零缺陷理论在腹壁下动脉穿支皮瓣乳房再造术围术期护理中的应用  

Study of zero defect theory in breast reconstruction of inferior abdominal artery perforator flap

作　　者：马悦 冯爱敏 舒晓 刘军晓 冯然 MA Yue;FENG Aimin;SHU Xiao;LIU Junxiao;FENG Ran(Department of Anesthesia and Perioperative Medicine,the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 540008,CHN)

机构地区：[1]郑州大学附属肿瘤医院麻醉与围术期医学科,郑州450008

出　　处：《河南大学学报（医学版）》2024年第4期308-312,共5页Journal of Henan University:Medical Science

基　　金：河南省卫生科技攻关计划(Wjlx2021343)。

摘　　要：目的:探讨总结DIEP乳房再造手术围术期手术配合流程的优化模式,以期指导临床工作。方法:应用零缺陷管理理论,选取2019年4月至2022年1月在我院接受DIEP乳房再造手术的48例乳腺癌患者,并根据围手术期护理模式,将其分为观察组及对照组。2组患者均常规给予乳腺癌手术配合流程护理。观察组在此基础上通过成立零缺陷理论护理小组,应用零缺陷理论模式对患者的围术期护理流程进行优化。观察并比较两组患者术中出血量,手术时间,住院时间,术后并发症及护理缺陷事件的发生率。结果:相比于对照组,观察组患者的术中出血量显著降低(P<0.001),手术时间无显著缩短(P=0.153),住院时间显著缩短(P<0.001)。在术后并发症方面,观察组的并发症发生率(19.2%)低于对照组(27.3%),但差异无统计学意义(P=0.732)。观察组相比于对照组在护理缺陷事件发生率方面明显较少,但差异无统计学意义(P均>0.05)。结论:这说明加速康复外科背景下的零缺陷理论模式在DIEP乳房再造手术围手术期护理中有积极意义。Objective: To explore and summarize the optimization model of perioperative coordination process of DIEP breast reconstruction surgery in order to guide clinical work. Methods: Using zero-defect management theory, A total of 48 patients with breast cancer who selected DIEP breast reconstruction surgery in our hospital from April 2019 to January 2022 were enrolled and divided into observation group(n=26) and control group(n=22). Patients in both groups were routinely given breast cancer surgery with process nursing. On this basis, the observation group established the zero-defect theory nursing group, and applied the zero-defect theory model to optimize the perioperative nursing process of patients. The amount of intraoperative blood loss, operation time, time of hospital stay, postoperative complications and incidence of nursing defect events were observed and compared between the two groups. Results: Compared with the control group, the observation group had significantly reduced the amount of intraoperative blood loss(P<0.001), not decreased operation time(P=0.153) and the time of hospital stay was significantly shortened(P<0.001). In terms of postoperative complications, the incidence of complications in the observation group(19.2%)was lower than that in the control group(27.3%), but the difference was not statistically significant(P=0.732). The incidence of nursing defect events was notsignificantly lower in the observation group than in the control group(All P>0.05). Conclusion: This indicates that the zero-defect theory model in the context of accelerated rehabilitation surgery has positive significance in perioperative nursing of DIEP breast reconstruction.

关 键 词：乳腺癌 DIEP乳房再造手术 零缺陷管理理论 护理缺陷事件 

分 类 号：R473[医药卫生—护理学]