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Article(id=1322168615936311365, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168583854080893, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.08.013, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757520000000, receivedDateStr=2025-09-11, revisedDate=1774540800000, revisedDateStr=2026-03-27, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159162744, onlineDateStr=2026-10-28, pubDate=1777046400000, pubDateStr=2026-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159162744, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159162744, creator=13701087609, updateTime=1793159162744, updator=13701087609, issue=Issue{id=1322168583854080893, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='8', pageStart='1241', pageEnd='1424', issueExtLink='null', onlineDate='null', pubDate='1777046400000', pubDateStr='2026-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159155095, creator='13701087609', updateTime=1793159155095, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1333, endPage=1338, ext={EN=ArticleExt(id=1322168616171192390, articleId=1322168615936311365, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application of integrated traditional Chinese and western medicine nursing based on health promotion model in postoperative care of patients in the hepatobiliary surgery department, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the application effect of integrated traditional Chinese and western medicine nursing based on the health promotion model in postoperative care of patients in the hepatobiliary surgery department.

Methods

A total of 80 patients who underwent surgery in the hepatobiliary surgery department of our hospital from August 2024 to January 2025 were selected as the research subjects.They were divided into control group and observation group by random number table method,40 cases each.The control group received routine care,while the observation group received integrated traditional Chinese and Western medicine nursing based on the health promotion model in addition to the routine care.The postoperative comfort,quality of life,and complication occurrence of the two groups of patients were compared.

Results

After 6 months of intervention,the comfort scores and quality of life scores of the observation group were significantly higher than those of the control group.The total incidence of complications of the observation group were lower than those of the control group(P<0.05).

Conclusions

Integrated traditional Chinese and western medicine nursing based on health promotion model could improve the postoperative comfort and quality of life of patients in the hepatobiliary surgery department.It could provide support for the construction of systematic postoperative nursing plan for patients in the hepatobiliary surgery department.

, authors=Jing FENG, authorsList=Jing FENG, authorCompany=null, correspAuthors=Jing FENG, authorNote=null, correspAuthorsNote=
FENG Jing, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168616552874055, articleId=1322168615936311365, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

探讨基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用效果。

方法

选取2024年8月—2025年1月在我院肝胆外科接受手术病人80例作为研究对象，采用随机数字表法分为对照组与观察组，每组40例。对照组给予常规护理，观察组在对照组基础上接受基于健康促进模型的中西医结合护理。比较两组病人术后舒适度、生活质量及并发症发生情况。

结果

干预6个月后观察组病人舒适度得分、生活质量得分明显高于对照组，并发症总发生率低于对照组（P<0.05）。

结论

基于健康促进模型的中西医结合护理可以提高肝胆外科病人术后舒适度及生活质量，可以为肝胆外科病人术后构建系统化护理方案提供支撑。

, authors=冯静, authorsList=冯静, authorCompany=null, correspAuthors=冯静, authorNote=null, correspAuthorsNote=
FENG Jing, E-mail:
冯静，副主任护师，本科，E-mail：
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unstructuredReference=郑洁,赵艳君,程建云.基于快速康复外科理念的疼痛管理联合中医疼痛护理干预在腹腔镜日间手术患者围术期护理中的应用效果[J].广西医学,2021,43(7):896-899., articleTitle=基于快速康复外科理念的疼痛管理联合中医疼痛护理干预在腹腔镜日间手术患者围术期护理中的应用效果, refAbstract=null), Reference(id=1322530864785899589, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, doi=null, pmid=null, pmcid=null, year=2024, volume=51, issue=9, pageStart=13, pageEnd=15, url=null, language=null, rfNumber=25, rfOrder=24, authorNames=王敏, 吴剑华, 张婷, journalName=辽宁中医杂志, refType=null, unstructuredReference=王敏,吴剑华,张婷,等.黄源鹏中西医结合治疗老年肝癌经验[J].辽宁中医杂志,2024,51(9):13-15., articleTitle=黄源鹏中西医结合治疗老年肝癌经验, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322530857336815635, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, xref=1, ext=[AuthorCompanyExt(id=1322530857345204244, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, companyId=1322530857336815635, language=EN, 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Comparison of GCQ scores between two groups of patients（x±s）

