目的 评估在城市医疗集团模式下，于医院就诊人群中实施基于单导联心房颤动（房颤）检测棒的机会性房颤筛查的长期成本效益。方法 基于经广州市本地流行病学数据校准的Markov模型，比较未筛查与基于单导联房颤检测棒的不同筛查频率（季度、半年、年度）的机会性筛查策略，从卫生服务提供方视角评估成本与质量调整生命年（QALY），计算增量净货币收益（INMB）与成本效果比（ICER），并进行概率及情景敏感性分析。结果 所构建的房颤模型具有良好的预测效度。在基线假设下，季度筛查策略表现最优，相较未筛查组可增加0.525 5个QALY，节省成本15?626.61元，INMB为85 312.14元。敏感性分析显示，抗凝治疗依从性对成本效益影响最大。情景分析中，不同灵敏度与特异度假设未改变最优策略结论。结论 在城市医疗集团情境下，针对65岁及以上就诊老年人群的基于单导联房颤检测棒的季度机会性房颤筛查具备稳健的成本效益。结合分级诊疗体系和全流程管理，以依从性管理作为干预重点，能够最大化卒中预防收益并提高资源配置效率。

      Objective To evaluate the long-term cost-effectiveness of opportunistic atrial fibrillation（AF）screening using a single-lead handheld ECG device among hospital-attending adults within an urban medical consortium．Methods No screening and opportunistic screening at different frequencies（quarterly，semiannual，and annual）were compared by a Markov model calibrated to Guangzhou-specific epidemiological data．From the healthcare provider perspective，we estimated costs and quality-adjusted life-years（QALYs），calculated incremental net monetary benefit（INMB）and incremental cost-effectiveness ratio（ICER），and performed probabilistic and scenario sensitivity analyses．Results The AF model demonstrated good predictive validity．Under the baseline scenario，quarterly screening was the optimal strategy，yielding a gain of 0.525 5 QALYs，cost savings of CNY 15 626.61，and an INMB of CNY 85 312.14 versus no screening．Sensitivity analyses indicated that adherence to anticoagulation had the greatest impact on cost-effectiveness．Scenario analyses varying diagnostic sensitivity and specificity did not change the conclusion regarding the optimal strategy．Conclusions In the context of an urban medical consortium，quarterly opportunistic AF screening based on a single-lead handheld ECG device for hospital-attending adults aged ≥65 years is robustly cost-effective．Integrating screening into tiered care with end-to-end management，while prioritizing adherence management，can maximize stroke-prevention benefits and improve resource allocation efficiency．

       目的 探讨营养风险管理结合分期饮食指导对溃疡性结肠炎（UC）患者营养状况的影响。方法 选择郑州市大肠肛门病医院收治的90例UC患者，纳入时间为2024年1月—2025年1月，按照计算机分组法分为对照组（45例），给予分期饮食指导，观察组（45例），在对照组的基础上增加营养风险管理，观察两组患者症状改善情况、营养状况、生活质量。结果 干预后，观察组Mayo评分（4.30±1.14）分、主观整体营养状况评价表（PG-SGA）评分（1.74±0.38）分低于对照组（5.48±1.33、2.28±0.43）分（P＜0.05）；观察组血红蛋白（HB）、前白蛋白（PA）、白蛋白（ALB）水平高于对照组（P＜0.05），IBDQ各维度评分及总分更高（P＜0.05）。结论 对UC患者应用营养风险管理结合分期饮食指导，能够减轻临床症状，改善营养状况，促进生活质量的提升。

       Objective To explore the influence of nutritional risk management combined with staged dietary guidance on the nutritional status of ulcerative colitis（UC）patients．Methods A total of 90 UC patients admitted to our hospital were selected and included from January 2024 to January 2025．According to the computer grouping method，45 cases were divided into control group with staged dietary guidance，and 45 cases were divided into observation group with nutritional risk management．The symptoms improvement，nutritional status，and quality of life of the two groups were observed．Results After intervention，the observation group had lower Mayo score（4.30±1.14）and Patient?Generated Subjective Global Assessment（PG-SGA）score（1.74±0.38）than the control group（5.48±1.33 and 2.28±0.43，respectively）（P＜0.05）；the observation group had higher levels of hemoglobin（HB），prealbumin（PA），and albumin（ALB）than the control group（P＜0.05），and also had higher scores in all dimensions and total score of the Inflammatory Bowel Disease Questionnaire（IBDQ）（P＜0.05）．Conclusions The application of nutrition risk management combined with staged dietary guidance in UC patients can reduce clinical symptoms，improve nutritional status，promote the improvement of life quality．

