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目的 探讨自发性脑出血(SICH)患者静脉血栓栓塞症(VTE)的独立危险因素,并评估针对性分层预防措施的有效性及安全性, 为临床优化防治策略提供依据。方法 回顾性纳入2022年1月—2025年1月收治的86例SICH患者, 根据下肢深静脉超声结果分为深静脉血栓(DVT)组(n=16)与非DVT组(n=70)。采集患者基线资料、临床特征及实验室指标, 采用单因素及多因素Logistic回归分析VTE危险因素, 并基于独立危险因素制定分层预防方案。结果 多因素分析显示, 体质指数(BMI)升高(OR=1.22, 95%CI:1.06~1.41)、中心静脉置管(OR=5.23, 95%CI:1.37~19.95)、止血药物使用(OR=4.80, 95%CI:1.21~19.01)及NIHSS评分升高(OR=1.20, 95%CI:1.02~1.42)是VTE的独立危险因素(均P<0.05)。因此需针对SICH患者进行针对性干预, 包括基于BMI的个体化干预、中心静脉置管的精细化管控、止血药物的动态调控及神经功能保护与早期康复。结论 SICH患者VTE发生与代谢、医源性及神经功能损伤多因素交互作用密切相关, 应针对患者构建基于BMI、中心静脉管理及凝血监测的分层预防策略。
Objective To explore the independent risk factors for venous thromboembolism(VTE)in patients with spontaneous intracerebral hemorrhage(SICH)and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic.Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025.Based on lower-extremity venous ultrasound findings, patients were divided into a deep venous thrombosis(DVT)group(n=16)and a non-DVT group(n=70).Baseline characteristics, clinical features, and laboratory indicators were collected.Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors, and a stratified prevention protocol was developed based on independent risk factors.Results Multivariate analysis revealed that elevated body mass index(BMI)(OR=1.22, 95%CI:1.06-1.41), central venous catheterization(OR=5.23, 95%CI:1.37-19.95), hemostatic drug use(OR=4.80, 95%CI:1.21-19.01), and higher NIHSS scores(OR=1.20, 95%CI:1.02-1.42)were independent risk factors for VTE(all P<0.05).Consequently, targeted nursing interventions should be implemented for SICH patients, including BMI-based personalized care, refined management of central venous catheters, dynamic regulation of hemostatic drugs, and neuroprotective early rehabilitation.Conclusions VTE in SICH patients is closely associated with the interplay of metabolic, iatrogenic,and neurological injury factors.A stratified prevention strategy incorporating BMI monitoring, central venous catheter management, and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety.
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目的 通过戴明循环管理法的品管圈(QCC)活动, 提升内镜中心病理标本标识的正确率与病理标本管理安全性。方法 采用基于戴明循环管理法的QCC活动, 对内镜中心病理标本标识质量进行现状把握、原因分析并制定对策, 比较QCC活动开展前后内镜病理标本标识的正确率。结果 QCC活动后, 内镜中心病理标本标识的正确率从99.8%提高至100%(P<0.05)。结论 内镜中心通过开展基于戴明循环管理法的QCC活动, 显著提升了内镜病理标本管理安全性与工作效率。
Objective To improve the accuracy of pathological specimen identification and the safety of pathological specimen management in endoscopy center through quality control circle(QCC)activity based on Deming cycle management.Methods QCC activity based on Deming cycle management was used to summarize the status quo,analyze the causes and formulate countermeasures for the quality control of pathological specimen identification in endoscopy center.The accuracy rate of endoscopic pathological specimen identification before and after QCC activity was compared.Results After QCC activity, the accuracy of pathological specimen identification in endoscope center increased from 99.8% to 100%.Conclusions QCC activities based on Deming cycle management can greatly improve the safety and efficiency of endoscopic pathological specimen management.
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目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭(CHF)并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低(P<0.05)。与对照组相比,观察组干预后左室射血分数(LVEF)水平明显更高,超敏心肌肌钙蛋白T(hs-cTnT)、N末端B型利钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)水平更低(P<0.05)。与对照组相比, 观察组干预后主观整体营养状况评价表(PG-SGA)评分明显更低,血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)水平更高(P<0.05)。与对照组相比,观察组干预后症状、身体、情感及总分更低(P<0.05)。观察组不良事件发生率(1.96%)低于对照组(15.69%)(P<0.05)。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure(CHF)and frailty.Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included. According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention.The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups.Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention(P<0.05).Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention(P<0.05).Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention(P<0.05).Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention(P<0.05).The incidence of adverse events in the observation group(1.96%)was lower than that in the control group(15.69%)(P<0.05).Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events.
