儿童活体肝移植链式管理模式的构建及实施  

Establishment and practice of chain management model for living donor liver transplantation in children

作　　者：雷雪雪[1] 李京[2] 于颖[2] Lei Xuexue;Li Jing;Yu Ying(Department of Radiotherapy,The First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院放疗科,吉林长春130021 [2]吉林大学第一医院肝胆胰外一科,吉林长春130021

出　　处：《护理学杂志》2022年第20期1-4,22,共5页Journal of Nursing Science

基　　金：吉林大学第一医院2020年护理科研基金项目(20200104)。

摘　　要：目的探讨儿童活体肝移植链式管理模式的临床实践效果。方法采取历史对照研究设计,选取移植中心2020年3月至2021年3月行原位肝移植术的患儿28例为对照组,实施常规护理;2021年5月至2022年2月行原位肝移植术的患儿30例为干预组,依托多学科团队实施链式管理,包括跨科间大循环及科内小循环双链式闭环管理。结果与对照组比较,干预组大小循环交接环节遗漏率显著降低,术前疫苗接种率、围术期疼痛控制率及照护者满意度显著提高(均P<0.05)。结论链式管理模式的实施能够改善科室间及科内大小循环的交接遗漏问题,普及患儿术前疫苗接种,解决患儿围术期疼痛问题,提升患儿照护者的满意度,保障患儿围术期护理安全。Objective To establish a chain management model for pediatric living donor liver transplantation and to explore its clinical effect.Methods Historical control study design was adopted.Twenty-eight children who received orthotopic liver transplantation in the transplantation center from March 2020 through March 2021 were selected as the control group and received routine care.Between May 2021 and February 2022,another 30 children of the same kind were selected as the intervention group,and were subjected to a multidisciplinary team(MDT)-led chain management model which encompassed a trans-department major cycle and a within-department closed-loop minor cycle.Results Compared with the control group,the rates of hand-over omissions in major cycle and minor cycle in the intervention group were significantly reduced,while the rates of preoperative vaccination,and perioperative pain control,and satisfaction of caregivers,were significantly improved(all P<0.05).Conclusion The establishment and practice of the chain management model can reduce handover omissions in major cycle(between departments)and minor cycle(within departments),improve uptake of preoperative vaccination in children,solve the problems of perioperative pain,enhance caregiver satisfaction,and ensure the safety of perioperative nursing service.

关 键 词：儿童 终末期肝病 肝移植 活体供者 链式管理 疼痛 满意度 护理 

分 类 号：R473.72[医药卫生—护理学] R473.6[医药卫生—临床医学]