基于ACE-Star模型的循证护理在经口腔入路腔镜甲状腺手术患者切口管理中的应用  

Effects of evidence-based nursing based on ACE-Star model in incision management of patients undergoing transoral endoscopic thyroidectomy

作　　者：张缦莉 张理想 陆莹 Zhang Manli;Zhang Lixiang;Lu Ying(Department of General Surgery,Nanyang Central Hospital of Henan Province,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院普外科,南阳473000

出　　处：《中华现代护理杂志》2022年第14期1890-1894,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨以ACE-Star模型为理论框架的循证护理用于经口腔入路腔镜甲状腺切除术患者切口管理的效果。方法采用便利抽样法,选取2019年6月—2020年6月河南省南阳市中心医院普外科收治的40例甲状腺肿瘤患者为对照组,给予常规甲状腺手术护理;选取2020年7月—2021年6月收治的32例患者为观察组,给予ACE-Star模型为理论框架的循证护理,包括体位管理、切口抗感染管理、头套使用管理。比较两组总引流量、拔管时间、住院时间、疼痛视觉模拟评分法(VAS)评分、并发症发生率(感染、颜面水肿、皮下淤血)、患者满意度,并记录观察组循证条目执行率。结果观察组患者的总引流量、拔管时间、住院时间、疼痛VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率低于对照组,差异有统计学意义(χ^(2)=6.57,P<0.05);观察组患者对护理的满意度高于对照组,差异有统计学意义(χ^(2)=6.68,P<0.05)。观察组患者体位管理、切口抗感染管理、头套的使用3个循证条目管理执行率分别为96.88%、96.88%、93.75%,执行率均高于90%。结论以ACE-Star模型为理论框架的循证护理用于经口腔前庭入路的腔镜甲状腺手术的切口管理,有利于减少术后并发症,提高患者满意度,具有一定的临床指导意义。Objective To explore the effect of evidence-based nursing based on the ACE-Star model as the theoretical framework for incision management of patients undergoing transoral endoscopic thyroidectomy.Methods Convenience sampling was used to select 40 patients with thyroid tumor in General Surgery of Nanyang Central Hospital in Henan Province from June 2019 to June 2020 as the control group,and received routine thyroidectomy nursing.A total of 32 patients admitted from July 2020 to June 2021 were selected as the observation group,and were given evidence-based nursing with the ACE-Star model as the theoretical framework,including body position management,incision anti-infection management,and headgear usage management.The total drainage volume,extubation time,hospital stay,Visual Analogue Scale(VAS)score,incidence of complications(infection,facial edema,subcutaneous congestion),and patient satisfaction were compared between the two groups,and the implementation rate of evidence-based items in the observation group was recorded.Results The total drainage volume,extubation time,hospital stay,and VAS score of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=6.57,P<0.05).The patients in the observation group had higher satisfaction with nursing than the control group,and the difference was statistically significant(χ^(2)=6.68,P<0.05).In the observation group,the implementation rates of three evidence-based management items,including body position management,incision anti-infection management,and headgear usage management,were 96.88%,96.88%,and 93.75%,respectively,and the implementation rates were all higher than 90%.Conclusions Evidence-based nursing with the ACE-Star model as the theoretical framework is used for the incision management of transoral endoscopic thyroidectomy,which is beneficial to

关 键 词：甲状腺肿瘤 甲状腺切除术 循证护理 腔镜 

分 类 号：R473.73[医药卫生—护理学] R-03[医药卫生—临床医学]