改良快速康复外科临床路径应用于甲状腺手术中的临床实践  

Clinical practice of rapid rehabilitation surgery in thyroid surgery

作　　者：严伟华[1] 谭杏映 伍志辉[1] 

机构地区：[1]广州中医药大学顺德医院,广东顺德528333 [2]顺德区大良街道社区卫生服务中心,广东顺德528333

出　　处：《岭南现代临床外科》2017年第6期684-687,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨探究改良快速康复外科临床路径应用于甲状腺手术中的临床应用。方法采用前瞻性研究的方法,患者来源于我院2016年9月到2017年9月期间接诊的120例甲状腺手术患者,分快速康复组和常规组(对照组),每组各60例,对照组给予传统快速康复外科临床路径干预,快速康复组采用快速康复的外科临床路径干预,对比两组患者治疗过程中各阶段焦虑程度、术后并发症发生情况,并调查患者治疗满意度。结果快速康复组患者平均手术时间、麻醉起效时间、术后苏醒时间、排气时间、住院时间等低于对照组,差异具有统计学意义(P<0.05);两组患者术中出血量、总住院费用差异无统计学意义(P>0.05);观察组患者术后STAI评分显著低于对照组,差异有统计学意义(P<0.05);观察组患者治疗满意度为(3.31±1.02)分,对照组患者治疗满意度评分为(5.25±2.57)分,差异有统计学意义(P<0.05);观察组患者总并发症率为8.33%;对照组患者总并发症率为11.67%,差异无统计学意义(P>0.05)。结论快速康复外科临床路径应用于甲状腺手术中,缩短了手术时间、降低患者痛苦、不良反应和缩短了住院时间。Objective To explore the feasibility of rapid rehabilitation surgery in thyroid surgery. Methods This was a prospective study. 120 cases of patients with thyroid surgery in our hospital from September 2016 to September 2017 were divided into observation group(n=60)and control group(n=60). The control group received traditional rapid rehabilitation surgery clinical pathway the intervention,and the observation group rapid rehabilitation surgery intervention. Results The average operation time,anesthesia onset time,postoperative recovery time,exhaust time,length of hospital stay of observation group were lower than those of control group(all P values <0.05). The intraoperative blood loss and total hospitalization expenses of two groups had no significant difference(P>0.05). The STAI score of observation group were lower than those of control group(P<0.05). The satisfaction of observation group and control group were(3.31±1.02)and(5.25±2.57),and the difference was statistically significant(P<0.05). The total complication rate of observation group and control group were8.33% and11.67%. And there was no significant difference between the two groups(P>0.05). Conclusion The clinical pathway of rapid rehabilitation surgery reduce patient's pain and adverse reaction,shortened the average surgery time and hospitalization time,and improve satisfaction.

关 键 词：快速康复外科 临床路径 甲状腺手术 

分 类 号：R493[医药卫生—康复医学] R653[医药卫生—临床医学]