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目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。
Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders.Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases.Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training.The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications.Results The observation group was generally more effective than the control group(P<0.05).After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group(P<0.05).After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group(P<0.05).The complication rate was lower in the observation group(P<0.05).Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes.
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目的 探讨富血小板血浆(PRP)联合关节镜治疗Ⅲ度半月板损伤患者的临床疗效,及其对膝关节功能恢复时间的影响。方法 选取2021年2月—2022年2月南方医科大学南方医院增城院区骨科收治的Ⅲ度半月板损伤患者45例,采用随机数字法分为观察组22例与对照组23例,对照组患者在关节镜下行半月板成形术,观察组在对照组基础上给予PRP治疗。观察两组患者术后恢复时间、治疗效果及并发症发生情况;比较两组治疗前和治疗后1、3、6个月膝关节功能、疼痛情况。结果 利用观察组患者自体全血制备的PRP,其血小板的回收率、红细胞留存率、白细胞留存率分别为(91.00±9.27)%、(0.29±0.12)%、(29.98±6.68)%,PRP制备质量稳定、可控。观察组联合PRP治疗术与关节镜手术治疗后恢复时间均短于对照组,观察组治疗有效率高于对照组(P<0.05)。经重复方差测量分析,两组美国特种外科医院膝关节评分系统(HSS)评分、西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟疼痛评分法(VAS)交互(F交互=1.869、F交互=1.482、F交互=2.193)比较差异均有统计学意义(P<0.05);与对照组治疗后1、3、6个月比较,观察组HSS评分升高,WOMAC评分、VAS评分下降(P<0.05);观察组并发症总发生率4.55%低于对照组30.43%(χ2=5.156、P=0.023)。结论 对于Ⅲ度半月板损伤患者,采用PRP联合关节镜手术治疗可帮助患者消炎止痛、加快疗效、加快膝关节功能的恢复,缩短其恢复的时间,效果良好,且安全性较高。
Objective To investigate the clinical effect of platelet rich plasma(PRP)combined with arthroscopy treatment on patients with third degree meniscus injury,and its impact on the recovery time of knee joint function.Methods From February 2021 to February 2022,45 patients with III-degree meniscal injuries admitted to the Department of Orthopedics,Zengcheng district,Nanfang Hospital of Southern Medical University were selected and divided into an observation group of 22 cases and a control group of 23 cases using the random number method.Patients in the control group received menisplasty under arthroscopy,and the observation group was given PRP treatment on the basis of the control group.The postoperative recovery time,treatment effects and complications of the two groups of patients were observed;the knee joint function and pain of the two groups before treatment and 1,3,and 6 months after treatment were compared.Results The platelet recovery rate,red blood cell retention rate,and white blood cell retention rate of PRP prepared from the autologous whole blood of patients in the observation group were(91.00±9.27)%,(0.29±0.12)%,and(29.98±6.68)% respectively.The PRP preparation quality is stable and controllable.The recovery time after combined PRP treatment and arthroscopic surgery in the observation group was shorter than that in the control group,and the treatment effectiveness of the observation group was higher than that of the control group(P<0.05).After repeated measures of variance analysis,the comparison of American Hospital for Special Surgery(HSS)Knee Scoring System,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and visual analogue pain scales(VAS)interacted(FInteraction=1.869,Finteraction=1.482,Finteraction=2.193),the differences were statistically significant(P<0.05).Compared with the control group 1,3,and 6 months after treatment,the HSS score of the observation group increased,and the WOMAC score,VAS score decreased(P<0.05);the total incidence of complications in the observation group was 4.55%,lower than that in the control group(30.43%,χ2=5.156,P=0.023).Conclusions For patients with III-degree meniscal injuries,PRP combined with arthroscopic surgery can help reduce inflammation and pain,speed up the curative effect,accelerate the recovery of knee joint function,and shorten the recovery time.It has good effects and is relatively safe.
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目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表(MoCA)评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高(P<0.05);住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少(P<0.05);护理后,联合组MoCA评分高于对照组(P<0.05)。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。
Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children.Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected.They were divided into two groups according to the nursing method,with 58 cases in each group.The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention.The satisfaction,the compliance rate and MoCA score were compared between two groups.Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group(P<0.05).Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group(P<0.05).After nursing,the MoCA score of the combined group was higher than that of the control group(P<0.05).Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction.
