目的 探究综合性口腔护理干预方案在机械通气患儿中的应用效果。方法 将2023年5月—12月泉州市妇幼保健院重症监护科接收的66例机械通气患儿选为研究对象。以密封信封抽签法分为综合干预组（n=33）及常规干预组（n=33）。常规干预组实施常规口腔护理，综合干预组实施综合性口腔护理模式干预。对比两组患儿口腔情况、并发症、静态全唾液流率（UWS）及机械通气时间。结果 干预后综合干预组Beck总分为（6.33±1.05）分，低于常规干预组的（8.55±1.85）分（t=6.069，P＜0.001）。综合干预组出现呼吸机相关肺炎（VAP）发生率较常规干预组更低（3.03% vs 18.18%）（χ²=3.995，P=0.046）。干预后综合干预组UWS为（0.37±0.09）mg/min，高于常规干预组的（0.29±0.09）mg/min（t=3.611，P=0.001）。结论 综合性口腔护理模式能较大程度改进机械通气患儿的口腔卫生问题，对菌斑、口腔异味及牙龈情况均有改善作用；也能减少并发症发生率，提升UWS，维持口腔卫生健康。

      Objective To explore the effect of comprehensive oral nursing intervention in children with mechanical ventilation．Methods A total of 66 mechanically ventilated children admitted to the intensive care department of the hospital from May 2023 to December 2023 were selected as the study objects．They were divided into comprehensive intervention group（n=33）and routine intervention group（n=33）by sealed envelope lottery method．The routine intervention group implemented routine oral care，and the comprehensive intervention group implemented comprehensive oral care mode intervention．Oral conditions，complications，unstimulated whole saliva（UWS）and mechanical ventilation time were compared between the two groups．Results After the intervention，the total Beck score of the comprehensive intervention group was（6.33±1.05），which was lower than that of the conventional intervention group（［8.55±1.85］，t=6.069，P＜0.001）．The incidence of ventilator-associated pneumonia（VAP）in the comprehensive intervention group was lower than that in the conventional intervention group（3.03% vs 18.18%）（χ²=3.995，P=0.046）．After the intervention，the UWS of the comprehensive intervention group was（0.37±0.09）mg/min，which was higher than that of the conventional intervention group（［0.29±0.09］ mg/min，t=3.611，P=0.001）．Conclusions The comprehensive oral care mode can improve the oral health of children with mechanical ventilation to a great extent，and can improve the plaque，oral odor and gingiva condition．It can also reduce the incidence of complications，improve UWS，and maintain oral health．

       目的 调查重型β地中海贫血患儿照顾者的负担现状，并分析其影响因素，为医护人员制定干预方案提供依据。方法 采用便利抽样法，于2024年1月—12月选取华南地区5家医院就诊的重型β地中海贫血患儿的主要照顾者作为调查对象，采用一般资料调查表、Zarit照顾者负担量表、中文简化版家庭弹性量表和社会支持评定量表进行调查，并采用单因素分析、相关性分析及多重线性回归探究其影响因素。结果 共发放问卷242份，回收232份，回收率为95.87%。重型β地中海贫血患儿主要照顾者照顾负担的总体平均得分为（36.67±18.63）分。多重线性回归分析结果显示，患儿输血频率、输血相关性皮肤过敏和社会支持是患儿照顾负担的影响因素（P＜0.001），可解释总变异的23.9%。结论 重型β地中海贫血患儿照顾者负担程度以中重度为主。患儿曾出现输血不良反应、输血频率更高，其照顾者负担更重；而主要照顾者具有良好的社会支持水平有助于降低其照顾者负担。医护人员应针对以上因素制定干预方案，以减轻重型β地中海贫血患儿照顾者负担水平。

      Objective To investigate the current burden in caregivers of children with β thalassemia major and analyze its influencing factors，so as to provide a basis for medical staff to formulate intervention plans．Methods By using the convenience sampling method，primary caregivers of children with β thalassemia major from five hospitals in South China from January to December 2024 were selected as the survey subjects．The general information questionnaire，Zarit Caregiver Burden Scale，Simplified Chinese Family Resilience Scale and Social Support Rating Scale were used for the survey．And univariate analysis，correlation analysis and multiple linear regression were adopted to explore its influencing factors．Results A total of 242 questionnaires were distributed and 232 were retrieved，with a recovery rate of 95.87%．The overall average score of care burden for primary caregivers of children with β thalassemia major was（36.67±18.63）．The results of multiple linear regression analysis showed that the frequency of blood transfusion in children，transfusion-related skin allergy and social support were the influencing factors of the care burden（P＜0.001），which could explain 23.9% of the total variation．Conclusions The burden level in caregivers of children with β thalassemia major is mainly moderate to severe．The children with adverse reactions to blood transfusion and higher frequency of blood transfusion impose a heavier burden on its caregivers．The primary caregivers who have good social support can help reduce the burden．Medical staff should formulate intervention plans based on the above factors to reduce the burden level of caregivers of children with β thalassemia major．

