基于循证指导的快速康复护理对甲状腺肿瘤患者术后恢复的影响  

The Effect of Evidence-Based Guided Rapid Rehabilitation Care on Postoperative Recovery in Patients with Thyroid Tumors

作　　者：李雪年 LI Xuenian(Surgery Department of Huai'an First People's Hospital Branch,Huai'an 223001,China)

机构地区：[1]江苏淮安市第一人民医院分院普外科,淮安223001

出　　处：《中国医药指南》2024年第2期149-152,共4页Guide of China Medicine

摘　　要：目的探讨基于循证指导的快速康复护理干预对甲状腺肿瘤患者术后恢复的影响。方法以2020年1月至2023年5月淮安市第一人民医院分院普外科收治的60例甲状腺肿瘤手术患者为研究对象,依据入组时间不同分观察组,先入组的30例为对照组,后入组的30例为观察组,观察组予以循证指导下的快速康复护理,对照组予以常规护理。干预前后,测定两组血清应激指标皮质醇(Cor)、肾上腺素(Ad)与C反应蛋白(CRP),评价两组围手术期应激状态。比较观察两组术后恢复指标,包括不同时点疼痛数字评分法(NRS)得分、术后首次下床时间、首次排气排便时间与住院时间。观察两组术后有无切口感染、切口出血、声嘶、消化道反应、下肢深静脉血栓形成(DVT)等并发症,统计发生率。术前及术后3天,分别以Kolcaba舒适状况量表(GCQ)和甲状腺疾病患者生活质量问卷(ThyPRO-39)评价两组围手术期舒适度与生活质量。结果观察组术后血Cor、Ad与CRP水平、并发症发生率均低于对照组(均P<0.05)。观察组术后12 h与术后1天NRS评分低于对照组,术后下床、排气与排便时间早于对照组,住院时间短于对照组(均P<0.05)。观察组术后GCQ评分高于对照组,ThyPRO-39评分低于对照组(均P<0.05)。结论围手术期予以甲状腺肿瘤手术患者基于循证指导的快速康复干预,可以更好的减轻患者手术应激反应与术后早期疼痛,预防和减少手术并发症,加快康复进程,对提高患者术后舒适度与生活质量也具有积极作用。Objective To investigate the impact of an evidence-based guided rapid rehabilitation nursing intervention on postoperative recovery in patients with thyroid tumors.Methods Sixty thyroid tumor surgery patients admitted to Surgery Department of the Branch of Huai'an First People's Hospital from January 2020 to May 2023 were taken as the study subjects,and were grouped according to the different time of enrollment,with 30 cases enrolled in the group first as the control group and 30 cases enrolled in the group afterward as the observation group,and the observation group was treated with evidence-based case-guided rapid rehabilitation nursing,while the control group was treated with routine nursing.Before and after the intervention,serum stress indicators cortisol(Cor),adrenaline(Ad)and C-reactive protein(CRP)were measured to evaluate the perioperative stress status of the two groups.The postoperative recovery indexes of the two groups were compared and observed,including the scores of Numerical rating scale for pain at different time points,the time of first getting out of bed,the time of first defecation and the hospitalization time after the operation.Observe whether there were any postoperative complications such as incision infection,incision bleeding,hoarseness,gastrointestinal reaction,and deep vein thrombosis(DVT)of the lower extremities in the two groups,and count the incidence rate.Perioperative comfort and quality of life were evaluated by Kolcaba Comfort Status Scale(GCQ)and Thyroid Disease Patient's Quality of Life Questionnaire(ThyPRO-39)in the two groups before surgery and 3 days after surgery,respectively.Results The postoperative blood Cor,Ad and CRP levels and complication rates of the observation group were lower than those of the control group(all P<0.05).The NRS scores of the observation group were lower than those of the control group at 12 h and 1 day after operation,and the postoperative time of getting out of bed,defecation and bowel movement was earlier than that of the control group,and the

关 键 词：甲状腺肿瘤 循证护理 快速康复干预 

分 类 号：R473.73[医药卫生—护理学] R736.1[医药卫生—临床医学]