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 合并肺纤维化的慢性阻塞性肺疾病（COPD）是COPD的特殊亚型，患者兼具气流受限与肺组织纤维化病理特征，临床症状更严重、肺功能下降更快，且现有单一治疗方案难以同时改善气流受限与纤维化进展，预后较差。基于此，本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响，为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者，采用前瞻性随机对照研究设计，应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗，对照组48例采取尼达尼布治疗，试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后，比较治疗前后症状评分、肺功能、纤维化指标、炎症指标，并分析两组治疗安全性。结果 治疗后，两组CAT评分、mMRC评分及VAS降低（P＜0.05）；且与对照组比较，试验组CAT评分、mMRC评分及咳嗽VAS评分较低（P＜0.05）。治疗后，两组FVC、FEV1、DLCO及FEV1/FVC比值均较治疗前改善（P＜0.05）；且与对照组比较，试验组FVC、FEV1、DLCO及FEV1/FVC比值较优（P＜0.05）。治疗后，两组血清KL-6、SP-D水平及CT纤维化评分均降低（P＜0.05）；且与对照组比较，试验组血清KL-6、SP-D水平及CT纤维化评分较低（P＜0.05）。治疗后，两组血清IL-6、TNF-α及TGF-β1水平降低（P＜0.05）；且与对照组比较，试验组血清IL-6、TNF-α及TGF-β1水平较低（P＜0.05）。试验组总不良反应发生率为8.33%（4/48），对照组为10.42%（5/48），两组比较差异无统计学意义（P＞0.05）。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好，可减轻患者临床症状，改善肺功能与肺纤维化，降低机体炎症反应，安全性较高。
Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease（COPD）patients with associated pulmonary fibrosis and its impact on lung function，providing a basis for optimizing clinical treatment strategies．Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected，and divided into experimental group and control group using a random number table method．Using a prospective randomized controlled study design，all patients received conventional treatment，with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide．After 24 weeks of treatment in both groups，the symptom scores，lung function，fibrosis indicators，and inflammation indicators were compared before and post-treatment，and the drug safety of the two groups was analyzed．Results Post-treatment，CAT score，mMRC score and VAS decreased in both groups（P＜0.05）．Compared with the control group，CAT score，mMRC score and cough VAS score were lower in the experimental group（P＜0.05）．Post-treatment，FVC，FEV1，DLCO and FEV1/FVC ratio of both groups improved compared with that before treatment（P＜0.05）．Compared with the control group，FVC，FEV1，DLCO and FEV1/FVC ratio of the experimental group were better（P＜0.05）．Post-treatment，serum KL-6，SP-D levels and CT fibrosis scores of both groups decreased（P＜0.05）．Compared with the control group，serum KL-6，SP-D levels and CT fibrosis scores of the experimental group were lower（P＜0.05）．Post-treatment，serum IL-6，TNF-α and TGF-β1 levels in both groups decreased（P＜0.05）．Compared with the control group，serum IL-6，TNF-α and TGF-β1 levels in the experimental group were lower（P＜0.05）．The incidence of total adverse reactions in the experimental group was 8.33%（4/48），and that in the control group was 10.42%（5/48）．There was no difference between the two groups（P＞0.05）．Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis，which can alleviate its clinical symptoms，improve lung function and pulmonary fibrosis，reduce the body’s inflammatory response，which is relatively safe．
