多学科协作下加速康复外科集束化措施在甲状腺癌手术中的应用  

Application of enhanced recovery after surgery approach in thyroid cancer patients with multi⁃disciplinary team and nursing bundle management

作　　者：杨俏兰[1] 李海量 林丽[1] 雷芬[1] 邱雨[1] 刘霞[1] YANG Qiaolan;LI Hailiang;LIN Li;LEI Fen;QIU Yu;LIU Xia(No.2 General Department of Surgery,Guangdong No.2 Provincial People′s Hospital,Guangzhou 510080,China)

机构地区：[1]广东省第二人民医院普外二科,广州510080

出　　处：《实用医学杂志》2020年第10期1394-1397,共4页The Journal of Practical Medicine

基　　金：广东省科技厅研究基金项目(编号:201904010257);广东省医学科学技术研究基金项目(编号:A2018217)。

摘　　要：目的探讨多学科协作下加速康复外科集束化措施在甲状腺癌手术中的研究。方法选取广东省某三甲医院普通外科入住的157例甲状腺癌患者,按要求分为观察组和对照组,分别施以多学科协作下加速康复外科集束化措施和传统的护理措施,比较两组患者疼痛评分、引流管留置时间、术后体位综合征例数、术后并发症发生率、住院时间、住院费用和患者满意度。结果观察组术后的疼痛评分、引流管留置时间、术后体位综合征的发生例数、并发症发生率、住院时间和住院费用明显低于传统护理措施下的对照组,患者满意度明显高于对照组;两组患者观察指标的比较差异具有统计学意义(P<0.05)。结论多学科协作是加速康复外科的重要保障,集束化护理促进加速康复外科有效开展,多学科协作下加速康复外科集束化措施能促进甲状腺癌手术患者早日康复。Objective The study aims to explore the effects of the multi⁃disciplinary team and the nursing bundle approach in enhanced recovery after surgery on thyroid cancer patients.Methods 157 thyroid cancer patients were selected from the general surgery department of a third⁃grade a hospital in Guangdong province,and they were divided into observation group and control group which based on inclusion and exclusion standard.The two groups were applied enhanced recovery after surgery under multi⁃disciplinary team with nursing bundle approach and traditional nursing measures separately.Postoperative pain score,drainage tube indwelling days,pos⁃tural syndrome cases,postoperative complications of cases,hospitalization days,hospitalization expenses and pa⁃tient satisfaction were compared with each group.Result Patients′postoperative pain score,drainage tube in⁃dwelling days,occurrence of postoperative position syndrome cases,complications of cases,hospitalization days and hospitalization costs were significantly lower than that in the control group,but the patients′satisfaction was significantly higher.Conclusion The multi⁃disciplinary team management is an important guarantee of ERAS.The bundle nursing approach could promote the effective implementation of ERAS,and they could promote the early recovery of thyroid cancer surgery patients as well.

关 键 词：加速康复外科 多学科协作 集束化护理 甲状腺癌 疼痛管理 早期康复 

分 类 号：R473.6[医药卫生—护理学]