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 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。
Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.
目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料,根据随机数字表法将患者分为两组:对照组40例,术前5 min予5 mL生理盐水;观察组40例,术前5 min予以0.25 mg/kg艾司氯胺酮(以生理盐水配置成5 mL)。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为(213.54±64.22)min、(240.67±81.26)min、(141.31±45.03)mL,与对照组的(210.43±65.71)min、(244.25±81.33)min、(137.64±42.75)mL比较,差异均无统计学意义(t=0.214、0.197、0.374,P均>0.05),而观察组丙泊酚、瑞芬太尼用量分别为(1 075.52±134.37)mg、(1 267.18±242.26)μg,虽然低于对照组的(1?126.64±150.21)mg、(1 352.50±295.14)μg,但差异也无统计学意义(t=1.604、1.413,P均>0.05);观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为(54.52±9.64)pg/mL、(40.08±7.75)pg/mL、(30.38±6.93)mg/L,均低于对照组的(77.31±10.86)pg/mL、(56.35±9.47)pg/mL、(43.73±7.61)mg/L(t=9.926、8.409、8.203,P均<0.05);术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为(51.92±4.41)分、(53.96±4.47)分、(3.59±1.14)分、(3.06±1.01)分、(2.89±0.91)分、(2.57±0.76)分,均低于对照组的(55.06±5.12)分、(57.21±5.19)分、(4.27±1.36)分、(3.68±1.18)分、(3.41±1.06)分、(2.96±0.92)分(t=2.939、3.001、2.423、2.525、2.329、2.067,P均<0.05),但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义(P>0.05);两组术后不良反应发生率也无显著差异(P<0.05)。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平,减轻术后疼痛,缓解术后负性情绪,且不会增加患者术后不良反应发生率。
Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer.Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed.The patients were divided into two groups according to the random number table method:40 cases in the control group were given 5 mL saline,five minutes before operation,40 cases in the observation group were treated with 0.25 mg / kg esketamine(in 5 mL saline)five minutes before operation.The perioperative indicators,inflammatory factors,negative emotions,pain and adverse reactions were compared between two groups.Results The operation time,anesthesia time and intraoperative blood loss of the observation group were(213.54±64.22)min,(240.67±81.26)min and(141.31±45.03)mL,respectively,which were not significantly different from those of the control group(210.43±65.71)min,(244.25±81.33)min and(137.64±42.75)mL(t=0.214,0.197,0.374,all P>0.05).The dosage of propofol and remifentanil in the observation group were(1 075.52±134.37)mg and(1 267.18±242.26)μg,respectively,which were lower than those in the control group of (1126.64±150.21)mg and(1352.50±295.14)μg,but the difference was not statistically significant(t=1.604,1.413,P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group at 24 h after operation were(54.52±9.64)pg / mL,(40.08±7.75)pg / mL and(30.38±6.93)mg / L,respectively,which were lower than those in the control group of (77.31±10.86)pg / ml,(56.35±9.47)pg / mL and 43.73±7.61)mg / L(t=9.926,8.409,8.203,all P<0.05).The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h,6 h,12 h and 24 h after operation were(51.92±4.41),(53.96±4.47),(3.59±1.14),(3.06±1.01),(2.89±0.91) and(2.57±0.76),respectively,which were lower than those of the control group(55.06±5.12),(57.21±5.19),(4.27±1.36),(3.68±1.18),(3.41±1.06) and(2.96±0.92)(t=2.939,3.001,2.423,2.525,2.329,2.067,P<0.05).However,no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively(P>0.05).Adverse event rates showed no significance in two groups(P>0.05).Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation,decrease pain,mitigate negative emotions,without increasing the incidence of postoperative adverse reactions.
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.
目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为(知信行)水平的现状,探究各因素是否对患者的营养风险、营养知信行水平具有影响,并分析两者之间的相关性。方法 选取中山大学附属第八医院(深圳福田)2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象,采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查,数据收集后进行统计分析,从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险,营养风险评分为(2.72±1.42)分。消化系统恶性肿瘤患者营养知识水平得分为(12.30±5.26)分、营养态度水平得分为(14.80±2.68)分、营养行为水平得分为(22.82±4.55)分、营养知信行水平总分为(49.96±9.50)分。家庭经济收入是患者营养风险水平的核心影响因素(P<0.05),学历水平是患者营养知信行水平的核心影响因素(P<0.05)。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关(r=-0.143,P<0.05)。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平,但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要,这将有助于提升患者的营养知识水平,从而整体性改善其营养知信行素养并降低其营养风险,但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。
Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors,to analyze the influencing factors of nutritional risk,nutritional knowledge-attitude-behavior,and explore the correlation between them.Methods From February 2024 to October 2024,244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects.A general information questionnaire,Nutritional Risk Screening 2002,and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3,and the overall score was(2.72±1.42).The scores of nutritional knowledge,attitude,behavior and total score of digestive system malignant tumors patients were(12.30±5.26),(14.80±2.68),(22.82±4.55)and(49.96±9.50),respectively.Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors,while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior.Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level,but there is a widespread situation of relatively high nutritional risk.It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period,which will help enhance patients’ nutritional knowledge level,thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks.However,when conducting nutrition education and formulating personalized nutrition plans,the patient’s family economic income,medical payment methods and educational level should be fully considered.