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目的 调查与探讨高龄髋部骨折患者术后谵妄(POD)的发生因素,并提出相关处理对策。方法 选取2019年8月—2022年12月择在南阳市中医院独山院区进行手术治疗的高龄髋部骨折患者82例为研究对象,所有患者在术前1 d进行机械痛阈评定,在术后7 d判定患者的POD发生情况,进行POD与术前痛阈水平的相关性分析,并提出相关的处理对策。结果 术后7 d,82例患者中发生POD 12例(谵妄组),占比14.6%,未发生POD 70例(非谵妄组),占比85.37%。谵妄组的性别、体质指数、骨折类型、骨折至手术时间与非谵妄组对比差异无统计学意义(P>0.05),谵妄组的年龄、术前血红蛋白水平、术前白蛋白水平与非谵妄组对比差异有统计学意义(P<0.05)。谵妄组的术前1 d的痛阈水平低于非谵妄组(P<0.05)。Spearman分析显示,POD与术前痛阈、年龄、术前血红蛋白、术前白蛋白均存在相关性(P<0.05)。Logistic回归分析显示,术前痛阈、年龄、术前血红蛋白、术前白蛋白等都为导致POD发生的影响因素(P<0.05),要积极加强预防性护理干预。结论 高龄髋部骨折患者POD的发生率较高,患者的术前痛阈、年龄、术前血红蛋白、术前白蛋白等均为导致POD发生的影响因素,要积极加强预防性护理干预。
Objective To investigate and explore the factors leading to postoperative delirium(POD)in elderly patients with hip fractures,and to propose relevant handling measures.Methods From August 2019 to December 2022,82 cases of elderly patients with hip fractures who underwent surgical treatment in Nanyang Hospital of Traditional Chinese Medicine Dushan District were selected as the research subjects.All patients underwent mechanical pain threshold assessment 1 day before surgery,and their postoperative delirium were determined 7 days after surgery,followed by correlation analysis,and relevant handling measures were proposed.Results Seven days after surgery,there were 12 patients(delirium group)of POD,accounted for 14.6%,and 70 patients(non delirium group)without POD,accounted or 85.37%.There was no significant difference in genders,body mass index,fracture types and fracture to surgery time compared between the delirium group and the non delirium group(P>0.05). However,there were significant differences in ages,preoperative hemoglobin levels and preoperative albumin levels compared between the delirium group and the non delirium group(P<0.05).The pain threshold level of the delirium group on the first day before surgery was significantly lower than that of the non delirium group(P<0.05).Spearman analysis showed that POD was associated with preoperative pain threshold,ages,preoperative hemoglobin and preoperative albumin levels(P<0.05).Logistic regression analysis showed that the preoperative pain threshold level,ages,preoperative hemoglobin and preoperative albumin levels were all independent risk factors for the development of POD(P<0.05),preventive nursing intervention should be actively strengthened.Conclusions The incidence of POD is high in elderly patients with hip fractures.Preoperative pain threshold level,age,preoperative hemoglobin and preoperative albumin levels are all factors that contribute to the occurrence of POD.It is necessary to actively strengthen preventive nursing interventions.