【摘要】目的：探讨五联综合预康复模式对肺癌患者术后整体康复进程及肺功能的改善效果。方法：研究对象选择2023年6月~2025年6月至我院行胸腔镜肺癌根治术治疗的100例非小细胞肺癌（NSCLC）患者，基于随机数字表法将入组患者分别列为常规组、试验组，每组50例。常规组实施三联预康复干预（运动疗法+心理干预+营养支持），试验组实施五联综合预康复干预（运动疗法+营养支持+心理干预+呼吸训练+疼痛干预），比较两组患者的身心状态，康复进程及肺部并发症发生情况，护理后随访半年，比较两组患者肺功能康复情况。结果：干预后，试验组的视觉模拟疼痛量表（VAS）评分、医院焦虑抑郁量表（HADS）均低于常规组，一般自我效能感量表（GSES）评分高于常规组（t=4.748，4.077，4.252；P＜0.05）。试验组的术后恢复排气时间、首次下床时间、首次有效排痰时间、引流管拔除时间、住院时间分别为（22.52±5.33）h、（25.49±5.16）h、（1.33±0.42）d、（2.05±0.31）d、（6.19±1.44）d，均低于常规组[（30.46±6.25）h、（35.62±6.45）h、（2.21±0.36）d、（2.96±0.45）d、（9.04±1.35）d]（t=6.835，8.672，11.249，11.776，10.210；P＜0.05）。试验组的肺部并发症发生率6.00%（3/50）低于常规组20.00%（10/50）（x2=24.018；P＜0.05）。截至随访结束时，试验组的第一秒用力呼气容积百分比（FEV1）、最大吸气压（MIP）、最大摄氧量（VO2max）、6min步行试验距离（6MWD）分别为（85.45±6.41）%、（89.44±6.29）cmH2O、（20.49±4.26）mL/kg/min、（470.35±42.29）m，均高于常规组[（80.29±5.33）%、（84.35±5.47）cmH2O、（17.33±3.15）mL/kg/min、（435.27±40.36）m]（t=4.377，4.318，4.218，4.242；P＜0.05）。结论：五联综合预康复模式有利于改善NSCLC患者术后身心状态并加快康复进程，对降低肺部并发症发生风险并促进肺功能康复均有积极影响
[Abstract]Objective:To explore the improvement effect of the five-component comprehensive prehabilitation model on the overall rehabilitation process and lung function of lung cancer patients after surgery.Methods:The research subjects selected 100 NSCLC patients who underwent thoracoscopic radical resection for lung cancer in our hospital from June 2023 to June 2025. Based on the random number table method, the enrolled patients were divided into a control group and an experimental group, with 50 patients in each group. The control group implemented triple prehabilitation intervention (exercise therapy+psychological intervention+nutritional support), while the experimental group implemented five-component comprehensive prehabilitation intervention (exercise therapy+nutritional support+psychological intervention+respiratory training+pain intervention). The physical and mental status, rehabilitation process, and incidence of pulmonary complications of the two groups of patients were compared. After nursing, a six-month follow-up was conducted to compare the pulmonary function recovery of the two groups of patients.Results:After intervention, the VAS score and HADS of the experimental group were lower than the control group, and the GSES score was higher than the control group (t=4.748，4.077，4.252; P<0.05). The postoperative recovery time, first time out of bed, first effective sputum evacuation time, drainage tube removal time, and hospitalization time of the experimental group were (22.52 ± 5.33) hours, (25.49 ± 5.16) hours, (1.33 ± 0.42) days, (2.05 ± 0.31) days, and (6.19 ± 1.44) days,lower than the control group [(30.46 ± 6.25) hours, (35.62 ± 6.45) hours, (2.21 ± 0.36) days, (2.96 ± 0.45) days, and (9.04 ± 1.35) days] (t=6.835，8.672，11.249，11.776，10.210; P<0.05). The incidence of pulmonary complications in the experimental group was 6.00% (3/50) lower than the control group 20.00% (10/50) (x2=24.018; P<0.05). As of the end of follow-up, the FEV1, MIP, VO2max, and 6MWD of the experimental group were (85.45 ± 6.41)%, (89.44 ± 6.29) cmH2O, (20.49 ± 4.26) mL/kg/min, and (470.35 ± 42.29) m, higher than the control group [(80.29 ± 5.33)%, (84.35 ± 5.47) cmH2O, (17.33 ± 3.15) mL/kg/min, and (435.27 ± 40.36) m](t=4.377，4.318，4.218，4.242; P<0.05).Conclusion:The five-component comprehensive prehabilitation model is beneficial for improving the physical and mental state of NSCLC patients after surgery and accelerating the rehabilitation process. It has a positive impact on reducing the risk of pulmonary complications and promoting lung function recovery.
