多学科协助模式的精准护理在喉功能保全术后患者吞咽功能康复中的应用  

Application of multi-disciplinary precise nursing in swallowing function rehabilitation of patients after laryngeal function preservation operation

作　　者：孙振[1] 查慧芳 尤莹莹 傅玉娟[1] 王俊国[1] 钱晓云[1] 佘万东[1] SUN Zhen;ZHA Huifang;YOU Yingying;FU Yujuan;WANG Junguo;QIAN Xiaoyun;SHE Wandong(Otolaryngology head and neck surgery,Gulou Hospital Affiliated to Nanjing University Medical College,Nanjing Jiangsu Province,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,江苏南京210008

出　　处：《中国中西医结合耳鼻咽喉科杂志》2020年第4期299-304,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：江苏省科教强卫工程医学重点学科(ZDXKB2016015)。

摘　　要：目的探讨多学科协助诊疗(Multi-Disciplinary Team,MDT)模式下,实施精准护理对喉功能保全术后患者吞咽功能康复的效果。方法根据喉功能保全术后患者的护理特点,通过多学科协助,文献循证,构建了吞咽功能康复过程中精准护理方案。选取我院耳鼻咽喉头颈外科2019年7月~12月收治的喉癌行喉功能保全术的40例患者作为观察组,2019年1~6月收治的40例喉癌患者作为对照组。观察组实施多学科精准护理干预策略,对照组给予常规护理。比较两组患者留置胃管的天数、胃管拔除后再插管率、出院前吞咽障碍患者生活质量量表(swallow-quality-of-life questionnaire,SWAL-QOL)评分。结果观察组留置胃管的天数为(9.36±1.29)天,显著少于对照组的(15.78±3.49)天,差异有统计学意义(t=-10.913,P<0.001);观察组胃管拔除后再插管率为4.44%,低于对照组的32.5%,差异有统计学意义(χ2=9.928,P<0.05);观察组SWAL-QOL生活质量量表的总分为(111.32±3.43)分,显著高于对照组的(91.24±2.74)分,差异有统计学意义(t=28.928,P<0.001)。结论采用多学科精准护理策略对喉功能保全术后患者进行吞咽功能康复的护理干预,能够促进吞咽功能恢复,提高患者的生活质量,值得临床推广。Objective To explore the effect of accurate nursing strategy on the swallowing function rehabilitation of patients after laryngeal function preservation operation under the Multi-Disciplinary Team(MDT)mode.Methods Based on the evidence-based literature,combined with the nursing characteristics of patients after laryngeal function preservation surgery,a multi-disciplinary accurate nursing program was developed.A total of 40 cases of laryngeal cancer treated by otolaryngology head and neck surgery from July to December 2019 were selected as the observation group and 40 cases of laryngeal cancer treated from January to June 2019 as the control group.On the basis of routine nursing,the observation group implemented the multi-disciplinary precise nursing intervention mode,while the control group received routine nursing.The time of indwelling gastric tube and the number of intubation cases after removal of gastric tube were recorded in the two groups,and the quality of life scale was used to evaluate the two groups before discharge.Results The time of indwelling gastric tube in the observation group was significantly shorter than that in the control group(P<0.001).The number of intubation cases after removal of gastric tube in the observation group was significantly less than that that in the control group(P<0.05).The quality of life scale at discharge in the observation group was significantly higher than that in the control group(P<0.001).Conclusion The nursing intervention of swallowing function rehabilitation after laryngeal function preservation by multi-disciplinary precise nursing strategy can promote the swallowing function recovery and improve the life quality of the patients,which is worthy of clinical promotion.

关 键 词：多学科协助诊疗 精准护理 喉功能保全手术 吞咽功能康复 护理 

分 类 号：R473.73[医药卫生—护理学]