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时间组别例数环境社会心理生理总分
干预前对照组4014.05±1.4813.70±1.1622.88±1.8013.28±1.1563.90±2.45
观察组4013.95±1.3614.13±1.4522.75±1.8213.43±1.1364.73±2.70
t值0.314-1.4460.309-0.587-1.432
P0.7540.1520.7580.5590.156
干预后6个月对照组4017.50±1.6317.75±1.7932.38±1.7515.78±1.4283.41±3.31
观察组4019.88±1.5919.50±1.7537.53±1.7818.78±0.9595.69±3.11
t值-6.594-4.411-13.039-11.100-17.106
P<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1322530860314771494, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=CN, label=表1, caption=

两组病人GCQ得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数环境社会心理生理总分
干预前对照组4014.05±1.4813.70±1.1622.88±1.8013.28±1.1563.90±2.45
观察组4013.95±1.3614.13±1.4522.75±1.8213.43±1.1364.73±2.70
t值0.314-1.4460.309-0.587-1.432
P0.7540.1520.7580.5590.156
干预后6个月对照组4017.50±1.6317.75±1.7932.38±1.7515.78±1.4283.41±3.31
观察组4019.88±1.5919.50±1.7537.53±1.7818.78±0.9595.69±3.11
t值-6.594-4.411-13.039-11.100-17.106
P<0.001<0.001<0.001<0.001<0.001
), ArticleFig(id=1322530860390268967, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=EN, label=Table 2, caption=

Comparison of VAS scores between two groups of patients（x±s）

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组别例数干预前出院前1 dP
对照组407.48±0.515.48±0.51<0.05
观察组407.55±0.502.53±0.51<0.05
t值-0.66426.086
P0.508<0.001
), ArticleFig(id=1322530860453183528, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=CN, label=表2, caption=

两组病人VAS评分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前出院前1 dP
对照组407.48±0.515.48±0.51<0.05
观察组407.55±0.502.53±0.51<0.05
t值-0.66426.086
P0.508<0.001
), ArticleFig(id=1322530860524486697, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=EN, label=Table 3, caption=

Comparison of EORTC QLQ-C30 scores between two groups of patients（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预后6个月P
对照组4032.10±4.2863.70±3.50<0.05
观察组4033.43±4.8182.10±4.87<0.05
t值-1.302-19.409
P0.197<0.001
), ArticleFig(id=1322530860587401258, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=CN, label=表3, caption=

两组病人EORTC QLQ-C30评分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数干预前干预后6个月P
对照组4032.10±4.2863.70±3.50<0.05
观察组4033.43±4.8182.10±4.87<0.05
t值-1.302-19.409
P0.197<0.001
), ArticleFig(id=1322530860667093035, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=EN, label=Table 4, caption=

Comparison of complication occurrences between two groups of patients

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组别例数感染恶心
呕吐		发热胆漏合计
对照组403(7.50)4(10.00)2(5.00)1(2.50)10(25.00)
观察组400(0.00)1(2.50)1(2.50)0(0.00)2(5.00)
), ArticleFig(id=1322530860725813292, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168615936311365, language=CN, label=表4, caption=

两组病人并发症发生情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数感染恶心
呕吐		发热胆漏合计
对照组403(7.50)4(10.00)2(5.00)1(2.50)10(25.00)
观察组400(0.00)1(2.50)1(2.50)0(0.00)2(5.00)
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基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用
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冯静
护理研究 | 综合研究 2026,40(8): 1333-1338
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护理研究 |综合研究 2026 , 40 (8) : 1333 -1338
基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用
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冯静
作者信息
  • 1山西省中西医结合医院，山西 030013
通讯作者:
FENG Jing, E-mail:
冯静，副主任护师，本科，E-mail：
Application of integrated traditional Chinese and western medicine nursing based on health promotion model in postoperative care of patients in the hepatobiliary surgery department
Jing FENG
Affiliations
  • 1Shanxi Provincial Integrated TCM and WM Hospital, Shanxi 030013 China
    • Corresponding Author:
    FENG Jing, E-mail:
出版时间: 2026-04-25 doi: 10.12102/j.issn.1009-6493.2026.08.013
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摘要
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目的

