2023年1月—2024年6月在广州市第一人民医院接受治疗的慢性创面患者80例作为研究对象,所有患者在住院期间均接受基于溃疡面积、深度及是否合并感染等因素的综合治疗,包括彻底清创、创缘处理、负压治疗、感染控制等治疗,并接受常规护理。出院前,通过随机数字表法将患者分为两组,每组40例。两组患者在住院期间均接受常规护理,出院后,对照组接受延续护理并定期复查。干预组40例患者在出院后接受医院-社区-家庭一体化康复护理模式。入组时及护理3个月后,使用生活质量调查表（SF-36）对患者生活质量和创面愈合率进行评估。结果 干预组创面愈合率为（32.61±4.26）%,高于对照组（11.48±1.04）%,差异具有统计学意义（t=19.473,P<0.05）。两组患者在护理3个月后的数字评定量表评分和创面疼痛频率评分均较入组时降低（P<0.05）。其中干预组护理3个月后的创面VAS评分为（1.82±0.17）分,创面疼痛频率评分为（1.28±0.25）分;而对照组分别为（3.91±0.22）分和（2.63±0.37）分,干预组低于对照组（P<0.05）。此外,干预组在护理后3个月的总体健康、生理功能、生理职能、精神健康、情感功能、社会功能评分均高于对照组（P<0.05）。在居家3个月期间,干预组的感染发生率为5.00%,而对照组为17.50%,干预组感染发生率低于对照组（χ²=3.781,P<0.05）。结论 本研究表明,医院-社区-家庭一体化康复护理模式干预能够促进慢性创面患者的创面愈合,降低居家期间感染的风险,并提升患者的生活质量。

Objective To assess the potential impact of the integrated hospital-community-home rehabilitation nursing model on the quality of life and wound healing in patients with chronic wounds．Methods A total of 80 patients with chronic wounds treated at the Guangzhou First People’s Hospital from January 2023 to June 2024 were selected as the study subjects．All patients received comprehensive treatment during their hospital stay,including thorough debridement,edge treatment,vacuum therapy,infection control and routine nursing care．Prior to discharge,the patients were randomly divided into two groups using a random number table,with 40 patients in each group．Both groups received routine nursing care during their hospital stay,and the control group received continuing nursing care and regular follow-up after discharge．Forty patients in the intervention group received the integrated hospital-community-home rehabilitation nursing model after discharge．Quality of life（QoL）and wound healing rates were assessed using the Short Form 36（SF-36）questionnaire at the time of enrollment and 3 months after nursing．Results The wound healing rate in the intervention group was significantly higher than that in the control group （[32.61±4.26]% vs [11.48±1.04]%）,with a statistical difference（t=19.473,P<0.05）．The numerical rating scale（NRS）scores and frequency of wound pain scores decreased in both groups 3 months after nursing compared to the enrollment period（P<0.05）．Specifically,the VAS score for wound pain in the intervention group 3 months after nursing was（1.82±0.17）,and the frequency of wound pain was（1.28±0.25）,in the control group,these scores were（3.91±0.22）and（2.63±0.37）,respectively,with the intervention group scoring significantly lower than the control group（P<0.05）．Furthermore,the scores for overall health,physical function,role physical,mental health,emotional function,and social function in the intervention group were higher than those in the control group 3 months after nursing（P<0.05）．During the 3-month home recovery period,the incidence of infection in the intervention group was 5.00%,whereas it was 17.50% in the control group,with the intervention group showing a lower incidence of infection（χ²=3.781,P<0.05）．Conclusions This study demonstrates that the hospital-community-home integrated rehabilitation care model intervention can promote wound healing in chronic wound patients,reduce the risk of infection during home care,and significantly improve patients’ quality of life．