      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．

       目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者，随机分为对照组（43例）、舒肝解郁胶囊组（43例），均进行常规治疗及体外反搏治疗，舒肝解郁胶囊组加用舒肝解郁胶囊，测量并比较两组患者治疗前后心肺功能，评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数（LVEF）和最大摄氧量（VO2max）均显著高于对照组（P＜0.05）；治疗后舒肝解郁胶囊组汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分均低于对照组（P＜0.05）；舒肝解郁胶囊组总有效率高于对照组（P＜0.05）；治疗后舒肝解郁胶囊组生活质量综合评定问卷（GQOLI-74）各维度评分均显著高于对照组（P＜0.05）。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著，可减轻患者负面情绪，改善其心肺功能及生活质量。

     Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention（PCI）．Methods From January 2023 to January 2025，86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group（43 cases） and a Shugan Jieyu Capsule group（43 cases）．All patients received conventional treatment and external counterpulsation．The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition．Cardiopulmonary function was measured and compared before and after treatment between the two groups，and anxiety and depression，clinical efficacy，and quality of life were evaluated．Results After treatment，the left ventricular ejection fraction（LVEF） and maximum oxygen uptake（VO2max） in the Shugan Jieyu Capsule group were significantly higher than those in the control group（P＜0.05）．The Hamilton Anxiety Rating Scale（HAMA） and Hamilton Depression Rating Scale（HAMD） scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group（P＜0.05）．The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group（P＜0.05）．After treatment，the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74（GQOLI-74） in the Shugan Jieyu Capsule group were significantly higher than those in the control group（P＜0.05）．Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI，alleviating negative emotions and improving cardiopulmonary function and quality of life．

       目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．

       目的 探究右美托咪定对腋路臂丛神经阻滞联合肩胛上神经阻滞患者术后反弹性疼痛的影响。方法 收录2024年9月—2025年10月期间我院接受肩关节镜手术治疗的患者，合计收录样本量为150例，将患者随机分为两组（n=150）：常规腋路臂丛神经阻滞联合肩胛上神经阻滞组（N组，n=75）、复合右美托咪定的腋路臂丛神经阻滞联合肩胛上神经阻滞组（D组，n=75）；评价组间反弹性疼痛、术后恢复情况及应急指标差异。结果 术后2 h、6 h、12 h、24 h疼痛视觉模拟量表（VAS）评分D组较N组更低（P＜0.05）。反弹性疼痛发生率D组（5.33%）较N组（20.00%）更低，首次发作时间D组较N组更迟，持续时间D组较N组更短（P＜0.05）。术后补救镇痛次数、阿片类药物用量、非甾体药物使用率D组较N组更低（P＜0.05）。术后首次下床时间和住院时长D组较N组更短，满意度评分D组较N组更高（P＜0.05）。不良反应发生率D组与N组比较，差异无统计学意义（P＞0.05）。术前组间应激反应指标未见明显差异，术后24 h两组均有不同程度的指标变化，但相较N组而言，D组心率、平均动脉压、收缩压、舒张压变化幅度更小（P＜0.05）。结论 右美托咪定用于腋路臂丛神经阻滞联合肩胛上神经阻滞患者，在降低术后疼痛程度及反弹性疼痛发生率、促进术后康复进程有显著价值，对术后不良反应发生率及应激反应的影响较小。

       Objective To explore the effect of dexmedetomidine on postoperative rebound pain in patients with axillary brachial plexus block combined with suprascapular nerve block．Methods From September 2024 to October 2025，150 patients who underwent arthroscopic surgery in our hospital were randomly divided into two groups（n=150）：conventional axillary brachial plexus block combined with suprascapular nerve block group（N group，n=75） and axillary brachial plexus block combined with dexmedetomidine group（D group，n=75）．The differences of rebound pain，postoperative recovery and emergency indicators between groups were evaluated．Results The pain scores at 2 hours，6 hours，12 hours and 24 hours after operation in group D were lower than those in group N（P＜0.05）．The incidence of rebound pain in group D（5.33%） was lower than that in group N（20.00%），the first attack time in group D was later and the duration in group D was shorter than those in group N（P＜0.05）．The times of postoperative salvage analgesia，the dosage of opioids and the utilization rate of non-steroidal drugs in group D were lower than those in group N（P＜0.05）．The time of getting out of bed for the first time and the length of hospitalization in group D were shorter than those in group N，and the satisfaction score in group D was higher than that in group N（P＜0.05）．There was no significant difference in the incidence of adverse reactions between group D and group N（P＞0.05）．There was no significant difference in stress response indexes between groups before operation，and the indexes of both groups changed in different degrees 24 hours after operation，but compared with group N，the changes of heart rate，mean arterial pressure，systolic pressure and diastolic pressure in group D were smaller（P＜0.05）．Conclusions Dexmedetomidine used in axillary brachial plexus block combined with suprascapular nerve block has significant value in reducing postoperative pain and incidence of rebound pain，promoting postoperative rehabilitation process，and has little effect on postoperative adverse reactions and stress response．

