基于循证依据的康复护理在甲状腺癌患者经口腔前庭腔镜甲状腺切除术后的应用  

Application of evidence-based rehabilitation nursing in patients with thyroid cancer after transoral endoscopic thyroidectomy vestibular approach

作　　者：刘萍 冯志玲 曹艳萍[1] 夏梦蝶 吴峰[1] LIU Ping;FENG Zhi-ling;CAO Yan-ping;XIA Meng-die;WU Feng(WordⅠ,Department of General Surgery,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]河南中医药大学第一附属医院普外科一区,河南郑州450000

出　　处：《海南医学》2024年第19期2856-2860,共5页Hainan Medical Journal

基　　金：河南省中医药科学研究专项课题(编号:2023ZY2011)。

摘　　要：目的探讨基于循证依据的康复护理在甲状腺癌患者经口腔前庭腔镜甲状腺切除术(TOETVA)后的应用效果。方法选择2022年3月至2024年3月在河南中医药大学第一附属医院接受TOETVA手术的113例甲状腺癌患者作为研究对象,按随机数表法分为观察组56例和对照组57例。对照组患者采用常规护理,观察组患者在对照组护理的基础上采用基于循证依据的康复护理,两组患者均护理至出院,出院后均随访1个月。护理结束出院前,比较两组患者术后引流量、拔引流管时间及住院时间;随访1个月后,比较两组患者术后1 d、7 d的颈部疼痛和残疾量表(NPDS)评分和颈部活动度的变化;随访1个月后,比较两组患者术前、随访1个月后的中国头颈癌生命质量测定量表(QLICP-HN)评分;随访1个月后回院复查时,比较两组患者的术后并发症发生情况。结果观察组患者的术后引流量、拔引流管时间及住院时间分别为(22.34±3.73)m L、(2.58±0.63)d、(5.63±1.29)d,明显少(短)于对照组的(34.71±3.95)m L、(3.87±0.75)d、(7.05±1.38)d,差异均有统计学意义(P<0.05);术后7 d,两组患者的NPDS评分明显低于术后1 d,颈部前屈、颈部后伸角度大于术后1 d,观察组患者术后7 d的NPDS评分为(16.82±2.10)分,明显低于对照组的(21.25±2.37)分,颈部前屈、颈部后伸角度分别为(41.67±4.81)°、(39.13±3.58)°,明显大于对照组的(36.08±4.09)°、(33.64±3.71)°,差异均有统计学意义(P<0.05);随访1个月后,两组患者的QLICP-HN评分明显高于术前,且观察组患者随访1个月后的QLICP-HN评分为(119.23±17.72)分,明显高于对照组的(103.81±15.91)分,差异有统计学意义(P<0.05);观察组患者术后并发症总发生率为3.57%,明显低于对照组的15.79%,差异有统计学意义(P<0.05)。结论基于循证依据的康复护理在甲状腺癌患者TOETVE术后应用效果明显,可促进颈部功能恢复,改善生活质量,并降低并发症发生率,值Objective To investigate the application effect of evidence-based rehabilitation nursing in patients with thyroid cancer after transoral endoscopic thyroidectomy vestibular approach(TOETVA).Methods A total of 113 patients with thyroid cancer who underwent TOETVA surgery in the First Affiliated Hospital of Henan University of Chinese Medicine from March 2022 to March 2024 were selected as study subjects,and they were divided into an observation group(56 cases)and a control group(57 cases)according to random number table method.Patients in the control group received routine nursing,and those in the observation group received evidence-based rehabilitation nursing based on the control group,all until discharge.The postoperative drainage volume,extraction time of drainage tube,and length of hospital stay of the two groups were compared,and the Neck Pain and Disability Scale(NPDS)and range of motion of the neck at 1 day and 7 days after surgery were compared,and the changes of Chinese Head and Neck Cancer Quality of Life Scale(QLICP-HN)scores at before and after surgery 1 month were compared.The incidence of postoperative complications were compared between the two groups when returning to the hospital for reexamination after one month of follow-up.Results The postoperative drainage volume,extraction time of drainage tube,and length of hospital stay in the observation group were(22.34±3.73)mL,(2.58±0.63)d,and(5.63±1.29)d,which were significantly less(shorter)than the control groups’(34.71±3.95)mL,(3.87±0.75)d,and(7.05±1.38)d(P<0.05).At 7 d after surgery,the NPDS score in the observation group were(16.82±2.10)points,which were significantly lower than the control groups’(21.25±2.37)points;the anteflexion and backward extension angle of neck were(41.67±4.81)°and(39.13±3.58)°,which were significantly higher than the control groups’(36.08±4.09)°and(33.64±3.71)°(P<0.05).At 1 month after surgery,the QLICP-HN score in the observation group were(119.23±17.72)points,which were significantly higher than th

关 键 词：甲状腺癌 经口腔前庭腔镜甲状腺切除术 循证依据 康复护理 并发症 

分 类 号：R473.73[医药卫生—护理学]