探讨基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用效果。

方法

选取2024年8月—2025年1月在我院肝胆外科接受手术病人80例作为研究对象，采用随机数字表法分为对照组与观察组，每组40例。对照组给予常规护理，观察组在对照组基础上接受基于健康促进模型的中西医结合护理。比较两组病人术后舒适度、生活质量及并发症发生情况。

结果

干预6个月后观察组病人舒适度得分、生活质量得分明显高于对照组，并发症总发生率低于对照组（P<0.05）。

结论

基于健康促进模型的中西医结合护理可以提高肝胆外科病人术后舒适度及生活质量，可以为肝胆外科病人术后构建系统化护理方案提供支撑。

健康促进模型  /  肝胆外科  /  舒适度  /  中西医结合  /  护理
Objective

To explore the application effect of integrated traditional Chinese and western medicine nursing based on the health promotion model in postoperative care of patients in the hepatobiliary surgery department.

Methods

A total of 80 patients who underwent surgery in the hepatobiliary surgery department of our hospital from August 2024 to January 2025 were selected as the research subjects.They were divided into control group and observation group by random number table method,40 cases each.The control group received routine care,while the observation group received integrated traditional Chinese and Western medicine nursing based on the health promotion model in addition to the routine care.The postoperative comfort,quality of life,and complication occurrence of the two groups of patients were compared.

Results

After 6 months of intervention,the comfort scores and quality of life scores of the observation group were significantly higher than those of the control group.The total incidence of complications of the observation group were lower than those of the control group(P<0.05).

Conclusions

Integrated traditional Chinese and western medicine nursing based on health promotion model could improve the postoperative comfort and quality of life of patients in the hepatobiliary surgery department.It could provide support for the construction of systematic postoperative nursing plan for patients in the hepatobiliary surgery department.