论著
目的 探讨特发性间质性肺炎(IIPs)[非特发性肺间质性纤维化(IPF)型]合并弥漫性肺部出血综合征患者治疗方案以及应用价值。方法 报道1例IIPs(非IPF型)合并弥漫性肺部出血综合征患者的治疗经过以及结果,结合文献分析治疗IIPs(非IPF型)合并弥漫性肺部出血综合症临床应用价值。结果 该文报道 l 例特发性肺间质肺炎(非IPF型)伴弥漫性肺泡出血综合征的老年男性患者,合并呼吸、循环衰竭,启用静脉-静脉体外膜肺氧合(VV-ECMO)抢救并成功撤机,病情好转出院。结论 IIPs作为病因以及发病机制未明、临床表现多样的一类肺间质性疾病,需临床多学科协作,及早诊断、治疗,才能成功挽救患者。
Objective To explore the treatment plan and application value of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome.Methods A case of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was reported.The clinical application value of treatment of idiopathic interstitial pneumonia(non IPF)complicated with diffuse alveolar hemorrhage syndrome was analyzed combined with the literature.Results A case of idiopathic interstitial pneumonia(non IPF type)with diffuse alveolar hemorrhage syndrome was reported in this paper. Combined with respiratory and circulatory failure,veno-venous extracorporeal membrane oxygenation was used to rescue and successfully wean,and the condition improved and discharged.Conclusions Through the curative effect evaluation of this patient,it is believed that idiopathic interstitial pneumonia,as a kind of pulmonary interstitial disease with unknown etiology and pathogenesis and diverse clinical manifestations,need clinical multidisciplinary cooperation,early diagnosis and treatment,in order to successfully save the patient.
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目的 分析恩格列净对2型心肾综合征(CRS)患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组(44例,给予常规治疗)、实验组(44例,在常规治疗的同时加用恩格列净),通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。
Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome(CRS).Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group(44 cases,receiving conventional treatment)and experimental group(44 cases,receiving conventional treatment combined with englaglitzin)by computer program.The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions.Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group.The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion.
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目的 探讨男性人乳头瘤病毒(HPV)基因分型感染情况。方法 收集采用聚合酶链式反应反向斑点杂交法进行28种HPV基因分型检测的1 137例男性检查结果,进行回顾性分析。结果 1 137例男性患者中阳性441例,阳性率为38.79%,感染率居前5位的亚型依次为HPV6(11.35%)、HPV11(7.92%)、HPV16(5.10%)、HPV52(3.52%)、HPV43(2.64%);就诊人群以20~39岁为主,感染人数也最多,各年龄组间阳性率比较差异无统计学意义(P>0.05),≥50岁组HPV52型阳性率高于20~29岁组(P<0.05)和30~39岁组(P<0.05)。单一感染占67.35%,多重感染占32.65%,单一感染中低危型占比最多(41.27%),多重感染中,二重感染占比最多(19.50%),高低危混合感染为各种类型感染之首(15.87%)。结论 1 137例样本中HPV阳性率为38.79%,感染亚型以HPV6、HPV11、HPV16、HPV52、HPV43为主,单一低危型感染较为常见,各年龄组间阳性率相近。
Objective To investigate the genotypes of human papillomavirus(HPV)infection.Methods A total of 1 137 male patients’ diagnoses were collected and analyzed retrospectively,which came from the detections using polymerase chain reaction reverse dot blot hybridization to genotype 28 HPV.Results Among 1 137 male patients,441 were HPV positive,with a positive rate of 38.79%,the infections of top five HPV types were HPV6(11.35%),HPV11(7.92%),HPV16(5.10%),HPV52(3.52%),HPV43(2.64%).The majority of the patients were the 20-39 age group,and the number of infections was also the highest.There was no statistical significance on the difference in the positive rate among different age groups(P>0.05).The positive rate of HPV52 in ≥50 years old group was higher than the groups of aged 20~29(P<0.05)and 30~39(P<0.05).The single and multiple infections accounted for 67.35% and 32.65%.The low-risk HPV accounted for the highest proportion(41.27%)in single infections,while in patients with multiple infections,the proportion of dual infections was the largest(19.50%)and the high- and low-risk HPV mixed infections was the maximum of the infection types(15.87%).Conclusions The detection rate of positive HPV in 1 137 male patients was 38.79%,mainly were type 6,type 11,type 16,type 52 and type 43,and the single low-risk HPV infected was common.Positive rates were similar among different age groups.