目的 分析早期活动康复对机械通气患儿肌力的影响,探讨影响肌力的相关因素。方法 采取回顾性研究,选择2021年4月—2023年4月医院收治的104例机械通气患儿临床资料,根据康复方法分为两组,其中采取常规康复训练的52例患儿为对照组,采取早期活动康复的52例患儿为观察组。两组均连续干预至出院,比较两组患儿的机械通气、住ICU、总住院时间、不同时点（转出ICU时、出院时、出院1个月）的肌力及Barthel日常生活能力（Barthel）评分;参照《中国重症肌无力诊断和治疗指南（2015年简版）》中诊断标准,评估机械通气患儿获得性肌无力（AW）发生情况。统计并比较两组基线资料,采用二元Logistic回归分析机械通气患儿AW发生的影响因素。结果 观察组的机械通气、住ICU及总住院时间[（7.28±2.47）d、（15.27±3.64）d、（27.08±5.68）d]均短于对照组[（10.64±3.39）d、（17.74±3.55）d、（32.57±6.14）d]（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时英国医学研究委员会（MRC）肌力评定法评分升高,且观察组转出ICU时、出院时MRC评分[（53.57±5.13）分、（56.84±2.16）分]均高于对照组[（50.13±4.57）分、（53.67±2.42）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;与转出ICU时、出院时相比,两组出院1个月时Barthel评分升高,且观察组转出ICU时、出院时Barthel评分[（65.03±12.47）分、（90.58±7.59）分]均高于对照组[（55.25±11.12）分、（84.13±9.62）分],两组组间·时点交互比较差异有统计学意义（P<0.05）;住院期间104例机械通气患儿发生AW 31例,发生率29.81%,AW组机械通气时间、营养风险筛查量表2002（NRS）评分[（11.84±4.19）d、（3.07±1.04）分]高于非AW组[（8.18±2.26）d、（1.61±0.75）分],且有创机械通气模式、使用罗库溴铵患儿[77.42%（24/31）、32.26%（10/31）]占比均高于非AW组[53.42%（39/73）、13.70%（10/73）]（P<0.05）;二元Logistic回归分析结果显示,机械通气时间长、有创机械通气模式、使用罗库溴铵、NRS评分高是机械通气患儿AW发生的危险因素（OR>1,P<0.05）。结论 早期活动康复能够有效缩短机械通气患儿患儿通气时间及住院时间,改善肌力,提高生活自理能力,同时机械通气时间、创机械通气模式、使用罗库溴铵、NRS评分与机械通气患儿肌力下降有关。

Objective To analyze the effect of early mobilization and rehabilitation on muscle strength in children with mechanical ventilation and to explore the risk factors affecting muscle strength．Methods A retrospective study was conducted on 104 children with mechanical ventilation admitted to the hospital from April 2021 to April 2023．According to the rehabilitation methods,they were divided into two groups．The clinical data of children with routine rehabilitation training were included in the control group（52 cases）,and the clinical data of children with early mobilization and rehabilitation were included in the observation group（52 cases）．Both groups were continuously intervened until discharged．The mechanical ventilation time,ICU stay and total hospital stay were compared between the two groups．Muscle strength and self-care ability at different time points（transfer out of ICU,discharge,1 month after discharge）,the incidence of acquired weakness（AW）in children with mechanical ventilation were evaluated according to the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis． Baseline data was collected and compared between the two groups．Binary logistic regression was used to analyze the risk factors of AW in children with mechanical ventilation．Results The mechanical ventilation time,ICU and total hospitalization time in the observation group[（7.28±2.47）d,（15.27±3.64）d,（27.08±5.68）d] were shorter than those in the control group[（10.64±3.39）d,（17.74±3.55）d,（32.57±6.14）d]（P<0.05）．Compared with those at the time of transfer out of ICU and discharge,the Medical Research Council（MRC）scores of the two groups increased at 1 month after discharge,and the MRC scores of the observation group at the time of transfer out of ICU and discharge[（53.57±5.13）,（56.84±2.16）] were higher than those of the control group[（50.13±4.57）,（53.67±2.42）]．There were significant differences between the two groups,time points and between groups · time points（P<0.05）．Compared with those at the time of transferring out of ICU and at discharge,the Barthel scores of the two groups increased at 1 month after discharge,and the Barthel scores of the observation group at the time of transferring out of ICU and at discharge[（65.03±12.47）,（90.58±7.59）] were higher than those of the control group[（55.25±11.12）,（84.13±9.62）]．There were significant differences in Barthel scores between the two groups,time points and groups · time points（P<0.05）．AW occurred in 31 of 104 children with mechanical ventilation during hospitalization,with an incidence of 29.81%．The mechanical ventilation time and Nutritional Risk Screening（NRS）score in the AW group[（11.84±4.19）d,（3.07±1.04）] were higher than those in the non-AW group[（8.18±2.26）d,（1.61±0.75）]．The proportion of children with invasive mechanical ventilation mode and the use of rocuronium[77.42%（24/31）,32.26%（10/31）] were higher than those in the non-AW group[53.42%（39/73）,13.70%（10/73）]（P<0.05）．Binary logistic regression analysis showed that long mechanical ventilation time,invasive mechanical ventilation,use of rocuronium and high NRS score were risk factors for AW in children with mechanical ventilation（OR>1,P<0.05）．Conclusions Early mobilization and rehabilitation can effectively shorten the ventilation time and hospitalization time of patients with mechanical ventilation,improve muscle strength and improve the ability of self-reliance．At the same time,mechanical ventilation time,mechanical ventilation mode,use of rocuronium and NRS score are related to the decrease of muscle strength in children with mechanical ventilation．

