基于全面质量管理的全程管理模式在帕金森患者脑深部电刺激术的应用研究  

Research on application of a full process management model based on total quality management in deep brain stimulation surgery for Parkinson's patients

作　　者：富晶[1] 牛娟娟 高冬梅 高源 夏小童 孟凡刚 张建国 FU Jing;NIU Juanjuan;GAO Dongmei(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100070 [2]北京市神经外科研究所

出　　处：《临床神经外科杂志》2023年第5期515-519,共5页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金资助项目(81830033)。

摘　　要：目的探讨基于全面质量管理(TQM)的围手术期全程管理模式在帕金森患者脑深部电刺激术(DBS)的应用效果。方法采用非同期对照的研究设计,选取2021年1月—8月和2022年1月—8月北京天坛医院功能神经外科帕金森病DBS患者为研究对象,其中2022年1月—8月81例患者为干预组,2021年1月—8月74例患者为对照组,对照组接受常规围手术期管理,干预组接受基于TQM的围手术期全程管理模式,通过帕金森病非运动症状评价量表(NMSS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及患者满意度进行评价。结果干预组患者较对照组患者的术后NMSS评分有显著统计学差异(P=0.002),两组间NMSS、HAMA、HAMD量表的临床症状改善率有显著统计学差异(分别为P=0.011,P=0.035,P=0.005),干预组患者的满意度高于对照组患者。结论基于TQM的围手术期全程管理模式能够有效改善帕金森病患者非运动症状,缓解患者焦虑、抑郁情绪,提高患者满意度,保障患者全程诊疗安全。Objective To explore the effect of total quality management(TQM)-based whole-course management mode in deep brain stimulation(DBS)patients with Parkinson's disease.Methods A non-simultaneous controlled study design was adopted.Patients with Parkinson's DBS in the Department of Functional Neurosurgery,Beijing Tiantan Hospital from January 2021 to August 2022 were selected for the study,81 patients from January to August 2022 were in the intervention group and 74 patients from January to August 2021 were in the control group.The control group received conventional care and the intervention group received TQM-based total management model care,which was evaluated by the Parkinson's disease Non-motor Symptom Evaluation Scale,Hamilton Anxiety Scale,Hamilton Depression Scale and patient satisfaction.Results Patients in the intervention group showed statistically significant differences in non-motor symptom scores compared to patients in the control group(P=0.002).There was a significant improvement in the rate of improvement of clinical symptoms such as non-motor symptoms,anxiety,and depression with statistically significant differences(P=0.011,P=0.035,P=0.005).The satisfaction of patients in the intervention group was higher than that of patients in the control group.Conclusion The TQM-based management model can effectively improve the non-motor symptoms of Parkinson's disease patients,relieve their anxiety and depression,improve patient satisfaction,and ensure patient safety throughout the treatment.

关 键 词：围手术期全面质量管理 全程管理 帕金森病 脑深部电刺激 

分 类 号：R742.5[医药卫生—神经病学与精神病学]