      目的 分析肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理的效果。方法 纳入2022年12月—2025年1月在河北省胸科医院进行经鼻高流量湿化氧疗的肺结核合并Ⅱ型呼吸衰竭患者294例，随机分为强化护理组（147例，多维度强化护理）、对照组（147例，常规护理），测量比较两组患者在护理前后气道重塑指标、肺功能指标、血气分析指标，进行疗效评估。结果 护理后强化护理组气道壁面积、气道壁厚度低于对照组，气道腔面积高于对照组（P＜0.05）；护理后强化护理组第1秒用力呼气容积、用力肺活量高于对照组（P＜0.05）；护理后强化护理组动脉血氧分压高于对照组，动脉血二氧化碳分压低于对照组（P＜0.05）；强化护理组总有效率高于对照组（P＜0.05）。结论 肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间接受多维度强化护理可改善其气道重塑及肺功能，有利于血气分析指标恢复，应用效果显著。

       Objective To analyze the efficacy of multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy in patients with pulmonary tuberculosis and type Ⅱ respiratory failure．Methods A total of 294 patients with pulmonary tuberculosis and type Ⅱ respiratory failure who received nasal high-flow humidified oxygen therapy at Hebei Chest Hospital between December 2022 and January 2025 were enrolled and randomly divided into an enhanced nursing group（147 patients，receiving multidimensional enhanced nursing）and a control group（147 patients，receiving conventional nursing）．Airway remodeling，pulmonary function，and blood gas analysis were measured and compared between the two groups before and after nursing，and the efficacy was evaluated．Results After nursing，the enhanced nursing group had lower airway wall area and airway wall thickness，and higher airway lumen area than the control group（P＜0.05）．The forced expiratory volume in 1 second and forced vital capacity in the enhanced nursing group were higher than those in the control group（P＜0.05）．The blood oxygen partial pressure（PaO₂）in the enhanced nursing group was higher than that in the control group，and the carbon dioxide partial pressure（PaCO₂）was lower than that in the control group（P＜0.05）．The total effective rate in the enhanced nursing group was higher than that in the control group（P＜0.05）．Conclusions Multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy can improve airway remodeling and lung function in patients with pulmonary tuberculosis and type Ⅱ respiratory failure，and is beneficial for the recovery of blood gas analysis indicators．The application effect is significant．

       目的 研究数字化口内扫描印模技术（DIOS）对重度牙周炎（SP）患者口腔种植修复效果及龈沟液炎症因子水平的影响并进行分析。方法 选取医院2022年1月—2025年1月收治的100例SP患者进行研究。以密封信封抽签法分为数字化组（n=50）及常规组（n=50）。两组均开展口腔种植修复，常规组采用常规硅橡胶印模技术，数字化组则采用DIOS。对比两组印模制取时间、印模过程中疼痛程度及种植成功率、修复体满意度、龈沟液炎症因子水平、并发症发生情况。结果 数字化组印模制取时间短于常规组，VAS评分低于常规组，而种植成功率高于常规组（均P＜0.05）。数字化组边缘密合度、咬合关系、邻接关系满意度均高于常规组（均P＜0.05）。修复3个月后两组龈沟液各项炎症因子水平均低于修复前，且数字化组低于常规组（均P＜0.05）。数字化组并发症总发生率低于常规组（P＜0.05）。结论 DIOS可显著提高SP患者口腔种植修复效果，降低龈沟液炎症因子水平，减少并发症的发生。