目的：探讨烯丙雌醇片联合阿托西班对晚期先兆流产（LTA）患者子宫血流情况及保胎结局的影响。方法：研究对象选择2024年3月~2025年12月就诊于我院的125例LTA患者，基于随机数字表法将其分别列为常规组（62例）、试验组（63例），常规组采用阿托西班治疗，试验组采用烯丙雌醇片联合阿托西班治疗，比较两组患者的激素水平，胎盘功能，子宫血流动力学及治疗安全性。所有患者均随访至妊娠终止，比较两组患者的保胎结局。结果：治疗后，试验组的孕酮（P）、雌三醇（E3）、人绒毛促性腺激素（hCG）均高于常规组，前列腺素E2（PGE2）低于常规组（t=5.195，5.251，11.029，6.031；P＜0.05）。试验组的胎盘生长因子（PIGF）、妊娠相关血浆蛋白A（PAPP-A）、胎盘血管化-血流指数（VFI）均高于常规组，胎盘弹性模量均值（Emean）低于常规组（t=5.869，5.387，4.267，6.936；P＜0.05）。试验组的子宫收缩期与舒张末期流速比值（S/D）、阻力指数（RI）、搏动指数（PI）分别为（1.22±0.45）、（0.41±0.12）、（0.66±0.13），均低于常规组[（1.94±0.33）、（0.72±0.11）、（0.97±0.12）]，平均血流量（Vm）（18.53±3.31）cm/s高于常规组（16.27±3.15）（t=10.188，15.049，13.848，3.909；P＜0.05）。试验组的药物相关副反应发生率与常规组比较，差异无统计学意义（P＞0.05）。截至随访结束时，试验组的保胎成功率、活产率分别为92.06%（58/63）、85.71%（54/63），均高于常规组[79.03%（49/62）、69.35%（43/62）]，早产率、流产率分别为6.35%（4/63）、3.17%（2/63），均低于常规组[12.90%（8/62）、16.13%（10/62）]（x2=4.305，4.811，38.821，36.634；P＜0.05）。结论：烯丙雌醇片联合阿托西班可调节LTA患者激素水平并改善胎盘功能，可在避免增加治疗风险同时，改善子宫血流动力学及保胎结局。
Objective:To explore the effects of allylestrenol tablets combined with atosiban on uterine blood flow and fetal preservation outcomes in patients with LTA.Methods:The research subjects selected 125 LTA patients who visited our hospital from March 2024 to December 2025. Based on the random number table method, they were divided into a control group (62 cases) and an experimental group (63 cases). The control group was treated with atosiban, while the experimental group was treated with a combination of allylestrenol tablets and atosiban. The hormone levels, placental function, uterine hemodynamics, and treatment safety of the two groups of patients were compared. All patients were followed up until the termination of pregnancy, and the fetal preservation outcomes of the two groups of patients were compared.Results:After treatment, the levels of P, E3, and hCG in the experimental group were higher than the control group, while PGE2 was lower than the control group (t=5.195，5.251，11.029，6.031; P<0.05). The PIGF, PAPP-A, and VFI in the experimental group were all higher than the control group, while the Emean was lower than the control group (t=5.869，5.387，4.267，6.936; P<0.05). The S/D,RI, and PI of the experimental group were (1.22 ± 0.45), (0.41 ± 0.12), and (0.66 ± 0.13), lower than the control group [(1.94 ± 0.33), (0.72 ± 0.11), and (0.97 ± 0.12)]. The Vm of (18.53 ± 3.31) cm/s was higher than that of the control group (16.27 ± 3.15) (t=10.188，15.049，13.848，3.909; P<0.05). The incidence of drug-related side effects in the experimental group was similar to the control group (P>0.05). As of the end of the follow-up, the success rate and live birth rate of the experimental group were 92.06% (58/63) and 85.71% (54/63), respectively, both higher than the control group [79.03% (49/62), 69.35% (43/62)]. The premature birth rate and miscarriage rate were 6.35% (4/63) and 3.17% (2/63), respectively, both lower than the control group [12.90% (8/62), 16.13% (10/62)] (x2=4.305，4.811，38.821，36.634; P<0.05).Conclusion:The combination of allylestrenol tablets and atosiban can regulate hormone levels and improve placental function in LTA patients. It can correct uterine hemodynamic disorders and improve fetal outcomes while avoiding increased treatment risks.
