基于循证的加速康复外科护理联合督导管理对甲状腺癌根治术后患者的影响研究

A Study on the Impact of Evidence-based Enhanced Recovery After Surgery Combine with Supervision Management on Postoperative Patients with Thyroid Cancer Undergoing Radical Surgery

目的分析基于循证的加速康复外科护理+督导管理对甲状腺癌根治术后患者的护理效果及对患者恢复质量的影响。方法选取2021年6月至2022年6月期间河南省人民医院收治的76例甲状腺癌患者作为研究样本,其中2021年6月至2021年12月的38例患者为对照组,2022年1月至2022年6月的38例患者为实验组,对照组围术期接受常规护理,实验组围术期接受基于循证的加速康复外科护理+督导管理。比较两组术后恢复指标(术后引流管留置时间、住院时间、颈部恢复活动时间)、术后并发症发生情况(颈部僵硬、声音嘶哑、四肢麻木)、术后疼痛程度变化情况及护理前后生活质量评分(SF-36)。结果实验组术后引流管留置时间、住院时间、颈部恢复活动时间均短于对照组,差异有统计学意义(P<0.05)。实验组术后并发症发生率(5.26%)低于对照组(18.42%),差异有统计学意义(P<0.05)。实验组术后1 d、2 d、3 d疼痛评分低于对照组,差异有统计学意义(P<0.05)。护理后,实验组生理功能评分、精神健康评分、社会功能评分、总体健康评分、精力评分、生理职能评分、情感职能评分、躯体职能评分方面的生活质量评分均高于对照组,差异有统计学意义(P<0.05)。结论基于循证的加速康复外科护理+督导管理在甲状腺癌根治术后患者中可取得较理想的护理效果,同时可有效预防术后并发症、减轻术后疼痛、提升恢复质量,值得应用。

Objective To analyze the evidence-based enhanced recovery after surgery with supervision management on the nursing outcomes and recovery quality after the total thyroidectomy.Methods A total of 76 thyroid cancer patients treated from July 2021 to July 2022 in Henan Provincial People’s Hospital were chosen as research samples.Among them,38 patients from June 2021 to December 2021 were selected as the control group,and 38 patients from January 2022 to June 2022 were selected as the experimental group.The control group received routine nursing during the perioperative period,while the experimental group received evidence-based enhanced recovery after surgery and supervision management during the perioperative period.The postoperative recovery indicators(postoperative drainage tube retention time,hospital stay,neck recovery time),incidence of postoperative complications(neck stiffness,hoarseness,limb numbness),changes in postoperative pain level,and The medical outcomes study 36-item short from health survey,before and after nursing(SF-36)were compared.Results The postoperative catheter indwelling,hospitalization,cervical function recovery and recurrent laryngeal nerve recovery time in the trial group were significantly shorter than control group,with statistical significance(P<0.05);the postoperative complication rates in the trial group(5.26%)were significantly lower than control group(18.42%),with statistical significance(P<0.05);the pain scores of the trial group were lower than those of the control group on the 1st,2nd,and 3rd day after surgery,and the difference was statistically significant (P < 0.05). After nursing, the quality of life scores of the trial group in terms of physiological function score, mental health score, social function score, overall health score, energy score, physiological function score, emotional function score, and physical function score were higher than those of the control group, with statistical significance (P < 0.05). Conclusion The evidence-based enhanced recovery after surgery combined with supervision management can effectively reduce the postoperative complications and pain degree, improve the nursing outcomes and recovery quality after the total thyroidectomy.