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目的 探讨产科监护室妊娠期糖尿病产妇泌乳启动延迟及影响因素,以期作为预防泌乳启动延迟的参考依据。方法 选择2021年1月—2023年5月期间医院产科监护室接收的妊娠期糖尿病产妇80例为研究对象,采用单因素和多因素分析产妇的年龄、体质指数、产次、定期复查血糖、妊娠期高血压、分娩方式、开奶时间、新生儿体质量、产后焦虑、产后抑郁、产后疲乏、吸吮次数等对泌乳启动延迟的影响。结果 妊娠期糖尿病产妇泌乳启动延迟33例,发生率41.25%;泌乳启动延迟产妇的年龄≥35岁者占51.52%、未定期复查血糖者占39.39%、合并妊娠期高血压者占54.55%、开奶时间≥6 h者占57.58%、产后焦虑者占30.0%、产后抑郁者占36.36%、产后疲乏者占36.36%、吸吮次数<6次者占60.61%,与非泌乳启动延迟产妇比较差异均有统计学意义(P<0.05)。两组孕前体质指数、产次、分娩方式、新生儿出生体质量比较差异无统计学意义(P>0.05)。年龄≥35岁、未定期复查血糖、合并妊娠期高血压、开奶时间≥6 h、产后焦虑、产后抑郁、产后疲乏、吸吮次数<6次为妊娠期糖尿病产妇泌乳启动延迟的危险因素(P<0.05)。结论 产科监护室妊娠期糖尿病产妇泌乳启动延迟发生率较高,主要受到年龄、未定期复查血糖、合并妊娠期高血压、开奶时间、产后心理状态、吸吮次数等因素影响,应重视健康教育和早期辅助干预,降低泌乳启动延迟发生率。
Objective To explore the delayed lactation initiation and its influencing factors of pregnant women with diabetes in the obstetric care unit,so as to provide a reference for preventing delayed lactation initiation.Methods A total of 80 pregnant women with diabetes who were received by the hospital obstetric care unit from January 2021 to May 2023 were selected as the research objects.The age,body mass index,parity,regular blood glucose recheck,pregnancy hypertension,delivery mode,starting time,neonatal weight,postpartum anxiety,postpartum depression,postpartum fatigue,sucking times and other factors that led to the delay of lactation initiation were analyzed by single factor and multi factor analysis.Results The onset of lactation was delayed in 33 pregnant women with diabetes,with an incidence of 41.25%.The age of postpartum women with delayed lactation initiation over 35 years old accounted for 51.52%,blood sugar was not regularly rechecked accounted for 39.39%,pregnancy induced hypertension accounted for 54.55%,lactation time over 6 hours accounted for 57.58%,postpartum anxiety accounted for 30.0%,postpartum depression accounted for 36.36%,postpartum fatigue accounted for 36.36%,and sucking frequency <6 times accounted for 60.61%,which were higher than that of non-delayed lactation initiation women(P<0.05).There was no statistically significant difference between the two groups in terms of pre pre-pregnancy body mass index,parity,delivery method and newborn birth weight(P>0.05).The risk factors of delayed lactation initiation in pregnant women with diabetes were age ≥ 35 years,no regular blood glucose review,hypertension during pregnancy,≥ 6 h of first milk expression time,postpartum anxiety,postpartum depression,postpartum fatigue and sucking times<6(P<0.05).Conclusions The incidence of delayed lactation initiation in pregnant women with diabetes in the obstetric care unit is high,which is mainly affected by age,pregnancy induced hypertension,time of starting breast feeding,postpartum psychological state and sucking times.Health education and early auxiliary intervention should be emphasized to reduce the incidence of delayed lactation initiation.