论著
目的 探究强化肢体沟通联合心理引导在肱骨髁上骨折患儿围术期照护中的应用。方法 选取2023年1月—2024年1月河南省儿童医院收治的84例肱骨髁上骨折患儿为研究对象。根据随机数字表法分为常规组和干预组, 每组各42例。对照组采用常规护理, 干预组采用强化肢体沟通联合心理引导的护理。比较两组肘关节功能疗效、疼痛程度、康复锻炼依从性、生活质量等。结果 两组优良率比较差异无统计学意义(P>0.05); 干预后,两组视觉模拟评分法(VAS)评分和儿童疼痛行为量表(FLACC)评分均降低,且干预组低于常规组(P<0.05); 干预组康复锻炼依从性为97.62%高于常规组的76.19%(P<0.05); 干预后, 两组生活质量均升高,且干预组高于常规组(P<0.05)。结论 强化肢体沟通联合心理引导对肱骨髁上骨折患儿护理效果显著, 可降低患者的疼痛程度,提高康复锻炼依从性,提高生活质量。
Objective To explore the application of strengthening physical communication combined with psychological guidance in perioperative care of children with supracondylar fracture of humerus.Methods From January 2023 to January 2024, 84 children with supracondylar fracture of humerus in Henan Children's Hospital were selected as the research objects.By the random number table method, these patients were evenly divided into the routine group and the observation group, with 42 patients each.The routine group received standard nursing care, while the observation group was provided with enhanced nursing interventions that incorporated physical communication and psychological guidance.A comparative analysis was conducted between the two groups in terms of elbow joint function recovery, pain intensity levels, compliance to rehabilitation exercises, and overall quality of life improvements.Results No statistically significant difference was observed in the proportion of excellent and good outcomes between the two groups(P>0.05).Following the implementation of the interventions, both the Visual Analog Scale(VAS)score and the Faces, Legs, Activity, Cry, Consolability(FLACC)score decreased in both groups,with the observation group demonstrating a more pronounced reduction compared to the routine group(P<0.05).The compliance rate for rehabilitation exercises in the observation group was notably higher, reaching 97.62%, in contrast to 76.19% of the routine group,with difference being statistically significant(P<0.05).Post-intervention, an improvement in the quality of life was noted in both groups,however,the observation group exhibited a superior increase compared to the routine group, with this superiority being statistically significant(P<0.05).Conclusions Strengthening physical communication combined with psychological guidance has obvious nursing effect on children with supracondylar fracture of humerus, which can reduce the pain degree of patients, improve the compliance of rehabilitation exercise and the quality of life.
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目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
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目的 本研究旨在探讨不同俯卧位通气(PPV)时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法 选择2020年7月—2023年7月在天津市人民医院重症监护病房(MICU)治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组(≥12 h, n=40)和短时组(<12 h, n=40)。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素(GAS)和血管活性肠肽(VIP)]、肠内营养达标率、胃肠并发症率等。结果 短时组治疗后, 1 d、3 d、5 d氧合指数为(189.93±33.72)、(247.53±63.01)、(325.03±58.11)mmHg,高于长时组的(161.63±36.88)、(191.83±57.65)、(267.95±46.25)mmHg,均P<0.05; 胃残留量为(29.00±7.92)、(19.75±4.45)、(11.00±1.87) mL低于长时组的(75.03±23.29)、(53.13±11.99)、(21.70±5.52) mL, 均P<0.05。短时组治疗后腹内压[(8.53±2.05)mmHg vs (9.75±2.05) mmHg]、VIP水平[(61.14±7.63) vs (67.49±4.43) pg/mL]低于长时组,GAS水平[(65.02±8.84) vs (54.22±9.21)pg/mL]升高(均P<0.05)。短时组总胃肠并发症发生率(7.50%)低于长时组(25.00%), P=0.034。结论 对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。
Objective To explore the effect of different duration of prone position ventilation(PPV)on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction.Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit(MICU)of a hospital from July 2020 to July 2023, and were selected as the research subjects.They were divided into the long-duration group(≥12 hours, n=40)and the short-duration group(<12 hours, n=40)according to the daily duration of PPV.The general data, oxygenation index, gastrointestinal function indicators(intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]), enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared.Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment([189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively)was significantly higher than that of the long-duration group([161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05).The gastric residual volume of the short-duration group([29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively)was significantly lower than that of the long-duration group([75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05).The intra-abdominal pressure([8.53±2.05] vs [9.75±2.05] mmHg)and VIP level([61.14±7.63] vs [67.49±4.43] pg/mL)of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level([65.02±8.84] vs [54.22±9.21] pg/mL)was significantly higher(all P<0.05).The total incidence of gastrointestinal complications in the short-duration group(7.50%)was significantly lower than that in the long-duration group(25.00%, P=0.034).Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance.