目的：探讨特立帕肽对胸腰椎压缩性骨折（TLCF）患者多模态影像学参数及骨微环境的改善效果。方法：研究对象选择2024年3月~2025年3月至我院行经皮椎体后凸成形术（PKP）治疗的109例TLCF患者，通过随机数字表法将其列为常规组（54例）、试验组（55例）。常规组术后实施常规药物治疗，试验组术后采用特立帕肽联合常规药物治疗，治疗周期为6个月，于治疗1个月后比较两组患者的骨微环境，症状及功能。于治疗6个月后比较两组患者的多模态影像学参数及短期预后情况，于治疗期间统计并对比两组治疗安全性。结果：治疗1个月后，试验组的骨钙素（OC）、骨特异性碱性磷酸酶（BALP）、Ⅰ型原胶原N端前肽（PⅠNP）、Ⅰ型原胶原C端前肽（PⅠCP）分别为（12.42±3.31）ng/mL、（7.02±1.55）μg/L、（25.19±5.46）ng/mL、（68.22±6.47）ng/mL，均高于常规组[（10.39±2.45）ng/mL、（5.77±1.29）μg/L、（21.41±4.33）ng/mL、（63.19±5.27）ng/mL]（t=3.634，4.572，4.000，4.446；P＜0.05）。试验组的视觉模拟疼痛量表（VAS）评分、Oswestry功能障碍指数（ODI）评分均低于常规组（t=6.096，2.754；P＜0.05）。治疗6个月后，试验组的面积骨密度（aBMD）、骨小梁评分（TBS）、预估椎体强度（EVS）分别为（0.75±0.11）g/cm2、（1.29±0.22）、（2.33±0.42）MPa，均高于常规组[（0.51±0.08）g/cm2、（0.82±0.13）、（1.62±0.25）MPa]，骨髓脂肪分数（MFF）（38.48±5.24）%低于常规组（43.19±6.33）%（t=13.007，13.547，10.670，4.235；P＜0.05）。试验组的不良预后发生率10.91%（6/55）低于常规组27.78%（15/54）（x2=4.985；P＜0.05）。试验组治疗期间的药物相关副反应发生率与常规组比较，差异无统计学意义（P＞0.05）。结论：特立帕肽可改善TLCF患者PKP术后骨微环境及疼痛症状、功能障碍，可在避免增加治疗风险同时，有效促进多模态影像学参数恢复，并降低不良预后发生风险。
Objective:To explore the improvement effect of teriparatide on multimodal imaging parameters and bone microenvironment in patients with TLCF.Methods:The research subjects selected 109 patients with TLCF who underwent PKP treatment at our hospital from March 2024 to March 2025. They were randomly divided into a control group (54 cases) and an experimental group (55 cases) using a random number table method. The control group received conventional drug treatment after surgery, while the experimental group received a combination of teriparatide and conventional drug treatment after surgery, with a treatment period of 6 months. After 1 month of treatment, the bone microenvironment, symptoms, and function of the two groups of patients were compared. Compare the multimodal imaging parameters and short-term prognosis of the two groups of patients after 6 months of treatment, and compare the safety of the two groups during the treatment period.Results:After one month of treatment, the levels of OC, BALP, PⅠNP, and PⅠCP in the experimental group were (12.42 ± 3.31) ng/mL, (7.02 ± 1.55) μg/L, (25.19 ± 5.46) ng/mL, and (68.22 ± 6.47) ng/mL, higher than the control group [(10.39 ± 2.45) ng/mL, (5.77 ± 1.29) μg/L, (21.41 ± 4.33) ng/mL, and (63.19 ± 5.27) ng/mL] (t=3.634，4.572，4.000，4.446; P<0.05). The VAS score and ODI score of the experimental group were lower than the control group (t=6.096，2.754; P<0.05). After 6 months of treatment, the aBMD, TBS, and EVS of the experimental group were (0.75 ± 0.11) g/cm2, (1.29 ± 0.22), and (2.33 ± 0.42) MPa, higher than the control group [(0.51 ± 0.08) g/cm2 (0.82 ± 0.13), and (1.62 ± 0.25) MPa], and the MFF was (38.48 ± 5.24)% lower than that of the control group (43.19 ± 6.33)% (t=13.007，13.547，10.670，4.235; P<0.05). The incidence of poor prognosis in the experimental group was 10.91% (6/55) lower than the control group, which was 27.78% (15/54) (x2=4.985; P<0.05). The incidence of drug-related side effects during the treatment period in the experimental group was similar to the control group (P>0.05).Conclusion:Teriparatide can improve the bone microenvironment, pain symptoms, and functional impairment in patients with TLCF after PKP surgery. It can effectively promote the recovery of multimodal imaging parameters while avoiding increased treatment risks, and reduce the risk of adverse prognosis.