health promotion model  /  hepatobiliary surgery department  /  comfort  /  integrated traditional Chinese and western medicine  /  nursing
冯静. 基于健康促进模型的中西医结合护理在肝胆外科病人术后护理中的应用. 护理研究, 2026 , 40 (8) : 1333 -1338 . DOI: 10.12102/j.issn.1009-6493.2026.08.013
Jing FENG. Application of integrated traditional Chinese and western medicine nursing based on health promotion model in postoperative care of patients in the hepatobiliary surgery department[J]. Chinese Nursing Research, 2026 , 40 (8) : 1333 -1338 . DOI: 10.12102/j.issn.1009-6493.2026.08.013
正文
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术后舒适度作为肝胆外科病人术后康复进程中的关键生理、心理综合指标，其水平直接关联治疗依从性、并发症发生率及生活质量改善程度[1]。临床观察表明，肝胆外科病人因疾病本身的解剖复杂性、手术创伤的侵入性及康复周期的长期性，普遍存在术后舒适度偏低的问题，尤其在术后急性期疼痛管理、恢复期饮食调控及功能锻炼适配性等方面表现突出[2]。现有研究多聚焦单一干预或常规护理对术后舒适度的影响，缺乏针对性与系统性方案，护理实践存在明显局限：1）护理侧重生理指标监测与技术操作，对病人心理舒适需求及主观感知动态评估不足，易出现重生理、轻心理偏差；2）传统中医护理虽注重整体调理，但缺乏标准化理论框架与操作规范，临床应用个体差异大、效果稳定性欠佳；3）忽视病人术后康复中健康行为与舒适状态的动态变化，未有效整合生理、心理、社会多维度支持，导致舒适度提升效果差、持续时间短，难以满足全程化、个性化需求[3-5]。基于此，本研究引入健康促进模型，该模型强调个体认知、环境因素与健康行为的交互作用，包含运动、健康责任、人际间关系、压力管理、营养、自我实现6个维度。中西医结合护理可发挥中医与西医优势，成为全面化的综合护理模式，更好地服务于肝胆外科病人术后护理，为构建系统化护理方案提供理论支撑[6-8]。通过整合中西医护理优势，形成兼具科学性与实践性的干预体系，旨在突破现有护理瓶颈，为提升肝胆外科病人术后舒适度提供新的实践路径。
1　对象与方法
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1.1　对象
采用随机对照试验，样本量采用两独立样本均数比较公式，n=2[（uα+uβ）/（δ/σ）]2，σ为两总体样本标准差估计值，δ为两样本均数差值，检验水准α=0.05，检验效能1-β=0.9，查表得uα=1.96，uβ=1.28，计算出每组样本量至少38例。选取2024年8月—2025年1月在我院肝胆外科手术治疗的病人80例为研究对象。纳入标准：确诊为肝胆外科类疾病；具备肝胆手术适应证；自愿参与研究；血液与免疫系统无异常；器官功能运作正常；无癌症与精神障碍；年龄>18岁，能够遵守研究步骤；对中草药无不良反应且接受中医治疗方式。排除标准：手术期间或术后出现严重并发症，导致无法继续参与研究；术前或术后伴随严重合并症，可能会干扰治疗效果和加大研究难度；已参加其他试验项目，干扰本研究判断；术后不遵循研究方案，无法随访监测；对中草药成分有过敏记录；研究过程中停止治疗或失联；术后所用药物会对研究结果判断造成干扰。本研究已获得医院伦理委员会审批（审批编号：NO.ZXYLLSC-2024-102）。采用随机数字表法将80例病人分为对照组和观察组各40例。对照组年龄35~55（43.48±8.67）岁；合并基础病史18例；肝脏手术3例，胆道手术37例；男17例，女23例。观察组年龄36~52（42.55±8.62）岁；合并基础病史16例；肝脏手术8例，胆道手术32例；男19例，女21例。两组病人一般资料比较差异均无统计学意义（P>0.05），具有可比性。