目的 探讨综合呼吸康复训练对老年慢性阻塞性肺疾病急性期（AECOPD）患者的临床症状、生活质量、活动能力、肺功能、肺康复依从性的影响。方法 纳入70 例AECOPD 患者,随机数字分为对照组（n=35）和干预组（n=35）,对照组在常规治疗基础上予缩唇腹式呼吸功能锻炼,干预组在常规治疗基础上进行综合呼吸康复训练,干预前后采用慢性阻塞性肺疾病评估测试（CAT）调查问卷、改良版英国医学研究委员会呼吸问卷（mMRC）、肺功能第一秒用力呼气容积（FEV1）预计值进行评估。结果 对照组呼吸康复训练前后CAT评分、mMRC量表呼吸困难评级比较差异均有统计学意义（t=16.781,t=8.103,均P<0.001）;干预组呼吸康复训练前后CAT评分、mMRC呼吸困难评级比较差异也均有统计学意义（t=24.035,t=15.938,均P<0.001）;干预组患者的CAT评分、mMRC量表呼吸困难评级较对照组下降明显。结论 综合呼吸康复训练能有效改善 AECOPD 患者临床症状、增强患者活动能力、提高生活质量、提高肺康复依从性。

Objective To investigate the effects of comprehensive respiratory rehabilitation training on clinical symptoms,quality of life,activity ability,lung function and compliance of elderly patients with acute exacerbation of obstructive pulmonary disease（AECOPD）．Methods Seventy patients with AECOPD were included and randomly divided into control group（n=35）and intervention group（n=35）．The control group was given routine treatment and respiratory muscle function exercise．The intervention group was given routine treatment and comprehensive respiratory rehabilitation training．COPD Assessment Test（CAT）,modified Medical Research Council Scale（mMRC）and FEV1 predicted value of lung function were used to evaluate before and after intervention．Results In the control group,differences of CAT score and mMRC score were significant（t=16.781,t=8.103,P<0.001）before and after respiratory rehabilitation training．In the intervention group,the CAT score before and after respiratory rehabilitation training showed a 0.01 level of significance（t=24.035,P<0.001）,and the mMRC score before and after training showed a 0.01 level of significance（t=15.938,P<0.001）．There were significant differences between control group and intervention group（P<0.01）．Compared with the control group,CAT score and mMRC score were significantly lower in the intervention group．Conclusions Comprehensive respiratory rehabilitation training can effectively improve the clinical symptoms of AECOPD patients,enhance the activity ability of patients,improve the quality of life,and improve the compliance of patients to perform pulmonary rehabilitation．