       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．

目的 研究基于儿童早期预警评分（PEWS）的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组（n=50）及对照组（n=50）。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程（相关指标涵盖症状持续时长及住院天数）、呼吸功能（涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量）、并发症发生情况（涵盖呼吸机相关性肺炎、肺大疱及胸膜炎）、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组（均P<0.05）。研究组各项呼吸功能指标水平均高于对照组（均P<0.05）。两组各项并发症发生率对比差异无统计学意义（P>0.05）。研究组患儿家属满意度高于对照组（96.00% vs 82.00%,P<0.05）。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。

Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score（PEWS）on the recovery process and respiratory function of children with severe pneumonia．Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed．Those children were divided into study group（n=50）and control group（n=50）according to the difference of intervention methods．Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group．The two groups were compared with each other in terms of recovery process（including duration of symptoms and length of stay）,respiratory function（including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity）,complications（including ventilators associated pneumonia,bullosa and pleurisy）,and family member satisfaction．Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group（all P<0.05）．The levels of respiratory function indexes in study group were higher than those in control group（all P<0.05）．There was no significant difference in the incidence of complications between the two groups（P>0.05）．The satisfaction of family member in the study group was higher than that in the control group（96.00% vs 82.00%）（P<0.05）．Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia．

目的 分析感恩拓延-建构理论在血友病患儿家庭护理中的应用效果。方法 对2021年1月—2022年1月期间在河南省儿童医院治疗的116例血友病患儿进行随机数表法分组,两组各58例。对照组给予常规临床干预,观察组给予感恩拓延-建构理论干预。比较两组患儿的负性情绪评分、家庭功能评分、自我意识评分、功能独立性评分、感恩问卷评分。结果 干预后观察组的焦虑性情绪障碍筛查表（SCARED）、儿童抑郁障碍自评量表（DSRSC）评分、各项家庭功能评分均低于对照组,干预后观察组的各项自我意识评分、各项功能独立性评分、感恩问卷评分均高于对照组,差异统计学有意义（P<0.05）。结论 感恩拓延-建构理论干预能够在一定程度上改善血友病患儿的负性情绪、家庭功能、自我意识、独立性及感恩水平。

Objective To analyze the application effect of gratitude extension-construction theory in family nursing of children with haemophilia．Methods A total of 116 children with haemophilia from January 2021 to January 2022 were randomly divided into two groups,58 children in each group．The control group received routine clinical intervention,while the observation group received gratitude extension-construction theory intervention．The negative emotional scores,family function scores,self-awareness scores,functional independence scores and gratitude questionnaire scores between the two groups were compared．Results After intervention,the SCARED,DSRSC,and family function scores of the observation group were lower than those of the control group．The self-awareness score,functional independence score,and gratitude questionnaire score of the observation group were higher than those of the control group,and the differences were significant（P<0.05）．Conclusions Gratitude extension-construction theory intervention can improve the negative emotion,family function,self-consciousness,independence and gratitude level of children with haemophilia to a certain extent．

目的 研究甲泼尼龙琥珀酸钠对重症支原体肺炎（SMPP）患儿的治疗效果及安全性。方法 采用随机数表法将南华大学附属长沙中心医院2021年1月—2022年12月收治的108例SMPP患儿分为两组,对照组（54例）采用常规治疗,研究组（54例）采用常规治疗联合甲泼尼龙琥珀酸钠治疗,比较2组临床疗效。结果 治疗后研究组炎症因子水平低于对照组,肺功能指标、健康状况评分均高于对照组,发热、咳嗽、肺啰音及肺阴影消失时间均短于对照组（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 应用甲泼尼龙琥珀酸钠治疗可加快患儿症状缓解,改善机体炎症反应及肺功能,且安全性较高。

Objective To study the therapeutic effect and safety of methylprednisolone sodium succinate on children with severe Mycoplasma pneumoniae pneumonia（SMPP）．Methods A total of 108 children with SMPP admitted to Changsha Central Hospital from January 2021 to December 2022 were divided into two groups by random number table method．The control group（54 cases）was treated with conventional therapy,and the study group（54 cases）was treated with conventional therapy combined with methylprednisolone sodium succinate．The clinical effects of the two groups were compared．Results After treatment,the levels of inflammatory factors in the study group were lower than those in the control group,and lung function indicators and health status scores were higher than those in the control group．The disappearance time of fever,cough,lung rales and lung shadows was shorter than that in the control group（P<0.05）．There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0.05）．Conclusions The application of methylprednisolone sodium succinate treatment can accelerate the relief of symptoms in children,improve the body's inflammatory response and lung function,and has high safety．