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.
目的 对比三维中等权重压缩感知并行采集序列(3D IW-CS-SENSE)与常规并行采集序列(3D IW-SENSE)在膝关节磁共振成像中的扫描时间、图像质量及诊断效能。方法 前瞻性采集100例膝关节磁共振影像。对比两组三维序列的定量指标、主观评分以及对损伤分级的准确率。结果 IW-CS-SENSE序列扫描时间显著缩短(122.0 ± 28.0 s vs. 221.0 ± 49.0 s,p<0.001)。IW-CS-SENSE序列信噪比、对比噪声比及显示效果评分均低于IW-SENSE序列(p<0.001),但IW-CS-SENSE序列的SENSE伪影评分更优(5.00 ± 0.00 vs. 4.59 ± 0.62,p<0.001)。两序列对半月板、韧带及软骨损伤分级的准确率均无统计学差异(p值分别为0.33,0.58和0.15)。 结论 3D IW-CS-SENSE序列可显著缩短扫描时间和消除SENSE伪影,同时保持与4倍加速3D IW-SENSE序列相当的诊断效能。
Objective To compare the imaging times, image quality, and diagnostic performance of three-dimensional (3D) intermediate-weighted compressed sensing sensitivity encoding (IW-CS-SENSE) sequence with conventional 3D IW-SENSE sequence in knee MR imaging. Methods MR images of one hundred knees were obtained prospectively. The quantitative indices, qualitative scores, and grading accuracies between the two 3D sequences were compared. Results Imaging times of IW-CS-SENSE sequences were significantly reduced (122.0 ± 28.0 s vs. 221.0 ± 49.0 s, p < 0.001). The signal-to-noise ratios, contrast-to-noise ratios, and visualization scores of IW-CS-SENSE sequences were significantly lower than IW-SENSE sequences (p < 0.001), while scores of SENSE artefact for IW-CS-SENSE sequences were superior (5.00 ± 0.00 vs. 4.59 ± 0.62, p < 0.001). The accuracies in grading meniscal, ACL, and cartilage tears were comparable between the two sequences (p = 0.33, p = 0.58 and p = 0.15, respectively). Conclusion 3D IW-CS-SENSE sequences can reduce scanning time significantly and eliminate SENSE artefacts, while maintaining the same diagnostic performance as the 4-fold accelerated 3D IW-SENSE sequences.
目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.
目的:基于文献计量学梳理惯性测量技术在步态分析领域的研究演进与热点结构,并从护理评估与干预转化角度分析其应用空白。方法:检索 Web of Science 核心合集2005年1月1日至2025年4月5日相关英文文献,纳入1,079篇记录;采用 CiteSpace 6.3.R1、VOSviewer 1.6.20 分析年度发文、国家/地区合作、期刊分布、关键词共现与突现,并在 Python 3.10 中以 PPMI/TF-IDF 表征、SVD降维、UMAP-HDBSCAN聚类开展关键词和摘要语义分析。结果:2006—2024年发文量由1篇增至140篇,年复合增长率为31.6%,2024年达到峰值;最高频关键词为 gait(404次)、gait analysis(268次)、walking(252次)、balance(183次)和 inertial sensors(156次)。关键词与摘要语义聚类的二维轮廓系数分别为0.579和0.642,热点集中于帕金森病/冻结步态、跌倒风险、平衡稳定性、可穿戴传感器、机器学习和康复干预。含 nursing/care 等护理相关词项的记录为142篇,但“护理”尚未形成独立主题簇。结论:惯性测量步态分析已形成医工交叉的成熟热点,但护理主导的连续评估、风险预警和干预闭环仍不足。未来应将步速、步态变异性、稳定性、对称性等参数转化为可执行的护理评估指标,推动精准护理场景中的临床验证与流程整合。
Objective: To map the research evolution and hotspot structure of inertial-measurement-based gait analysis and to examine its translational gap in nursing assessment and intervention. Methods: A total of 1,079 English records published from January 1, 2005 to April 5, 2025 were retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 and VOSviewer 1.6.20 were used for annual output, collaboration, journal distribution, keyword co-occurrence and burst analyses. Keyword and abstract semantic clusters were further examined in Python 3.10 using PPMI/TF-IDF representation, SVD, UMAP and HDBSCAN. Results: Publications increased from 1 in 2006 to 140 in 2024, with a compound annual growth rate of 31.6%. The most frequent terms were gait, gait analysis, walking, balance and inertial sensors. The two-dimensional silhouette coefficients of keyword and abstract semantic clusters were 0.579 and 0.642, respectively. Major hotspots involved Parkinson disease/freezing of gait, fall risk, balance and stability, wearable sensors, machine learning and rehabilitation. Records containing nursing/care-related terms accounted for 142 publications, but nursing did not form an independent topic cluster. Conclusion: Inertial-measurement-based gait analysis has become a mature medical-engineering research field, while nurse-led continuous assessment, risk warning and intervention feedback loops remain underdeveloped. Translating gait speed, variability, stability and symmetry into actionable nursing indicators should be prioritized in future clinical validation.