基于FMEA模型的质控护理对乳腺癌根治术手术室护理的效果及患者的应激反应和并发症的影响  

Effect of quality control nursing based on FMEA model on the nursing effect,stress reaction,and complications in the operating room of radical mastectomy

作　　者：周盼 王芳[1] 聂云飞[1] 王君[1] 池玉杰 赵静[1] 陈伟华 ZHOU Pan;WANG Fang;NIE Yun-fei;WANG Jun;CHI Yu-jie;ZHAOJing;CHEN Wei-hua(Department of Daytime Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院日间手术部,河南郑州450000

出　　处：《海南医学》2024年第13期1964-1967,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:201702016)。

摘　　要：目的探讨基于失效模式与效应分析(FMEA)模型的质控护理对乳腺癌根治术手术室护理的效果及应激反应、并发症的影响。方法选择2022年1月至2023年9月于郑州大学第一附属医院接受乳腺癌根治术的96例患者作为研究对象,按照随机数表法分为观察组和对照组各48例。对照组患者采用常规手术室护理,观察组患者采用基于FMEA模型的质控护理。比较两组患者的围术期情况,以及术前(T0)、手术开始后30 min(T1)、手术开始后60 min(T2)、手术结束时(T3)的鼻咽温变化和T0、T3时间点的去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平,并比较两组患者的并发症发生率。结果两组患者的手术时间、术中出血量和住院时间比较差异均无统计学意义(P>0.05);观察组患者T1、T2、T3时间点的鼻咽温分别为(36.40±0.41)℃、(36.31±0.37)℃、(36.21±0.30)℃,明显高于对照组的(36.22±0.35)℃、(36.15±0.28)℃、(36.07±0.26)℃,差异均有统计学意义(P<0.05);观察组患者T3时间点的血清NE、E、Cor水平分别为(168.91±15.23)ng/L、(43.27±4.06)ng/L、(317.62±38.07)nmol/L,明显低于对照组的(179.38±18.14)ng/L、(48.91±4.42)ng/L、(340.39±34.25)nmol/L,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为8.33%,明显低于对照组的25.00%,差异有统计学意义(P<0.05)。结论基于FMEA模型的质控护理有助于缓解乳腺癌根治术后患者的应激反应,减少并发症发生率,值得临床推广应用。Objective To study the effect of quality control nursing based on failure mode and effect analysis model(FMEA)model on the nursing effect,stress reaction,and complications in the operating room of radical mastectomy.Methods A total of 96 patients who received radical mastectomy in the First Affiliated Hospital of Zhengzhou University from January 2022 to September 2023 were selected and divided into an observation group and a control group according to random number table method,with 48 cases in each group.Patients in the control group were treated with conventional nursing of operating room,and patients in the observation group were treated with quality control nursing based on FMEA model.The perioperative conditions of the two groups patients were compared,and the changes of nasopharyngeal temperature before surgery(T0),30 min after surgery(T1),60 min after surgery(T2),and at the end of surgery(T3)were compared,as well as the changes of norepinephrine(NE),epinephrine(E)and cortisol(Cor)at T0 and T3 time points.The incidences of complications were also compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss,and length of hospital stay between the two groups(P>0.05).The nasopharyngeal temperature at T1,T2,and T3 points in the observation group were(36.40±0.41)℃,(36.31±0.37)℃,(36.21±0.30)℃,which were significantly higher than(36.22±0.35)℃,(36.15±0.28)℃,(36.07±0.26)℃in the control group(P<0.05);the serum NE,E,and Cor levels in the observation group at T3 were(168.91±15.23)ng/L,(43.27±4.06)ng/L,and(317.62±38.07)nmol/L,which were significantly lower than(179.38±18.14)ng/L,(48.91±4.42)ng/L,(340.39±34.25)nmol/L in the control group(P<0.05).The total incidence of complications in the observation group was 8.33%,which was significantly lower than 25.00%in the control group(P<0.05).Conclusion The quality control nursing based on FMEA model can help alleviate the stress reaction of patients after radical mastectomy and reduce the incide

关 键 词：乳腺癌根治术 失效模式与效应分析模型 质控护理 应激反应 并发症 

分 类 号：R473.73[医药卫生—护理学]