目的 探讨快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察。方法 选取焦作市妇幼保健院2021年1月—2023年1月收治的86例腹股沟疝患儿进行分析与研究,应用随机数字表法将其分为观察组与对照组,各组均为43例。所有患儿均采取腹腔镜手术治疗,对照组采取常规护理,观察组采取快速康复理念护理。对比两组围术期恢复情况,术后4、12、24、48 h疼痛程度,并发症及护理满意度情况。结果 观察组首次下床时间、首次肛门排气时间、进食时间、住院时间短于对照组（P<0.05）;两组患儿术后4、12、24、48 h视觉模拟量表（VAS）评分逐渐降低,观察组低于对照组（P<0.05）;两组恶心呕吐、尿潴留、腹胀腹痛、感染并发症发生率对比差异无统计学意义（P>0.05）;观察组患儿及家长健康教育、住院环境、专科护理、检查指导、病情观察相关护理满意度评分高于对照组（P<0.05）。结论 快速康复理念联合腹腔镜手术治疗小儿腹股沟疝效果显著,可进一步促进患儿早日康复,缩短住院时间,术后疼痛水平低,同时可提升患儿及家长护理满意度。

Objective To explore the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery on pediatric inguinal hernia．Methods A total of 86 children with inguinal hernia admitted to Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected for analysis and study,and divided into observation group and control group by random number table method,with 43 cases in each group．All patients were treated with laparoscopic surgery,while the control group received routine care,while the observation group received rapid recovery concept care．The perioperative recovery,pain level,complications,and nursing satisfaction at 4,12,24,and 48 hours after surgery were compared．Results The first discharge time,first anal exhaust time,feeding time,and hospitalization time were shorter than the control group（P<0.05）．The VAS scores decreased after 4 h,12 h,24 h and 48 h,and the observation group was lower than the control group（P<0.05）．The incidences of nausea and vomiting,urinary retention,abdominal distension,abdominal pain and infectious complications between the two groups were significantly insignificant（P>0.05）．The health education,inpatient environment,specialized care,nursing examination guidance and condition observation were significantly higher than that of the observation group（P<0.05）．Conclusions The combination of rapid recovery concept and laparoscopic surgery for the treatment of inguinal hernia in children has a significant effect,which can further promote early recovery,shorten hospital stay,lower postoperative pain levels．At the same time,it can improve the nursing satisfaction of children and parents．

目的 研究影响冠状动脉粥样硬化性心脏病（冠心病）患者参与心脏康复意愿的因素及干预措施。方法 选取高州市人民医院 2021年1月—2022年3月收治的624例冠心病患者为研究对象,使用自行设计的调查问卷心脏康复参与意愿调查表及西雅图心绞痛量表对患者进行调查评估,分析冠心病患者心脏康复参与意愿现状及其影响因素。结果 624例冠心病患者中,162例愿意参加（25.96%）,126例希望参加（20.19%）,66例计划参加（10.58%）;单因素分析显示影响冠心病患者心脏康复参与意愿的因素主要包括社会支持、文化水平、娱乐活动、呼吸困难及心绞痛,社会支持方面,主观支持、客观支持、支持利用度得分分别为（2.32±0.41）（2.99±0.74）（2.58±0.95）分,组间比较差异有统计学意义（F=53.428,P<0.001）;文化水平方面,初中及以下、高中及中专、大专及以上得分分别为（2.35±0.18）（2.61±0.90）（3.09±0.63）分,组间比较差异有统计学意义（F=29.947,P<0.001）;娱乐活动方面,无、偏少、正常得分分别为（2.60±0.12）（2.88±0.29）（3.13±0.72）分,组间比较差异有统计学意义（F=44.903,P<0.001）;呼吸困难方面,≥1次/天、≥1次/周、<1次/月或无得分分别为（2.09±0.84）（2.31±0.70）（3.06±0.53）分,组间比较差异有统计学意义（F=116.082,P<0.001）;心绞痛方面,≥1次/天、≥1次/周、<1次/月或无得分分别为（2.51±0.33）（2.82±0.76）（3.15±0.87）分,组间比较差异有统计学意义（F=16.442,P<0.001）;多因素分析显示影响冠心病患者心脏康复参与意愿的独立影响因素主要包括文化程度、娱乐活动、呼吸困难及社会支持,结果有统计学意义（P<0.05）。结论 文化程度、娱乐活动、呼吸困难及社会支持等因素是导致冠心病患者心脏康复参与意愿较低的主要原因,临床上应对此予以重视,并采取康复教育、实施延续性护理、建立支持环境等措施,促使冠心病患者积极参与到心脏康复中,从而有效改善其预后。