【摘要】目的 探讨老年基底动脉闭塞性急性脑梗死发病24h内血管内治疗（EVT）后再通无效发生风险影响因素。方法：回顾性纳入2021年6月~2025年6月发病24h内于本院接受EVT治疗的老年基底动脉闭塞性急性脑梗死患者共242例，根据治疗后3个月再通效果分为有效组和无效组；对比两组的各项数据资料，利用单因素以及多因素的分析方法，分析老年基底动脉闭塞性急性脑梗死发病24h内血管内治疗后再通无效发生的独立影响因素。结果：本研究入组242例患者EVT治疗后3个月再通有效130例，无效112例，再通无效率为46.28%。单因素分析结果显示，入院时美国国立卫生院卒中量表评分、治疗前是否桥接静脉溶栓、动脉闭塞性病变分级、术后24h是否出现症状性颅内出血及中性粒细胞与淋巴细胞比值均与老年基底动脉闭塞性急性脑梗死发病24h内EVT后再通无效发生有关（P＜0.05）。Logistic多因素分析结果显示，入院时美国国立卫生院卒中量表评分、治疗前是否桥接静脉溶栓、动脉闭塞性病变分级、术后24h是否出现症状性颅内出血及入院时中性粒细胞与淋巴细胞比值均是老年基底动脉闭塞性急性脑梗死发病24h内EVT后再通无效发生风险独立影响因素（P<0.05）。结论：老年基底动脉闭塞性急性脑梗死发病24h内EVT后再通无效发生与入院时美国国立卫生院卒中量表评分、治疗前是否桥接静脉溶栓、动脉闭塞性病变分级、术后24h是否出现症状性颅内出血及入院时中性粒细胞与淋巴细胞比值独立相关。
Abstract：Objective To explore the influencing factors of ineffective recanalization after endovascular treatment (EVT) within 24 hours after the onset of acute cerebral infarction with basilar artery occlusion in the elderly patients. Methods A total of 242 elderly patients with basilar artery occlusive acute cerebral infarction who received EVT treatment within 24 hours of onset in our hospital from June 2021 to June 2025 were retrospectively included. They were divided into the effective group and the ineffective group according to the recanalization effect in 3 months after treatment. By comparing the data of the two groups, univariate and multivariate analysis methods were used to analyze the independent influencing factors of ineffective recanalization after endovascular treatment within 24 hours of onset in elderly patients with acute basilar artery occlusive cerebral infarction. Results 242 patients were enrolled in this study. Three months after EVT treatment, 130 cases had effective recanalization and 112 cases had no recanalization. The recanalization failure rate was 46.28%. Univariate analysis showed that the National Institutes of Health Stroke Scale score on admission, bridging intravenous thrombolysis before treatment, arterial occlusive lesion grade, symptomatic intracranial hemorrhage at 24 hours postoperatively, and the neutrophil-to-lymphocyte ratio were all associated with ineffective recanalization after endovascular treatment (EVT) within 24 hours of onset in elderly patients with acute basilar artery occlusive cerebral infarction (P＜0.05). Logistic multivariate analysis demonstrated that the National Institutes of Health Stroke Scale score on admission, bridging intravenous thrombolysis before treatment, arterial occlusive lesion grade, symptomatic intracranial hemorrhage at 24 hours postoperatively, and the neutrophil-to-lymphocyte ratio on admission were all independent risk factors for ineffective recanalization after EVT within 24 hours of onset in elderly patients with acute basilar artery occlusive cerebral infarction (P＜0.05). Conclusion The occurrence of ineffective recanalization after EVT within 24 hours after the onset of acute cerebral infarction with basilar artery occlusion in the elderly is independently associated with the score of the National Institutes of Health Stroke Scale at admission, whether intravenous thrombolysis was bridged before treatment, the grade of arterial occlusive lesions, whether there was hemorrhage transformation after surgery, and the ratio of neutrophils to lymphocytes.
