阶段性管理模式干预对腹腔镜子宫肌瘤切除术患者手术结局、短期预后及护理质量的影响

Effect of Staged Management Model Intervention on Surgical Outcomes,Short-term Prognosis,and Quality of Care in Patients Undergoing Laparoscopic Myomectomy

目的:为行腹腔镜子宫肌瘤切除术的患者提供阶段性管理模式干预,探究其应用效果。方法:选取郑州大学第二附属医院妇科实施应用阶段性管理前后的80例行腹腔镜子宫肌瘤切除术患者作为研究对象,将2019年7月1日—9月30日收治的患者纳入对照组,将2019年10月1日—12月31日收治的患者纳入观察组,每组各40例。对照组采用常规围术期护理干预,观察组应用阶段性管理模式干预。同时将科室18名护士纳入研究。对比两组患者的手术结局、短期预后,分析阶段性管理模式应用后科室护理质量的改善情况。结果:与对照组相比,观察组术后痊愈率更高,差异有统计学意义(χ^(2)=5.541,P<0.05)。观察组术后排气时间、下床活动时间早于对照组,术后住院时间短于对照组,差异有统计学意义(t=5.783、6.187、5.356,P<0.05)。观察组术后并发症总发生率为5%,低于对照组的25%,差异有统计学意义(χ^(2)=5.941,P<0.05)。阶段性管理模式应用后,科室护理质量评分明显升高,差异有统计学意义(t=6.453、7.269、6.318、7.539、9.854,P<0.05)。结论:为子宫肌瘤行腹腔镜切除术的患者提供基于阶段性管理模式的干预临床效果显著,有利于改善患者手术结局与短期预后,提升护理质量。

Objective:To provide a stage-management model intervention for patients undergoing laparoscopic myomectomy and to explore the effectiveness of its application.Methods:80 patients undergoing laparoscopic myomectomy before and after the implementation of applied stage management in the hospital were selected for the study.Patients from July 1 to September 30,2019 were included in the control group,and patients from October 1 to December 31,2019 were included in the observation group,with 40 cases in each group.The control group used conventional perioperative nursing interventions and the observation group applied a stage-based management model intervention.18 nurses from the department were also included in the study.The surgical outcomes and short-term prognosis of the two groups were compared,and the improvement of the quality of care in the de⁃partment after the application of the stage-based management model was analyzed.Results:Compared with the control group,the postoperative healing rate was higher in the observation group,and the difference was statistically significant(χ^(2)=5.541,P<0.05).The postoperative time to exhaustion and time to bed activity were earlier in the observation group than in the control group,and the postoperative hospital stay was shorter than in the control group,with statistically significant differences(t=5.783,6.187,5.356,P<0.05).The overall incidence of postoperative complications was 5%in the observation group,which was lower than that of 25%in the control group,and the difference was statistically significant(χ^(2)=5.941,P<0.05).The quality of care scores in the depart⁃ment were significantly higher after the application of the stage management model,with statistically significant differences(t=6.453,7.269,6.318,7.539,9.854,P<0.05).Conclusion:The stage-based management model of intervention for patients undergoing laparoscopic resection for uterine fibroids is clinically effective in improving surgical outcomes and short-term prognosis and en⁃hancing the quality of care.