目的 探讨计划-实施-检查-处理（PDCA）循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压（PaO₂）、动脉血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）]、肺功能指标[第1秒用力呼气容积（FEV₁）、潮气量（VT）]、炎症免疫指标[单核细胞趋化蛋白-1（MCP-1）、可溶性髓系细胞触发受体-1（sTREM-1）、可溶性细胞间黏附分子-1（sICAM-1）]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义（P<0.05）。干预前,两组患儿PaO₂、SaO₂、PaCO₂、FEV₁、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义（P>0.05）;干预后,两组患儿上述指标水平均有不同程度变化（P<0.05）,观察组PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）、SaO₂（93.58±3.82% vs 86.30±4.21%）、FEV₁（2.66±0.46 L vs 1.97±0.34 L）、VT（11.92±1.89% vs 9.83±1.10%）水平均高于对照组,观察组PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）、MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）、sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）、sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）水平低于对照组,差异均有统计学意义（P<0.05）。观察组患儿家属满意度整体优于对照组（P<0.05）;观察组总满意率（97.5% vs 77.5%）高于对照组,差异有统计学意义（P<0.05）。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。

Objective To explore the application effect of Plan-Do-Check-Action（PDCA）circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation．Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study．Based on the random number table method,they were divided into two groups,with 40 cases in each group．The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention．The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure（PaO₂）,arterial oxygen saturation（SaO₂）,arterial partial pressure of carbon dioxide（PaCO₂）],lung function indicators [（forced expiratory volume in 1 second,FEV₁）,tidal volume（VT）],and inflammatory immune indicators [monocyte chemotactic protein-1（MCP-1）,soluble myeloid cell trigger receptor-1（sTREM-1）,soluble intercellular adhesion molecule-1（sICAM-1）] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared．Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Before intervention,there was no statistically significant difference in the levels of PaO₂,SaO₂,PaCO₂,FEV₁,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children（P>0.05）．After intervention,the levels of the above indicators in both groups of children showed varying degrees of change（P<0.05）．The levels of PaO₂（97.18±7.90 mmHg vs 90.30±7.12 mmHg）,SaO₂（93.58±3.82% vs 86.30±4.21%）,FEV₁（2.66±0.46 L vs 1.97±0.34 L）,VT（11.92±1.89% vs 9.83±1.10%）in the observation group were higher than those in the control group．The levels of PaCO₂（36.70±3.97 mmHg vs 40.65±3.79 mmHg）,MCP-1（58.45±11.94 ng/L vs 74.46±16.69 ng/L）,sTREM-1（36.25±8.30 ng/L vs 51.57±9.51 ng/L）and sICAM-1（187.52±31.22 mg/L vs 243.73±46.79 mg/L）in the observation group were lower than those of the control group,with statistically significant differences（P<0.05）．The overall satisfaction of the observation group was better than that of the control group（P<0.05）,the total family members’ satisfaction rate of the observation group was higher than that of the control group（97.5% vs 77.5%）,with a statistically significant difference（P<0.05）．Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction．

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

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

目的 探讨俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果。方法 选取泉州市儿童医院2020年9月—2023年9月收治的72例脓毒症合并急性肺损伤患儿,应用抽签法将其分为观察组与对照组,均为36例。对照组患儿实施常规仰卧位机械通气与对应护理,观察组患儿在常规护理基础上增加俯卧位通气与对应护理。对比两组患儿机械通气时间,干预前和干预3 d后气道平台压和心率水平,动脉血二氧化碳分压（PaCO₂）、动脉血氧分压（PaO₂）,并计算动脉血氧分压与吸入气中的氧浓度分数比值（PaO₂/FiO₂）,评价两组患儿预后及不良事件发生情况。结果 观察组机械通气时间明显低于对照组（P<0.05）,干预后两组患儿气道平台压、心率均降低,且观察组低于对照组（P<0.05）;干预后两组患儿PaO₂/FiO₂、PaO₂水平升高,观察组高于对照组,PaCO₂降低,观察组低于对照组（P<0.05）;干预后两组患儿全身性感染相关性器官功能衰竭评分（SOFA）、急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）评分均降低,观察组低于对照组（P<0.05）;两组患儿呼吸机管路折管、管路滑脱、压力性损伤等不良事件发生率对比差异无统计学意义（P>0.05）。结论 俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果显著,可降低患儿气道平台压及心率,缩短机械通气时间,改善患儿通气功能,有助提升预后水平。