论著
目的 探索α-突触核蛋白(α-Syn)干预对人单核细胞白血病细胞系(THP-1)巨噬细胞源性泡沫细胞的影响。方法 通过佛波酯(PMA)和氧化型低密度脂蛋白(ox-LDL)构建THP-1巨噬细胞源性泡沫细胞模型,使用不同浓度(33、66、100、133 nmol/L)α-Syn处理泡沫细胞,随后检测细胞胆固醇含量和炎症因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)的mRNA表达以及核因子κB(NF-κB)和凝集素样氧化低密度脂蛋白受体-1(LOX-1)的蛋白表达变化。结果 高剂量(100和133 nmol/L)α-Syn处理可以减少THP-1巨噬细胞源性泡沫细胞内胆固醇的含量(P<0.05),并且减少IL-1β、IL-6和IL-8的mRNA表达(P<0.05)。进一步发现(100 nmol/L和133 nmol/L)α-Syn可以降低THP-1巨噬细胞源性泡沫细胞p-NF-κB和LOX-1的蛋白表达(P<0.05)。结论 α-Syn可以降低THP-1源性巨噬细胞泡沫细胞胆固醇蓄积和炎症反应,可能是通过下调p-NF-κB和LOX-1蛋白表达。
Objective To explore the effects of α-synuclein(α-Syn)intervention on human monocytic leukemia cell(THP-1)macrophage-derived foam cells.Methods The THP-1 macrophage-derived foam cell model was constructed by phorbol 12-myristate 13-acetate(PMA)and oxidized low-density lipoprotein(ox-LDL).Foam cells were treated with different concentrations(33, 66, 100, and 133 nmol/L)of α-Syn, and the cellular cholesterol contents, as well as the mRNA expression of IL-1β、IL-6 and IL-8 were detected.Subsequently,alternation in protein expression of NF-κB and LOX-1 was measured.Results High-dose(100 and 133nmol/L)α-Syn treatment significantly reduced the levels of intracellular cholesterol in THP-1-derived macrophage foam cells(P<0.05)and decreased the mRNA expression of IL-1β、IL-6 and IL-8(P<0.05).It was further found that(100 nmol/L and 133 nmol/L)α-Syn decreased the protein expression of p-NF-κB and LOX-1 in THP-1 macrophage-derived foam cells(P<0.05).Conclusions The results of the present study suggest that α-Syn reduces cholesterol accumulation and inflammatory response in THP-1-derived macrophage foam cells, possibly by down-regulating p-NF-κB and LOX-1 protein expression.