探索 PDCA循环模式应用于麻精药品规范化管理的效果。方法：选取2023年6月至2025年7月该院所辖各科室 100例麻精药品管理全过程作为研究样本，随机分为实施 PDCA前（50例）与实施 PDCA后（50例），以 PDCA循环法对该类药物从购进到使用各个环节进行标准化管理，比较两组管理前后相关质控指标的变化情况。结果：实施后，我院麻精药品管理质量显著提升：库存周转率由 2.15次/月提升至 3.52次/月，提高63.72%；处方合格率由 87.50% 提升至?96.80%；空安瓿批号准确率由 84.30% 提升至?98.50%。同时，处方质量评分从73.41±7.85 升至 96.93±1.62分P<0.001；审核规范性得分从20.16±3.97分增长到25.85±3.18分（P=0.001）；登记完整性和及时性得分分别从22.33±4.15分和20.15±4.21分增加到26.87±3.38分和23.85±3.62分P<0.001；用药合理性得分从19.25±4.13分增至22.07±3.34分P=0.003。此外，处方医师知晓WHO治疗方案的比例增加。 医务人员对麻精药品专业知识掌握程度大幅提升，总体得分由74.00±3.43分涨至92.60±2.58分P<0.001，其中WHO治疗方案知识掌握度增加幅度最大，达78.7%（P=0.001）。结论：PDCA循环管理模式可有效地促进麻精药品管理工作的开展，最大限度地保障患者的安全并简化操作程序，并且能够使医护人员的知识水平以及专业素养得到有效提升，为医疗卫生机构麻精药品的规范化管理工作提供切实可行的方法。
To explore the effectiveness of applying the PDCA cycle model in standardized management of anesthetic and psychotropic drugs. Method: A total of 100 cases from all departments under the hospital's jurisdiction were selected as research samples covering the entire process of psychotropic and anesthetic drug management from June 2023 to July 2025. These cases were randomly divided into two groups: 50 before implementing the PDCA cycle (pre-implementation) and 50 after implementation. The PDCA cycle method was applied to standardize drug management from procurement to usage, with comparative analysis of quality control indicators before and after implementation. Results:Following the implementation, our hospital's quality management of anesthetic and psychotropic drugs has shown significant improvements: Inventory turnover rate increased from 2.15 times/month to 3.52 times/month, representing a 63.72% improvement; prescription qualification rate rose from 87.50% to 96.80%; accuracy rate of empty ampoule batch numbers improved from 84.30% to 98.50%. Concurrently, prescription quality scores jumped from 73.41±7.85 to 96.93±1.62 points (P<0.001); audit standardization scores grew from 20.16±3.97 to 25.85±3.18 points (P=0.001); registration completeness and timeliness scores increased from 22.33±4.15 and 20.15±4.21 points respectively to 26.87±3.38 and 23.85±3.62 points (P<0.001); medication rationality scores rose from 19.25±4.13 to 22.07±3.34 points (P=0.003). Additionally, the proportion of prescribing physicians familiar with WHO treatment protocols saw notable growth. Medical staff's expertise in anesthetic and psychotropic drug knowledge improved substantially, with overall scores rising from 74.00±3.43 to 92.60±2.58 points (P<0.001), particularly marked by a 78.7% increase in WHO protocol knowledge mastery (P=0.001).Conclusion: The PDCA cycle management mode can effectively promote the development of narcotic drug management, maximize the safety of patients and simplify the operation procedures, and can effectively improve the knowledge level and professional quality of medical staff, providing a feasible method for the standardized management of narcotic drugs in medical and health institutions.
