基于FMEA及灾害脆弱性分析的手术室管理对老年肺癌术后临床效果的影响分析  

Analysis of the Impact of Operating Room Management Based on FMEA and Disaster Vulnerability Analysis on the Postoperative Clinical Effect of Elderly Lung Cancer Patients

作　　者：张西莲 ZHANG Xilian(Jinan Hospital of Integrative Medicine,Jinan 271100,China)

机构地区：[1]济南市中西医结合医院,山东济南271100

出　　处：《中外医学研究》2025年第1期70-74,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究基于失效模式与效应分析(failure mode and effect analysis,FMEA)及灾害脆弱性分析的手术室管理对老年肺癌术后临床效果的影响。方法:前瞻性选取2021年9月—2023年9月济南市中西医结合医院收治的94例行择期根治术治疗老年肺癌患者,按照随机数表法分为研究组47例、对照组47例。对照组患者接受常规手术室管理,研究组患者接受基于FMEA及灾害脆弱性分析的手术室管理,比较两组手术相关指标、负性情绪[汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)评分、汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)评分]、Kolcaba舒适状况量表(general comfort questionnaire,GCQ)评分、术后并发症。结果:研究组首次下床活动时间、进食时间、胸腔引流管停留时间、住院时间均优于对照组,差异有统计学意义(P<0.05)。两组护理后HAMD评分、HAMA评分均低于护理前,差异有统计学意义(P<0.05);且研究组HAMD评分、HAMA评分、差值均优于对照组,差异有统计学意义(P<0.05)。两组护理后GCQ量表各维度得分均高于护理前;且研究组GCQ量表各维度得分均高于对照组,差异有统计学意义(P<0.05)。研究组与对照组肺漏气发生率、胸腔积液发生率、吻合口渗血发生率比较,差异无统计学意义(P>0.05),但研究组术后切口感染发生率、总术后并发症发生率均低于对照组,差异有统计学意义(χ^(2)=3.859、8.689,P<0.05)。结论:基于FMEA及灾害脆弱性分析的手术室管理应用于老年肺癌术后患者具有较好的临床效果,可有效缓解负性情绪,提高舒适度,降低术后切口感染与并发症发生风险,促进术后早期恢复。Objective:To explore the effect of operating room management based on failure mode and effect analysis(FMEA)and disaster vulnerability analysis on the postoperative clinical effect of elderly lung cancer patients.Method:A total of 94 elderly patients with lung cancer undergoing elective radical surgery treated in Jinan Hospital of Integrative Medicine from September 2021 to September 2023 were prospectively selected and divided into 47 cases in the study group and 47 cases in the control group according to random number table method.Patients in the control group received routine operating room management,and patients in the study group received operating room management based on FMEA and disaster vulnerability analysis.Surgery-related indicators,negative emotion[Hamilton anxiety rating scale(HAMA)score,Hamilton depression rating scale(HAMD)score],Kolcaba general comfort questionnaire(GCQ)score,postoperative complications were compared between the two groups.Result:The first time of getting out of bed,eating time,residence time of thoracic drainage tube and hospital stay in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).HAMD scores and HAMA scores after nursing in both groups were lower than before nursing,and the differences were statistically significant(P<0.05).The HAMD scores,HAMA scores and differences of the study group were better than those of the control group,and the differences were statistically significant(P<0.05).The scores of GCQ scale after nursing were higher than before nursing in both groups,the score of GCQ scale in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of pulmonary air leakage,pleural effusion and anastomotic bleeding between the study group and the control group(P>0.05),but the incidence of postoperative incision infection and total postoperative complications in the study group were lower th

关 键 词：肺癌 失效模式与效应分析 灾害脆弱性分析 手术室管理 术后切口感染 

分 类 号：R472.3[医药卫生—护理学]