围手术期PD3C2A管理模式在乳腺良性肿瘤微创旋切术中的应用  

Application of Perioperative PD3C2A Management Mode in Minimally Invasive Rotational Resection of Benign Breast Tumors

作　　者：封帮助 范毓权 艾炜发 FENG Bangzhu;FAN Yuquan;AI Weifa(Department of General Surgery,Qianxinan Traditional Chinese Medicine Hospital,Xingyi Guizhou 562400,China)

机构地区：[1]黔西南州中医院普外科,贵州兴义562400

出　　处：《中国卫生标准管理》2025年第2期110-113,共4页China Health Standard Management

基　　金：黔西南州科技计划项目(2022-2-51)。

摘　　要：目的分析围手术期计划(plan,P)、执行(do,D)、检查(check,C)3个阶段(3 check,3C)、处理(act,A)2个阶段(2 act,2A)管理模式在乳腺良性肿瘤微创旋切术中的应用。方法选取黔西南州中医院外一科2022年7月—2024年6月诊治的80例乳腺良性肿瘤患者,利用掷硬币法分为2组各40例。2组均接受乳腺微创旋切术治疗,对照组采取传统围手术期PDCA管理模式,观察组采取围手术期PD3C2A管理模式。统计手术相关指标、乳房美学评分、并发症总发生率后进行对比。结果观察组的手术时间(15.47±1.53)min、切口愈合时间(3.34±0.22)d、住院时间(3.89±0.28)d,短于对照组的(18.14±2.07)min、(4.10±0.31)d、(4.77±0.45)d,差异有统计学意义(P<0.001);术中出血量(5.99±1.04)mL,少于对照组的(9.67±1.23)mL,差异有统计学意义(P<0.001);手术费用(2684.33±102.59)元、疼痛评分(2.32±0.28)分、并发症总发生率7.50%,低于对照组的(3587.58±121.42)元、(3.45±0.67)分、27.50%;外观色泽评分(95.41±4.04)分、血管分布评分(94.87±3.85)分、厚度评分(95.10±3.99)分、柔软度评分(95.52±4.28)分,高于对照组的(91.57±2.59)分、(90.74±2.44)分、(91.34±2.54)分、(91.63±2.62)分,差异有统计学意义(P<0.001)。结论围手术期PD3C2A管理模式能够促进乳腺良性肿瘤微创旋切术患者术后恢复效果,经济效益与社会效益高。Objective To analyze the application of the perioperative planning(plan,P),execution(do,D),inspection(check,C)three-stage(3 check,3C),and treatment(act,A)twostage(2 act,2A)management model in minimally invasive rotational resection of benign breast tumors.Methods A total of 80 patients with benign breast tumors diagnosed and treated in the department of general surgery of Qianxinan Traditional Chinese Medicine Hospital from July 2022 to June 2024 were selected.They were divided into two groups using a coin toss method,with 40 cases in each group.Both groups were treated with minimally invasive rotational mastectomy,and the control group were treated with the traditional perioperative PDCA management mode,while the observation group were treated with the perioperative PD3C2A management mode.Surgical related indicators,breast aesthetic scores,and total incidence of complications were compared.Results The surgical time(15.47±1.53)min,incision healing time(3.34±0.22)d,and hospitalization time(3.89±0.28)d in the observation group were shorter than those of the control group[(18.14±2.07)min,(4.10±0.31)d,and(4.77±0.45)d],and the differences were statistically significant(P<0.001).The intraoperative bleeding volume(5.99±1.04)mL was lower than that of the control group[(9.67±1.23)mL],and the difference was statistically significant(P<0.001).The surgical cost(2684.33±102.59)yuan,pain score(2.32±0.28)points,and the total incidence rate of complications were 7.50%,lower than those of the control group[(3587.58±121.42)yuan,(3.45±0.67)points,27.50%],appearance color score(95.41±4.04)points,vascular distribution score(94.87±3.85)points,thickness score(95.10±3.99)points,and flexibility score(95.52±4.28)points were higher than those of the control group[(91.57±2.59)points,(90.74±2.44)points,and(91.34±2.54)points(91.63±2.62)points],and the differences were statistically significant(P<0.001).Conclusion The perioperative PD3C2A management model can promote the postoperative recovery of patients with benign breast

关 键 词：乳腺良性肿瘤 乳腺微创旋切术 围手术期PD3C2A管理模式 手术相关指标 乳房美学评分 并发症 

分 类 号：R665[医药卫生—外科学]