目的 探究小剂量多巴胺联合重组人脑利钠肽（rhBNP）对射血分数降低心力衰竭（HFrEF）肾血流阻力指数（RRI）及利尿效果的作用。方法 选择2022年10月-2025年9月104例于本院诊治的HFrEF患者，随机对照法分为两组，在接受心力衰竭常规治疗基础上，对照组接受rhBNP治疗，观察组接受小剂量多巴胺联合rhBNP治疗。比较两组RRI、利尿效果、心肾功能指标及不良反应。结果 两组治疗前血肌酐（SCr）、尿素氮（BUN）、估算肾小球滤过率（eGFR）及RRI均无统计学差异（P>0.05），治疗后两组SCr、BUN、RRI下降、而eGFR上升（P<0.05），且与对照组相比，观察组SCr、BUN、RRI更低、eGFR更高（P<0.05）。治疗期间观察组24 h尿量多于对照组，治疗前后观察组体质量下降幅度高于对照组（P<0.05）。两组治疗前左心室射血分数（LVEF）、N末端前脑钠肽（NT-proBNP）无统计学差异（P>0.05），治疗后两组LVEF升高、NT-proBNP降低（P<0.05），且与对照组相比，观察组LVEF更高、NT-proBNP更低（P<0.05）。对照组（3/52）与观察组（5/52）不良反应比较，差异无统计学意义（χ2=0.135，P>0.05）。结论 小剂量多巴胺联合rhBNP治疗HFrEF患者可降低肾血流阻力指数，改善肾脏血流灌注与心肾功能，加强利尿效果，且具有良好安全性。
Objective To investigate the effects of low-dose dopamine combined with recombinant human brain natriuretic peptide (rhBNP) on renal blood flow resistance index (RRI) and diuretic efficacy in patients with heart failure with reduced ejection fraction (HFrEF). Methods From October 2022 to September 2025, 104 HFrEF patients treated at our hospital were randomly divided into two groups. Both groups received standard heart failure therapy; the control group received rhBNP alone, while the study group received low-dose dopamine combined with rhBNP. The RRI, diuretic effect, cardiac and renal function indicators, and adverse reactions were compared between the two groups. Results Before treatment, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and RRI showed no significant differences between the two groups (P > 0.05). After treatment, both groups exhibited decreased SCr, BUN, and RRI, along with increased eGFR (P < 0.05). Compared with the control group, the study group had significantly lower SCr, BUN, and RRI, and higher eGFR (P < 0.05). During treatment, the study group had greater 24-hour urine output than the control group, and the reduction in body weight was more pronounced in the study group before and after treatment (P < 0.05). There were no significant differences in left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups before treatment (P > 0.05). After treatment, both groups showed improved LVEF and reduced NT-proBNP levels (P < 0.05), and the study group demonstrated higher LVEF and lower NT-proBNP compared to the control group (P < 0.05). Adverse reactions occurred in 3 out of 52 patients in the control group and 5 out of 52 in the study group, showing no statistically significant difference (χ2 = 0.135, P > 0.05). Conclusion Low-dose dopamine combined with rhBNP can reduce the renal blood flow resistance index, improve renal perfusion and cardiorenal function, enhance diuresis, and is safe and well-tolerated.
目的 探究小剂量多巴胺联合重组人脑利钠肽（rhBNP）对射血分数降低心力衰竭（HFrEF）肾血流阻力指数（RRI）及利尿效果的作用。方法 选择2022年10月-2025年9月104例于本院诊治的HFrEF患者，随机对照法分为两组，在接受心力衰竭常规治疗基础上，对照组接受rhBNP治疗，观察组接受小剂量多巴胺联合rhBNP治疗。比较两组RRI、利尿效果、心肾功能指标及不良反应。结果 两组治疗前血肌酐（SCr）、尿素氮（BUN）、估算肾小球滤过率（eGFR）及RRI均无统计学差异（P>0.05），治疗后两组SCr、BUN、RRI下降、而eGFR上升（P<0.05），且与对照组相比，观察组SCr、BUN、RRI更低、eGFR更高（P<0.05）。治疗期间观察组24 h尿量多于对照组，治疗前后观察组体质量下降幅度高于对照组（P<0.05）。两组治疗前左心室射血分数（LVEF）、N末端前脑钠肽（NT-proBNP）无统计学差异（P>0.05），治疗后两组LVEF升高、NT-proBNP降低（P<0.05），且与对照组相比，观察组LVEF更高、NT-proBNP更低（P<0.05）。对照组（3/52）与观察组（5/52）不良反应比较，差异无统计学意义（χ2=0.135，P>0.05）。结论 小剂量多巴胺联合rhBNP治疗HFrEF患者可降低肾血流阻力指数，改善肾脏血流灌注与心肾功能，加强利尿效果，且具有良好安全性。
Objective To investigate the effects of low-dose dopamine combined with recombinant human brain natriuretic peptide (rhBNP) on renal blood flow resistance index (RRI) and diuretic efficacy in patients with heart failure with reduced ejection fraction (HFrEF). Methods From October 2022 to September 2025, 104 HFrEF patients treated at our hospital were randomly divided into two groups. Both groups received standard heart failure therapy; the control group received rhBNP alone, while the study group received low-dose dopamine combined with rhBNP. The RRI, diuretic effect, cardiac and renal function indicators, and adverse reactions were compared between the two groups. Results Before treatment, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and RRI showed no significant differences between the two groups (P > 0.05). After treatment, both groups exhibited decreased SCr, BUN, and RRI, along with increased eGFR (P < 0.05). Compared with the control group, the study group had significantly lower SCr, BUN, and RRI, and higher eGFR (P < 0.05). During treatment, the study group had greater 24-hour urine output than the control group, and the reduction in body weight was more pronounced in the study group before and after treatment (P < 0.05). There were no significant differences in left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups before treatment (P > 0.05). After treatment, both groups showed improved LVEF and reduced NT-proBNP levels (P < 0.05), and the study group demonstrated higher LVEF and lower NT-proBNP compared to the control group (P < 0.05). Adverse reactions occurred in 3 out of 52 patients in the control group and 5 out of 52 in the study group, showing no statistically significant difference (χ2 = 0.135, P > 0.05). Conclusion Low-dose dopamine combined with rhBNP can reduce the renal blood flow resistance index, improve renal perfusion and cardiorenal function, enhance diuresis, and is safe and well-tolerated.