Objective To study the factors and intervention measures that affect the willingness of coronary heart disease patients to participate in cardiac rehabilitation．Methods A total of 624 patients with coronary heart disease admitted to Gaozhou People's Hospital from January 2021 to March 2022 were selected as the research subjects．A self-designed survey questionnaire on willingness to participate in cardiac rehabilitation and the Seattle Angina Pectoris Scale were used to investigate and evaluate the patients．The current status and influencing factors of willingness to participate in cardiac rehabilitation in coronary heart disease patients were analyzed．Results Among 624 patients with coronary heart disease,162 were willing to participate（25.96%）,126 hoped to participate（20.19%）,and 66 planned to participate（10.58%）．Uunivariate analysis showed that the main factors affecting the willingness of coronary heart disease patients to participate in cardiac rehabilitation included social support,education level,entertainment activities,breathing difficulties,and angina．In terms of social support,subjective support,objective support,and support utilization scores were（2.32±0.41）points,（2.99±0.74）points,and（2.58±0.95）points,respectively,with statistically significant differences（F=53.428,P<0.001）．In terms of education level,the scores for middle school and below,high school and vocational school,college and above were（2.35±0.18）points,（2.61±0.90）points,and（3.09±0.63）points,respectively,with statistically significant differences（F=29.947,P<0.001）．In terms of entertainment activities,the scores for none,less and normal were（2.60±0.12）points,（2.88±0.29）points,and（3.13±0.72）points,respectively,with statistically significant differences（F=44.903,P<0.001）．In terms of breathing difficulties,the scores for ≥1 time/day,≥1 time/week,<1 time/month,or no were（2.09±0.84）points,（2.31±0.70）points,and（3.06±0.53）points,respectively,with statistical significance（F=116.082,P<0.001）．In terms of angina,the scores for ≥1 time/day,≥1 time/week,<1 time/month,or no were（2.51±0.33）points,（2.82±0.76）points,and（3.15±0.87）points,respectively,with statistical significance（F=16.442,P<0.001）．Multivariate analysis showed that the independent influencing factors on the willingness of coronary heart disease patients to participate in cardiac rehabilitation mainly include education level,entertainment activities,breathing difficulties,and social support,and the results were statistically significant（P<0.05）．Conclusions Education level,entertainment activities,breathing difficulties,and social support are the main reasons for the low willingness of coronary heart disease patients to participate in cardiac rehabilitation．Clinical attention should be paid to this and measures such as rehabilitation education,implementation of continuity of care,and establishment of a supportive environment should be taken to encourage coronary heart disease patients to actively participate in cardiac rehabilitation and effectively improve their prognosis．

目的 探讨关节镜下外侧韧带增强固定修复术治疗慢性踝关节不稳定的护理和康复方案。方法 回顾性分析2023年1月–2023年8月广州市正骨医院收治的31例采用关节镜下外侧韧带增强固定修复术治疗的慢性踝关节不稳定患者的围术期护理措施和康复指导措施。结果 31例患者均随访无脱落,于术后3、6、12个月返院复查随访,患者手术后患足美国矫形外科足踝协会（AOFAS）踝-后足评分均较前次随访评分提高（均P<0.05）。患者术后3个月Zung焦虑评分和Zung抑郁评分较术前均明显下降（均P<0.05）。31例患者术后无1例发生踝关节不稳定复发、腓肠神经损伤和感染等并发症。结论 关节镜下外侧韧带增强固定修复术的方法治疗慢性踝关节不稳定患者,加强术前术后的护理措施、康复指导,对恢复踝关节稳定性和灵活性有重要作用,有利于提高患者生活质量和满意度。