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目的 分析儿童大环内酯类耐药重症肺炎支原体肺炎(SMPP)的危险因素,构建列线图预测模型。 方法 回顾性收集2023年1月—2024年9月在广州医科大学附属番禺中心医院儿科住院治疗的1 121例大环内酯类耐药肺炎支原体肺炎患儿入院初期的临床资料。按7∶3比例将患儿资料随机分为训练集(784例)和验证集(337例)。采用R4.4.1软件使用10重交叉验证最小绝对收缩与选择算法(LASSO)回归分析进行单因素变量筛选,采用Logistics回归分析建立预测模型, 绘制可视化列线图。使用受试者操作特征曲线(ROC), 校准曲线、Hosmer-Lemeshow(HL)检验及临床决策曲线(DCA)分别评估模型的区分度、校准度和临床使用价值。 结果 在训练集中, LASSO回归结合Logistics回归分析结果显示,院前发热时间>5.5 d、谷丙转氨酶>14.5 U/L、乳酸脱氢酶>287.5 U/L、C反应蛋白>18.65 mg/L、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的危险因素(P<0.05), 根据上述危险因素构建列线图预测模型。训练集和验证集ROC曲线下面积分别为0.847和0.822; 校准曲线和HL检验显示模型具有良好的校准度; DCA显示预测模型在风险阈值为0.05~0.95时预测性能最优。 结论 院前发热时间、谷丙转氨酶、乳酸脱氢酶、C反应蛋白、肺实变、合并病毒感染是大环内酯类耐药SMPP发生的影响因素, 基于以上因素构建的列线图模型具有较好的预测效能, 有利于早期识别耐药重症病例, 及早采取有效干预,改善患者预后。
Objective To explore the risk factors and to construct a nomogram prediction model for severe macrolide-resistant Mycoplasma pneumoniae pneumonia(MPP)in children.Methods The clinical data during the initial admission period of 1 121 children with macrolide-resistant MPP who were hospitalized in the Department of Pediatrics of the Affiliated Panyu Central Hospital of Guangzhou Medical University from January 2023 to September 2024 were retrospectively collected.The children data were randomly divided into a training set(n=784)and a validation set(n=337)at a ratio of 7∶3.With R language software(version 4.4.1), least absolute shrinkage and selection operator(LASSO)regression analysis with tenfold cross-validation was used to screen risk factors, Logistics regression analysis was used to establish prediction model, and a visualization of the risk variables was created using a nomogram.The receiver operating characteristic(ROC)curves, calibration curves, Hosmer-Lemeshow(HL)test and clinical decision curve analysis(DCA)were used to evaluate the discrimination, calibration and clinical application value of the model.Results In the training set, LASSO regression analysis combined with Logistics regression analysis showed that prehospital fever duration > 5.5 days, alanine aminotransferase level> 14.5 U/L, lactate dehydrogenase level> 287.5 U/L, C-reactive protein > 18.65 mg/L, lung consolidation, and co-infection with virus were risk factors for severe macrolide-resistant MPP(P<0.05).A nomogram prediction model was constructed based on the above risk factors.The area under the ROC curves of the training set and the validation set were 0.847 and 0.822, respectively.The calibration curves and HL test showed that the model had good calibration. The DCA curves showed that the prediction model had the best prediction performance when the risk threshold was between 0.05-0.95.Conclusions Prehospital fever duration, alanine aminotransferase level, lactate dehydrogenase level, C-reactive protein level, lung consolidation and co-infection with virus were risk factors for prediction of severe macrolide-resistant MPP.The nomogram model based on the above factors had a good prediction efficiency, which was conducive to early identification of severe cases with macrolide-resistant, and taking early effective interventions to improve the prognosis.
论著
目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题:多重躯体症状负担持续存在(术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感); 负性心理情绪困扰(病耻感、疾病不确定感与复发恐惧); 心理调适过程(诊断冲击与认知失调、角色适应与主动应对); 创伤后成长与健康行为转变(生命意义感提升、健康促进行为强化); 强烈的康复信息支持需求(自我保健知识需求、结构化康复锻炼指导需求)。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。
Objective To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions.Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer.Colaizzi's 7-step analysis method was used to summarize and extract themes.Results Five themes and 12 sub-themes were summarized:Persistent burden of multiple physical symptoms(postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue); negative emotional experiences(stigma of illness, illness uncertainty and fear of recurrence); psychological adjustment processes(diagnostic shock and denial, role acceptance and active coping); post-traumatic growth and health behavior transformation(enhanced sense of meaning in life, strengthened health-promoting behaviors); strong demand for rehabilitation information support(self-care knowledge, rehabilitation exercise knowledge).Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life.
综述
炎症性肠病是一种慢性复发性疾病, 患者希望水平较低, 可能加剧疾病活动度、降低治疗依从性并降低其生活质量。文章从炎症性肠病患者希望水平的现状、评估工具、影响因素及干预方法四方面进行综述, 剖析现存挑战并提出未来研究方向, 旨在提升医护人员对希望水平管理的重视,为进一步构建科学、合理的炎症性肠病患者希望水平规范化管理方案提供参考。
Inflammatory bowel disease(IBD)is a chronic and frequently recurring disease, and low level of hope in patients may exacerbate disease activity, reduce treatment adherence,and lower their quality of life.This article reviews the current situation of hope level, assessment tools, influencing factors and intervention methods, to analyze the existing challenges and proposes future research directions, aiming to raise the attention of hope level management among healthcare professionals, and to provide reference for the construction of a scientific, reasonable and standardized management plan for hope level of patients with inflammatory bowel disease.