以品管圈活动为框架的优化手术室干预路径对腹腔镜下全子宫切除术患者的影响  

Effects of the optimal operating room intervention path based on the quality control circle activities as the framework on patients with laparoscopic total hysterectomy

作　　者：费钧雪 刘艳 张慧 顾兢兢 FEI Junxue;LIU Yan;ZHANG Hui;GU Jingjing(Haian People's Hospital,Haian,Jiangsu Province,226600)

机构地区：[1]江苏省海安市人民医院,226600

出　　处：《中国计划生育学杂志》2025年第4期835-839,共5页Chinese Journal of Family Planning

摘　　要：目的:观察以品管圈活动为框架的优化手术室干预路径对腹腔镜下全子宫切除术患者影响。方法:纳入2021年1月-2023年10月本院收治的拟行腹腔镜下全子宫切除术患者102例,采随机数字表法分为观察组和对照组各51例,两组均实施手术室常规干预,观察组同时实施以品管圈活动为框架的优化手术室干预路径干预,对照组脱落1例,观察组无病例脱落,观察两组手术耐受性优良率、麻醉诱导开始(T0)、手术开始10min(T1)、手术开始20min(T2)、手术结束即刻(T3)等体温,术前1d及手术开始前患者心率、呼吸频率与收缩压、舒张压等应激状态指标,手术相关指标,术后患者焦虑自评量表(SAS)及抑郁自评量表(SDS)评分、术后疼痛评分(VAS评分)与干预满意度评分。结果:观察组手术耐受性优良率(94.1%)高于对照组(80.0%),T1、T2、T3时体温观察组均高于对照组,干预后手术开始前心率、呼吸频率、收缩压、舒张压等应激状态指标观察组均优于对照组(均P<0.05),两组手术时间及出血量指标无差异(P>0.05),观察组术后胃肠功能恢复时间(1.72±0.20d)与住院时间(6.99±0.83d)均短于对照组(1.96±0.12d、8.41±0.82d),术后SDS(38.64±5.92分)、SAS(38.65±4.41分)、VAS评分(2.53±0.25分)均低于对照组(45.23±4.23分、46.84±3.82分、3.23±0.38分),干预满意度评分(95.23±1.73分)高于对照组(90.34±2.12分)(均P<0.05)。结论:以品管圈活动为框架的优化手术室干预路径对腹腔镜下全子宫切除术患者具有积极影响,可提升患者手术耐受性,较好维持患者术中体温,缓解患者术前应激状态及术后疼痛,促进患者术后更快恢复,患者满意度提高。Objective:To observe the effects of the optimal operating room intervention path based on the quality control circle activities as the framework on patients with laparoscopic total hysterectomy.Methods:A total of 102 patients who wanted laparoscopic total hysterectomy were included and were divided into observation group(51 cases)and control group(51 cases)by random number table method from January 2021 to October 2023.The patients in the control group received routine intervention in operating room,while the patients in the observation group received the optimized intervention path intervention in operating room based on quality control circle activities as the framework.Only 1 patient in the control group was excluded.The excellent and better rate of the surgical tolerance,and the body temperature at the beginning of anesthesia induction(T0),at 10 min after operation(T1),at 20 min after operation(T2)and immediately after operation(T3),the values of the heart rate,respiratory rate,systolic blood pressure,diastolic blood pressure and other stress state indicators in 1 day before operation and before operation,the operation related indicators values of the patients in the two groups were observed.The scores of the postoperative self-rating anxiety scale(SAS),the self-rating depression scale(SDS),the postoperative pain score evaluated by visual analogue scale(VAS)and the score of intervention satisfaction of the patients in the two groups were also recorded.Results:The excellent rate(94.1%)of the surgical tolerance of the patients in the observation group was significantly higher than that(80.0%)of the patients in the control group.The body temperature of the patients in the observation group at T1,at T2or at T3was significantly higher than that of the patients in the control group.After intervention,the values of the heart rate,respiratory rate,systolic blood pressure,diastolic blood pressure and other stress state indicators of the patients in the observation group before the operation were significantly better t

关 键 词：腹腔镜下全子宫切除术 以品管圈活动为框架 优化手术室干预路径 手术耐受性 体温 应激状态 疼痛 

分 类 号：R713.4[医药卫生—妇产科学]