1.2　护理方法
1.2.1　对照组
按照常规流程给予护理干预措施，干预6个月。
1.2.1.1　基本护理
实时监测病人的术后血压、心率等相关生命体征数值变化，并严格按照规范流程对创口进行清洁，定期为病人身体进行卫生清洁，并在必要情况下协助不能自理病人完成下床活动、进食等行为活动，术前采用耳穴贴压、穴位贴敷中医特色疗法进行干预并辅助实施对应的护理措施，术后加用雷火灸特色疗法进行干预，为病人的术后康复提供保障。
1.2.1.2　术后疼痛管理
术后可以通过辅助使用药物或镇痛泵的方式进行止痛并定时评估疼痛程度，按照病人反馈适当调整镇痛方案以及参数。
1.2.1.3　个性化营养规划
术后根据病人身体素养与恢复情况制订个性化营养计划，尽量按照易消化以及增加蛋白质、增加维生素含量的标准设定，针对存在进食障碍的部分病人，可依据实际情况采取静脉营养补充措施。
1.2.1.4　功能锻炼指导
通过言语鼓励与技巧指导等方式辅助病人尽早下床进行简易活动，并根据恢复情况适当增加活动量与单次活动时间，针对呼吸功能、肢体功能等进行锻炼技巧指导。
1.2.1.5　药物监督指导
术后每次服药需逐一核对病人的药物信息与剂量，并解释药物服用的具体效果以及可能产生的不良反应，强调按医嘱服药的必要性，并以视频、图片等多元化形式进行健康教育。
1.2.1.6　并发症监测与心理护理
定期观察评估病人的创面愈合情况与感染风险，出现并发症需立即向临床医生汇报并采取有效的应急处理措施。通过言语鼓励以及制定目标的方式辅助病人养成健康的生活习惯与自我保健行为意识，为病人提供个性化心理疏导与心理干预技巧。
1.2.1.7　出院指导
病人出院前针对居家护理药物服用注意事项、后续复诊安排等相关问题进行详细讲解与流程指导。
1.2.2　观察组
在常规护理基础上实施基于健康促进模型的中西医结合护理策略，围绕运动、健康责任、人际间关系、压力管理、营养、自我实现展开，干预6个月。
1.2.2.1　运动方面
在个体化康复流程中纳入阶梯式运动指导，结合中医“气血流通”理论，根据病人术后体质评估结果，制定包含腹式呼吸训练、肢体功能操及散步等的分阶段运动方案，通过图片手册明确每个动作的标准姿势，每日训练时长从5~10 min逐步增至20~30 min，频率每日2次或3次，并在智能APP中设置运动提醒与记录功能，确保运动干预的规范性与可追踪性。
1.2.2.2　健康责任
构建“评估-教育-反馈”闭环体系，术前通过一对一咨询完成疾病认知与健康需求评估，发放包含中西医护理核心知识的纸质手册与视频教程，术后每周2次专项讲座讲解耳穴贴压、雷火灸等操作要点，建立“护理疑问即时反馈群”，48 h内响应病人咨询，强化病人对自身健康管理的主动性与责任感。
1.2.2.3　人际间关系
建立三级支持网络，组建6~8人同伴小组，每周开展1次线上经验分享会，每个月组织病人及家属参与家庭护理培训，教授穴位贴敷等家庭操作技巧，依托社区-医院联动机制，明确社区护士每个月2次上门随访职责，形成医院指导、家庭协作、同伴互助的人际支持体系。
1.2.2.4　压力管理
实施多元化镇痛减压方案。疼痛急性期采用耳穴贴压选取神门、交感等穴位，3 d更换1次，联合药物镇痛，恢复期每日指导正念冥想，提供10 min标准化音频，音乐疗法精选舒缓中医五行音乐，设置心理疏导专线，每周针对性情绪干预1次，帮助病人建立负面情绪应对机制。
1.2.2.5　营养健康
结合中医体质辨识与西医营养需求，制定个性化饮食方案，通过专题讲座与图文手册讲解药食同源知识，明确术后不同阶段的饮食禁忌与推荐食材，每周1次营养状况评估并动态调整方案，确保营养干预的科学性。
1.2.2.6　自我实现
通过自助护理工作坊分阶段培养病人技能，设置“操作达标认证”机制，在智能APP中建立康复目标达成记录模块，将功能恢复、疼痛控制等指标量化为阶段性成就，每个月召开小组表彰会，强化病人自我管理效能感与康复成就感。
1.3　观察指标
干预前后评估病人舒适度、生活质量、疼痛程度及并发症发生情况。
1.3.1　疼痛程度
采用视觉模拟评分量表（Visual Analogue Scale，VAS）[9]评估疼痛强度，得分为0~10分，得分越高表明病人疼痛越明显。
1.3.2　生活质量