Objective To explore the application effect of prone position ventilation in children with sepsis complicated with acute lung injury．Methods From September 2020 to September 2023,72 children with sepsis and acute lung injury admitted to Quanzhou Children's Hospital were selected and divided into observation group and control group by drawing lots,both with 36 cases．The children in the control group received routine supine mechanical ventilation and corresponding nursing,and the children in the observation group added prone ventilation and corresponding nursing on the basis of routine nursing．By comparing the duration of mechanical ventilation,airway plateau pressure and heart rate level,PaCO₂,PaO₂,PaO₂/FiO₂,the prognosis and occurrence of adverse events in the two groups were evaluated．Results The mechanical ventilation time in the observation group was significantly shorter than that in the control group（P<0.05）．After intervention,the airway plateau pressure and heart rate levels of the two groups of children decreased,and the observation group was lower than the control group（P<0.05）．After the intervention,the levels of PaO₂/FiO₂ and PaO₂ in the two groups of children increased,with the observation group higher than the control group,while the level of PaCO₂ was lower,with the observation group lower than the control group（P<0.05）．After the intervention,the SOFA and APACHE II scores of the two groups of children decreased,and the observation group was lower than the control group（P<0.05）．There was no difference in the incidence of adverse events such as ventilator tube folding,tube slip and pressure injury between the two groups（P>0.05）．Conclusions The application of prone position ventilation in children with sepsis combined with acute lung injury has a significant effect,which can reduce airway plateau pressure,lower heart rate,shorten mechanical ventilation time,improve ventilation function,and assist in improving prognosis．

目的 分析流行性感冒（流感）患儿的流行病学特征及病原学分布。方法 纳入2020年3月—2023年2月在开封市祥符区第一人民医院确诊为流感的394例1~10岁患儿的咽拭子标本,通过实时荧光定量聚合酶链式反应完成流感病毒检测,分析此394例流感患儿感染的病毒类型及年龄、季节、性别、年份等分布情况。结果 甲型H1N1流感病毒为本次研究检出占比最高的流感病毒,占36.04%;男女患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）;春季及冬季流感患儿占比最多,分别为41.12%、35.53%,且不同季节之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异有统计学意义（P<0.05）;7~10岁流感患儿占比最高,为42.13%,不同年龄段患儿之间的甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）;2020年流感患儿占比最高,为43.40%,后续依次为2022年的29.70%,2021年的26.90%;不同年份的冬季流感患儿占比比较差异有统计学意义（P<0.05）;不同年份的各年龄段流感患儿占比比较差异无统计学意义（P>0.05）;各年甲型H3、甲型H1N1、乙型BV、乙型BY流感病毒占比比较差异无统计学意义（P>0.05）。结论 年龄7~10岁的患儿为流感高危群体,且甲型流感为患儿主要感染类型,而甲型流感病毒多见于春、冬季,新型冠状病毒肺炎疫情期间防控政策变化对流感流行有影响,应加强春、冬季7~10岁年龄段患儿的甲流预防工作。

Objective To analyze the epidemiological characteristics and etiological distribution of children with influenza（flu）．Methods The throat swab specimens of 394 children aged 1 to 10 years old who were diagnosed with influenza at the First People's Hospital of Xiangfu District,Kaifeng City from March 2020 to February 2023 were included．The samples were analyzed by real-time fluorescence quantitative polymerase chain reaction to complete influenza virus detection and analyze the virus types and distribution of age,season,gender,year,etc．among these 394 children with influenza were analyzed．Results Influenza A H1N1 virus was the influenza virus with the highest proportion detected in this study,accounting for 36.04%;there were differences in the proportions of influenza A H3,A H1N1,BV,and B BY influenza viruses between male and female children,with no statistical significance（P>0.05）;the proportion of children with influenza is the largest in spring and winter,41.12% and 35.53% respectively,and proportions of influenza A H3,A H1N1,B BV,and B BY influenza in different seasons were significantly different（P<0.05）．Children aged 7 to 10 accounted for the highest proportion of influenza patients,42.13%．Among children of different ages,the proportion of influenza A H3,A H1N1,B BV,B BY had no statistically significant difference（P>0.05）．The proportion of children with influenza in 2020 was the highest at 43.40%,followed by 29.70% in 2022 and 26.90% in 21;in different years there is a statistically significant difference in the proportion of children with influenza in winter（P<0.05）．There is no statistically significant difference in the proportion of children with influenza of all ages in different years（P>0.05）．The preportions of influenza A H3 and A H1N1,B BV and B BY viruses in each year,had no statistically significant difference（P>0.05）．Conclusions Children aged 7 to 10 years old are a high-risk group for influenza,and influenza A is the main type of infection in children．Influenza A viruses are more common in spring and winter．Changes in prevention and control policies during the new coronavirus pneumonia epidemic have an impact on the epidemic of influenza．Therefore,prevention of influenza A for children aged 7 to 10 years old in spring and winter should be strengthened．