论著
目的 探讨唐氏综合征血清学筛查风险值异常孕妇选择接受无创产前基因检测(NIPT)的影响因素,为临床制定对应策略提供参考依据。方法 选取2022年1月—2022年12月唐氏综合征血清学筛查风险值异常孕妇229例,根据是否接受NIPT分为接受组(195例)与不接受组(34例)。收集两组临床资料,采用Lasso-Logistic回归分析唐氏综合征血清学筛查风险值异常孕妇接受NIPT的影响因素。结果 单因素分析显示,年龄、文化水平、居住地、家庭平均月收入、孕前优生优育检查、孕前合并生殖相关疾病、受孕方式、不良孕产史、家族史、补充叶酸、配偶意愿、NIPT认知水平、血清学风险等级是血清学筛查异常孕妇接受NIPT的影响因素(P<0.05);Lasso回归分析筛选出7个变量,分别为年龄、文化水平、家庭平均月收入、不良孕产史、家族史、NIPT认知水平、血清学风险等级;Logistic回归分析,年龄(OR=6.269,95%CI:2.413~16.285)、文化水平(OR=4.119,95%CI:1.627~10.430)、家庭平均月收入(OR=5.102,95%CI:2.067~12.594)、不良孕产史(OR=5.247,95%CI:1.833~15.021)、家族史(OR=7.416,95%CI:2.952~18.629)、NIPT认知水平(OR=5.751,95%CI:2.338~14.146)、血清学风险等级(OR=7.866,95%CI:3.057~20.238)是血清学筛查异常孕妇接受NIPT的影响因素(P<0.05)。结论 唐氏综合征血清学筛查风险值异常孕妇选择接受NIPT的影响因素较多,包括年龄、文化水平、家庭平均月收入、不良孕产史、家族史、NIPT认知水平、血清学风险等级,能为临床提高NIPT接受度提供指导信息。
Objective To explore the influencing factors of noninvasive prenatal testing(NIPT)for pregnant women with abnormal risk value of serological screening for Down syndrome,and to provide reference for clinical development of corresponding strategies.Methods A total of 229 pregnant women with abnormal serological screening risk values for Down syndrome from January 2022 to December 2022 were selected and divided into acceptance group(195 cases)and non-acceptance group(34 cases)according to whether they received NIPT.The clinical data of the two groups were collected and Lasso-Logistic regression was used to analyze the factors influencing the acceptance of NIPT in pregnant women with abnormal serological screening risk value for Down syndrome.Results In single factor analysis,age,education level,place of residence,average monthly family income,pre-pregnancy and childbearing examination,pre-pregnancy combined with reproductive diseases,conception method,adverse pregnancy history,family history,folic acid supplementation,spouse intention,NIPT cognition level and serological risk grade were the influencing factors for the acceptance of NIPT in pregnant women with abnormal serological screening(P<0.05).Seven variables were selected by Lasso regression analysis,which were age,education level,average monthly family income,adverse pregnancy history,family history,NIPT cognition level and serological risk level.Logistic regression analysis showed that age(OR=6.269,95%CI:2.413-16.285),education level(OR=4.119,95%CI:1.627-10.430),average monthly family income(OR=5.102,95%CI:2.067-12.594),adverse pregnancy history(OR=5.247,95%CI:1.833-15.021),family history(OR=7.416,95%CI:2.952-18.629),NIPT cognitive level(OR=5.751,95%CI:2.338-14.146)and serological risk level(OR=7.866,95%CI:3.057-20.238)were independent influencing factors for NIPT acceptance in pregnant women with abnormal serological screening(P<0.05).Conclusions There are many influencing factors for pregnant women with abnormal serological screening risk value to accept NIPT,including age,education level,average monthly family income,adverse pregnancy history,family history,NIPT cognition level,serological risk grade,etc.,which can provide guidance information for clinical improvement of NIPT acceptance.
论著
本文探讨临床药师对口服靶向药物的非小细胞肺癌患者开展药学服务的要点,以案例为依据,通过查阅药品说明书、指南及文献等,分析药学服务的内容和方向。临床药师在安全性评估、剂量调整、个体化治疗方案选择、用药教育和健康宣教等方面为患者和临床医生提供专业、全面的药学服务。临床药师通过全程参与患者的治疗过程,指导患者正确用药、优化治疗方案,利用专业优势解决临床实际问题,提升药学服务质量的同时体现了药师的职业价值。
To explore the key points of pharmaceutical care for non-small cell lung cancer patients with oral targeted drugs.Based on clinical cases,the content and direction of pharmaceutical care were analyzed with drug instructions,guidelines and literature.Clinical pharmacists provided professional and comprehensive pharmaceutical services for patients and clinicians in safety assessment,dose adjustment,individualized treatment plan selection,medication education and health education.Clinical pharmacists participate in the whole treatment process,guide patients to use drugs correctly,optimize treatment plans,use professional advantages to solve clinical practical problems,improve the quality of pharmaceutical care and reflect the professional value of pharmacists.