采用生活质量量表（European Organization for Research and Treatment of Cancer Quality of Life Questionnaire，EORTC QLQ-C30）[10]进行评价，包含生理功能、症状困扰、情绪状态、社会功能4个维度，各维度得分均为0~100分，总分通过线性转换公式转换为0~100分，得分越高生活质量越好。
1.3.3　舒适度
采用精简版Kolcaba舒适状况量表（General Comfort Questionnaire，GCQ）[11]评价病人的舒适度，包括环境（6个条目）、社会（6个条目）、心理（11个条目）、生理（5个条目）4个维度，共28个项目，每个条目采用Likert 4级评分法（1~4分），负向项目应用负向评分，正向项目应用正向评分，总分为28~112分，得分越高表示舒适度越好。
1.3.4　并发症
记录干预期间病人感染、恶心呕吐、发热、胆漏的并发症发生率。
1.4　统计学方法
采用SPSS 27.0软件进行统计处理。定性资料用频数、百分比（%）表示，采用χ2检验。符合正态分布的定量资料以均数±标准差（x±s）表示，采用t检验；不符合正态分布的定量资料以中位数（四分位数）[M(P25,P75)]表示，采用秩和检验。以P<0.05为差异有统计学意义。
2　结果
收起
2.1　两组病人舒适度比较（见表1）
2.2　两组疼痛程度比较（见表2）
2.3　两组生活质量比较（见表3）
2.4　两组并发症发生情况比较（见表4）
3　讨论
收起
肝胆外科常见疾病如胆囊结石、肝癌、胆管癌等，需结合影像与化验精准诊断，手术多采用腹腔镜微创或开腹术切除病灶并重建胆道，术后需监测肝功能、引流情况，预防感染与胆漏，良性疾病预后多良好，但恶性肿瘤若晚期确诊、手术切除不彻底，易出现复发转移、预后较差，定期复查对病人预后不良防控至关重要[11]。肝胆外科术后康复与护理难度较大，术后留置引流管会限制病人活动易引发负面情绪，影响术后护理配合，而活动量不足会减缓恢复速度、阻碍血液流动、增加并发症风险，加之病人存在个体差异，若护理不当易导致病情恶化，因此，有效的术后护理是改善预后的关键[12]。
3.1　基于健康促进模型的中西医结合护理可以提升肝胆外科病人术后舒适度
肝胆疾病对病人的不良影响不仅限于身体层面，还会加重其心理负担，病人术后面对护理挑战时也易因信心与能力不足产生不良情绪，进而降低术后舒适度。有研究表明，针对舒适度的干预可提升病人主观能动性，推动其主动配合康复措施，并从生理与心理层面优化认知，在改善术后舒适度的同时，增强医疗依从性[13]。本研究结果表显示，干预后观察组GCQ得分高于对照组（P<0.001）。证实肝胆外科病人通过基于健康促进模型的中西医结合护理模式，术后舒适度显著提升。分析其原因是基于健康促进模型的中西医结合护理方案通过运动、健康责任、人际间关系、压力管理、营养、自我实现多维度协同作用，构建多维度改善肝胆外科病人术后舒适度的动态机制。运动维度采用阶梯式方案结合中医理论适配术后体能，分阶段目标降低执行难度以规避运动相关不适，智能工具强化运动一致性，使病人在适宜运动中减少腹胀、肌肉酸痛等躯体不适，积累舒适体验。健康责任维度的闭环体系通过精准评估匹配舒适需求，多元化教育载体降低舒适管理知识门槛，即时反馈快速解决切口护理、饮食适配等影响舒适的问题，推动病人从被动接受护理转为主动管理舒适状态，强化对舒适感知的掌控感。人际间关系维度的三级网络构建社会支持矩阵，同伴分享术后舒适管理经验提供参考，家庭与社区参与增强情感支持以减少孤独感，避免负面情绪放大躯体不适，形成群体支持下的舒适感知叠加效应。压力管理维度的中西医联合方案直击影响舒适的核心因素，耳穴贴压与药物镇痛快速缓解疼痛，正念冥想与心理干预稳定焦虑情绪，减少压力导致的舒适感下降，构建症状缓解、情绪平稳、舒适度提升的路径。营养维度的个性化方案通过中医体质辨识实现精准干预，动态评估调整保障营养支持适配恢复需求，减少营养失衡引发的乏力、腹胀等不适。知识传授增强病人对舒适物质基础的掌控，巩固舒适状态。自我实现维度通过舒适管理技能认证与目标量化，将抽象舒适改善转化为可感知成就，表彰机制强化对舒适管理能力的认同，形成舒适改善、成就获得、持续优化舒适状态的高阶循环，最终实现病人术后舒适度的全面提升[14-16]。
3.2　以健康促进模型为基础的中西医结合护理可以减少肝胆外科病人术后并发症，提升生活质量