目的 探究小剂量多巴胺联合重组人脑利钠肽（rhBNP）对射血分数降低心力衰竭（HFrEF）肾血流阻力指数（RRI）及利尿效果的作用。方法 选择2022年10月-2025年9月104例于本院诊治的HFrEF患者，随机对照法分为两组，在接受心力衰竭常规治疗基础上，对照组接受rhBNP治疗，观察组接受小剂量多巴胺联合rhBNP治疗。比较两组RRI、利尿效果、心肾功能指标及不良反应。结果 两组治疗前血肌酐（SCr）、尿素氮（BUN）、估算肾小球滤过率（eGFR）及RRI均无统计学差异（P>0.05），治疗后两组SCr、BUN、RRI下降、而eGFR上升（P<0.05），且与对照组相比，观察组SCr、BUN、RRI更低、eGFR更高（P<0.05）。治疗期间观察组24 h尿量多于对照组，治疗前后观察组体质量下降幅度高于对照组（P<0.05）。两组治疗前左心室射血分数（LVEF）、N末端前脑钠肽（NT-proBNP）无统计学差异（P>0.05），治疗后两组LVEF升高、NT-proBNP降低（P<0.05），且与对照组相比，观察组LVEF更高、NT-proBNP更低（P<0.05）。对照组（3/52）与观察组（5/52）不良反应比较，差异无统计学意义（χ2=0.135，P>0.05）。结论 小剂量多巴胺联合rhBNP治疗HFrEF患者可降低肾血流阻力指数，改善肾脏血流灌注与心肾功能，加强利尿效果，且具有良好安全性。
Objective To investigate the effects of low-dose dopamine combined with recombinant human brain natriuretic peptide (rhBNP) on renal blood flow resistance index (RRI) and diuretic efficacy in patients with heart failure with reduced ejection fraction (HFrEF). Methods From October 2022 to September 2025, 104 HFrEF patients treated at our hospital were randomly divided into two groups. Both groups received standard heart failure therapy; the control group received rhBNP alone, while the study group received low-dose dopamine combined with rhBNP. The RRI, diuretic effect, cardiac and renal function indicators, and adverse reactions were compared between the two groups. Results Before treatment, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and RRI showed no significant differences between the two groups (P > 0.05). After treatment, both groups exhibited decreased SCr, BUN, and RRI, along with increased eGFR (P < 0.05). Compared with the control group, the study group had significantly lower SCr, BUN, and RRI, and higher eGFR (P < 0.05). During treatment, the study group had greater 24-hour urine output than the control group, and the reduction in body weight was more pronounced in the study group before and after treatment (P < 0.05). There were no significant differences in left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups before treatment (P > 0.05). After treatment, both groups showed improved LVEF and reduced NT-proBNP levels (P < 0.05), and the study group demonstrated higher LVEF and lower NT-proBNP compared to the control group (P < 0.05). Adverse reactions occurred in 3 out of 52 patients in the control group and 5 out of 52 in the study group, showing no statistically significant difference (χ2 = 0.135, P > 0.05). Conclusion Low-dose dopamine combined with rhBNP can reduce the renal blood flow resistance index, improve renal perfusion and cardiorenal function, enhance diuresis, and is safe and well-tolerated.