      Objective To investigate the effects of digital intraoral scanner（DIOS）on the oral implant restoration effect and the levels of inflammatory factors in gingival crevicular fluid in patients with severe periodontitis（SP）．Methods A total of 100 SP patients admitted to the hospital from January 2022 to January 2025 were selected for the study．They were divided into the digital group（n=50）and the conventional group（n=50）by the sealed envelope lottery method．Both groups underwent oral implant restoration．The conventional group used the conventional silicone rubber impression technology，while the digital group underwent DIOS．The time of impression preparation，the degree of pain during the impression process，the success rate of implantation，the satisfaction of restorations，the levels of inflammatory factors in gingival crevicular fluid，and the occurrence of complications were compared between the two groups．Results The impression acquisition time of the digital group was shorter than that of the conventional group，the VAS score was lower than that of the conventional group，while the implantation success rate was higher than that of the conventional group（all P＜0.05）．The marginal fit，occlusal relationship and adjacent relationship in the digital group were all higher than those of the conventional group（all P＜0.05）．Three months after repair，the levels of various inflammatory factors in gingival crevicular fluid in both groups were lower than those at admission，and the digital group was lower than the conventional group（all P＜0.05）．The total incidence of complications in the digital group was lower than that in the conventional group（P＜0.05）．Conclusions DIOS can significantly improve the oral implant restoration effect of SP patients，reduce the levels of inflammatory factors in gingival crevicular fluid，and reduce the occurrence of complications．

       目的 探讨不同附着体类型对上颌种植覆盖义齿修复患者种植体周围软硬组织健康状况的影响。方法 选取2020年1月—2023年12月于南京医科大学附属口腔医院就诊并接受上颌种植覆盖义齿修复的90例患者，根据所用附着体类型分为杆卡组（n=30）、球帽组（n=30）和Locator组（n=30）。戴用后随访12个月，比较三组种植体周围探诊深度（PD）、探诊出血（BOP）、菌斑指数（PLI）、牙龈指数（GI）、边缘骨吸收（MBL）等指标，并记录机械并发症发生情况。结果 佩戴12个月后，杆卡组在PD［（3.25±0.41） mm vs （3.58±0.50） mm，校正后P＜0.016 7］、PLI（1.25±0.38 vs 1.55±0.44，校正后P＜0.016 7）、GI（1.15±0.35 vs 1.37±0.42，校正后P＜0.016 7）及MBL［（0.38±0.11） mm vs （0.63±0.14） mm，校正后P＜0.016 7］方面的表现均优于Locator组；球帽组PLI（1.42±0.41 vs 1.55±0.44，校正后P＜0.016 7）、GI（1.28±0.39 vs 1.37±0.42，校正后P＜0.016 7）低于Locator组；三组间BOP阳性率两两比较差异均无统计学意义（校正后P＞0.016 7）。三组机械并发症总发生率的总体差异具有统计学意义（P＜0.05），进一步两两比较显示，杆卡组并发症发生率最低（16.67%），Locator组最高（50.00%）（校正后P＜0.016 7）。结论 对于上颌种植覆盖义齿修复，杆卡式附着体在维持种植体周围软硬组织健康、减少边缘骨吸收及降低机械并发症方面表现出相对优势，临床适用性较高。

       Objective To investigate the effects of different attachment types on the health of peri-implant soft and hard tissues in patients rehabilitated with maxillary implant-supported overdentures．Methods A total of 90 patients who received maxillary implant-supported overdentures at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2020 and December 2023 were selected and divided into three groups based on the attachment type：bar-clip group（n=30），ball attachment group（n=30），and Locator group（n=30）．After prosthesis delivery，patients were followed up for 12 months．Parameters including probing depth（PD），bleeding on probing（BOP），plaque index（PLI），gingival index（GI），and marginal bone loss（MBL）were compared among the groups，and mechanical complications were recorded．Results At 12 months after delivery，the bar-clip group demonstrated significantly better performance in PD（［3.25±0.41］mm vs ［3.58±0.50］mm，adjusted P＜0.016 7），PLI（［1.25±0.38］ vs ［1.55±0.44］，adjusted P＜0.016 7），GI（［1.15±0.35］ vs ［1.37±0.42］，adjusted P＜0.016 7），and MBL（［0.38±0.11］mm vs ［0.63±0.14］mm，adjusted P＜0.016 7）compared to the Locator group．The ball attachment group showed significantly lower PLI（［1.42±0.41］ vs ［1.55±0.44］，adjusted P＜0.016 7）and GI（［1.28±0.39］ vs ［1.37±0.42］，adjusted P＜0.016 7）values than the Locator group．No statistically significant difference was observed in BOP positive rates among the three groups in pairwise comparisons（adjusted P＞0.016 7）．The overall difference in the total incidence of mechanical complications among the three groups was statistically significant（P＜0.05），and further pairwise comparisons showed that the bar-clip group had the lowest incidence（16.67%），while the Locator group had the highest（50.00%）（adjusted P＜0.016 7）．Conclusions For maxillary implant-supported overdentures，bar-clip attachments demonstrate relative advantages in maintaining peri-implant soft and hard tissue health，reducing marginal bone loss，and minimizing mechanical complications，suggesting good clinical applicability．