术后病人因术中出血量多、使用呼吸机辅助以及手术时间长等因素导致产生并发症的风险较高，影响病人生活质量与康复情况，联合应用西医常规护理以及中医护理的中西医结合护理模式干预使病人生活品质显著升级[17-18]。本研究结果显示，干预后观察组并发症发生率低于对照组，生活质量得分高于对照组（P<0.05）。阶梯式的健康促进运动方案基于气血流通则脏腑安和理论，通过腹式呼吸训练改善腹腔脏器血供，肢体功能操逐步恢复躯体活动能力，直接提升病人生理领域功能评分。营养方案结合体质辨识与西医代谢需求，通过药食同源调理改善消化吸收功能，缓解术后食欲缺乏、乏力等症状，增强病人精力储备。压力管理中的五行音乐与正念冥想协同作用，调节自主神经功能，降低焦虑抑郁情绪对生活质量的情感维度损耗。而人际支持网络的构建则通过归属感强化提升社会功能领域评分[19-20]。在并发症防控方面基于健康促进模型的中西医结合护理形成多层级风险阻断机制，运动干预通过逐步增加腹压适应性训练，促进腹腔静脉回流，降低术后肠粘连、深静脉血栓形成风险。健康责任体系中的耳穴贴压、雷火灸等中医操作，通过刺激特定穴位调节胃肠蠕动功能，降低腹胀、恶心等消化道并发症发生率。营养方案的动态调整确保蛋白质、维生素等关键营养素供给，维持机体免疫功能，降低切口感染风险。智能APP的运动记录与随访监测功能实现并发症早期症状的及时识别与干预，通过“预防-监测-处置”闭环管理阻断并发症进展链条。此外，自我实现维度的技能培养增强病人对并发症预警信号的识别能力，主动护理行为进一步降低不良事件发生率[21-22]。李艳艳等[23]联合应用西医常规护理以及中医特色护理干预的中西医结合护理模式对改善肝癌肝动脉化疗栓塞术后顽固性呃逆病人的中医症状具有良好效果。本研究结果还显示，出院前1 d观察组病人疼痛得分较对照组降低（P<0.05）。通过多靶点镇痛机制降低肝胆外科病人疼痛程度，形成中西医协同的疼痛管理体系。在外周镇痛层面中医外治技术发挥直接干预作用，耳穴贴压选取神门、交感等穴位，通过刺激迷走神经分支抑制疼痛信号外周传导；雷火灸产生的温热效应可改善手术区域局部血液循环，减少炎症介质如前列腺素、缓激肽的聚集，降低伤害性感受器的敏感性。在中枢调控维度正念冥想与中医五行音乐形成联合干预，通过激活前额叶皮层与边缘系统的神经通路，调节内源性阿片肽系统功能，提升脑内β-内啡肽等镇痛物质水平，同时抑制杏仁核过度活化导致的疼痛放大效应。阶梯式运动指导通过促进脑脊液循环与脑源性神经营养因子分泌，优化中枢疼痛调控网络的平衡状态。在疼痛感知重塑层面个性化营养方案通过补充锌、维生素B族等营养素，维持神经髓鞘完整性以稳定疼痛传导功能。健康责任维度的疼痛认知教育帮助病人建立科学的疼痛评估体系，减少负性认知对疼痛感受的强化作用，通过认知重构、情绪调节、疼痛感知弱化的路径降低主观疼痛体验。此外，人际支持网络通过缓解病人孤独感与焦虑情绪，减少心理应激导致的疼痛敏感性升高，形成生物-心理-社会多层面的疼痛缓解机制[24-25]。
综上所述，以健康促进模型为基础的中西医结合护理在辅助治疗方面效果良好，可增强肝胆外科病人术后舒适度及生活质量，降低病人并发症发生率，改善疼痛状况。但本研究观察时间较短，未来可以延长研究时间以进一步验证。

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doi: 10.12102/j.issn.1009-6493.2026.08.013
  • 接收时间：2025-09-11
  • 首发时间：2026-10-28
  • 出版时间：2026-04-25
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  • 收稿日期：2025-09-11
  • 修回日期：2026-03-27
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    1山西省中西医结合医院，山西 030013

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FENG Jing, E-mail:
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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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