Objective To investigate the nursing and rehabilitation of chronic ankle instability with reinforcement fixation and repair of lateral ligament under arthroscopy．Methods The perioperative nursing measures and rehabilitation guidance of 31 patients with chronic ankle instability treated with lateral ligament reinforcement fixation under arthroscopy from January 2023 to August 2023 were analyzed retrospectively．Results None of the 31 patients was disassociated during follow-up．The American Orthopaedic Foot and Ankle Society（AOFAS）scores of the patients were significantly higher and higher at 3,6 and 12 months after surgery（all P<0.05）．The Zung anxiety score and Zung depression score at 3 months after operation were significantly lower than those before operation（all P<0.05）．None of the 31 patients had postoperative complications such as ankle instability recurrence,sural nerve injury,peroneal tendinitis and infection．Conclusions In arthroscopic reinforcement fixation of lateral ligament in the treatment of patients with chronic ankle instability,strengthening the perioperative nursing measures and rehabilitation guidance,plays an important role in restoring the stability and flexibility of the ankle,and is conducive to improving the quality of life and satisfaction of patients．

目的 探讨脊柱外科围术期康复指导方案的临床疗效。方法 选取毕节市第三人民医院脊柱外科184例行择期手术治疗的患者,对照组继续脊柱外科原康复方案行术前及术后管理,观察组使用新的康复行为规范方案,即系统行术前预康复指导和术后规范管理。对患者的术后起床活动、在院时间、住院费用、疼痛恢复情况、满意调查情况进行对比。结果 术前,患者的性别、年龄、病种分布对比差异无统计学意义（P>0.05）。术后,观察组的术后下床活动时间（3.09±1.02）d、住院时间（10.73±3.96）d、住院费用（17 388±5 217）元、术后2天VAS评分（3.04±1.19）分、出院时VAS评分（2.36±1.25）分、住院患者满意度（89.80±8.20）分,均优于对照组的术后起床活动时间（4.44±1.58）d、住院时间（13.38±2.73）d、住院费用（23 242±7 971）元、术后2天VAS评分（4.01±1.44）分、出院时VAS评分（3.39±1.38）分、住院满意度（80.27±11.45）分。新的康复指导方案在脊柱外科患者中较对照组减轻术后疼痛、减少患者卧床时间及缩短住院时间（P<0.05）。结论 围手术期加快患者术后康复及提高术后恢复优良率,提高患者就医满意度,使医患关系更加融洽。

Objective To investigate the clinical effect of the rehabilitation guidance protocol of spinal surgery in perioperative period．Methods A total of 184 patients undergoing selective surgery in the spine surgery department of the Third People's Hospital of Bijie City were selected．The conventional rehabilitation group was the control group,which preoperative and postoperative management was continued with the original rehabilitation program of spine surgery;the rehabilitation guidance group was the observation group：the new rehabilitation behavior code program was used to provide systematic preoperative pre-rehabilitation guidance and postoperative standardized management．The patients' activities of getting up after surgery,days in hospital,economic use,pain recovery and satisfaction survey were compared．Results Before surgical treatment,the gender,age and disease distribution of patients were compared（P>0.05）．After surgical treatment,observation group：Postoperative time of getting out of bed（3.09±1.02）d,length of hospitalization（10.73±3.96）d,hospitalization expenses（17 388±5 217）yuan,VAS score of 2 days after surgery（3.04±1.19）,VAS score of discharge（2.36±1.25）,inpatient satisfaction（89.80±8.12）,were significantly better than the control group：Postoperative activity time（4.44±1.58）d,length of hospitalization（13.38±2.73）d,hospitalization expenses（23 242±7 971）yuan,VAS score（4.01±1.44）,VAS score at discharge（3.39±1.38）,hospitalization satisfaction（80.27±11.45）．Compared with the control group,the new rehabilitation guidelines significantly reduced postoperative pain,bed time and hospital days in spinal surgery patients（P<0.05）．Conclusions Speeding up the postoperative rehabilitation of patients and improving the rate of postoperative recovery,improving patients' sense of access to medical treatment,can make the doctor-patient relationship more harmonious．