多学科协作下加速康复外科集束化措施对甲状腺癌手术患者预后 不良情绪及生活质量的影响

Effects of enhanced recovery after surgery cluster measures under multidisciplinary cooperation on the prognosis,unhealthy emotion and quality of life of patients undergoing thyroid cancer surgery

目的探讨多学科协作下加速康复外科集束化措施对甲状腺癌手术患者预后、不良情绪及生活质量的影响。方法将116例甲状腺癌手术患者按随机数字表法分为两组,每组58例。两组均予以常规护理干预,研究组在此基础上联合多学科协作下加速康复外科集束化措施,观察住院全程。比较两组治疗情况(引流管留置时间、住院时间、视觉模拟评分法评分、住院费用)、并发症发生率及干预前后华西心晴指数量表评分、欧洲癌症研究与治疗组织生命质量测定量表评分。结果研究组引流管留置时间、住院时间显著短于对照组(P<0.01),视觉模拟评分法评分显著低于对照组(P<0.01),住院费用显著少于对照组(P<0.01)。干预后两组华西心晴指数量表的焦虑、急性焦虑、抑郁维度评分均较干预前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。干预后两组欧洲癌症研究与治疗组织生命质量测定量表的躯体功能、角色功能、情绪功能、认知功能、社会功能维度评分均较干预前显著升高(P<0.01),研究组显著高于对照组(P<0.01)。研究组并发症总发生率显著低于对照组(P<0.05)。结论多学科协作下加速康复外科集束化措施可促进甲状腺癌患者术后康复,明显改善患者的情绪状态,提高其生存质量。

Objective To analyze the effects of enhanced recovery after surgery cluster measures under multidisciplinary cooperation on the prognosis,unhealthy emotion and quality of life of patients undergoing thyroid cancer surgery.Methods A total of 116 thyroid cancer patients undergoing surgery were divided into two groups according to random number table method,with 58 cases in each group.The control group was treated with conventional nursing intervention,and the study group was treated with enhanced recovery after surgery cluster measures under multidisciplinary cooperation on the basis of the control group.The whole course of hospitalization was observed.The treatment situation[indwelling time of drainage tube,hospital stay,visual analogue scale(VAS),hospitalization expenses]and the incidence of complications of the two groups were counted,and the scores of Huaxi emotional-distress index(HEI)and European organization for research and treatment of cancer quality of life questionnaire(EORTC QLQ-C30)were compared between the two groups.Results The indwelling time of drainage tube and hospital stay in the study group were significantly shorter than those in the control group(P<0.01),the VAS score was significantly lower than that in the control group(P<0.01),and the hospitalization expenses was significantly lower than that in the control group(P<0.01).After intervention,the dimension scores of anxiety,acute anxiety and depression of HEI in the two groups were significantly lower than those before intervention(P<0.01),and the study group was significantly lower than the control group(P<0.01).After the intervention,the dimension scores of physical function,role function,emotional function,cognitive function and social function of EORTC QLQ-C30 in the two groups were significantly higher than those before intervention(P<0.01),and the study group was significantly higher than the control group(P<0.01).The total complication rate of the study group was significantly lower than that of the control group(P<0.05).Conclusions Enhanced recovery after surgery cluster measures under multidisciplinary cooperation can promote postoperative recovery of thyroid cancer patients,improve their emotional state and quality of life.