甲状腺良性肿瘤手术患者应用快速康复外科理念结合临床护理路径模式的效果观察

摘要

目的 探讨甲状腺良性肿瘤(TBT)手术患者应用快速康复外科理念(FTS)结合临床护理路径(CNP)模式的效果.方法 选择我院于2014年10月至2016年3月期间收治的180例TBT患者为研究对象,根据信封法随机分为观察组和对照组,每组各90例.其中对照组于围手术期常规护理,观察组患者应用FTS结合CNP的护理模式,比较两组患者围手术期临床指标、健康知识掌握情况及护理满意度.结果 观察组患者术前等候时间、术后胰岛素抵抗指数(HOMA-IR)及疼痛程度(Ⅱ~Ⅲ级比例)、术后首次离床时间、术后首次进食时间、术后住院时间、手术并发症发生率、术后住院费用分别为(2.4±0.6)d、(1.2±0.4)、8.89%、(7.2±3.5)h、(6.4±2.9)h、(3.2±0.9)d、0、(7.5±0.8)×103元,均低于对照组的(3.7±0.9)d、(1.9±0.7)、18.89%、(43.4±13.2)h、(12.3±4.9)h、(5.1±1.4)d、4.44%、(8.4±0.9)×103元,差异均有统计学意义(P<0.05);观察组患者的健康知识评分优良率及护理满意率分别为88.89%和94.44%,均明显高于对照组的76.67%和83.33%,差异均有统计学意义(P<0.05).结论 TBT患者应用FTS结合CNP护理模式减轻了手术应激反应和手术并发症,优化了围术期临床指标,有利于术后的快速康复,减轻患者的经济负担,提高护理满意度.%Objective To explore the effect of fast track surgery (FTS) combined with clinical nursing pathway (CNP) on the patients with thyroid benign tumor (TBT). Methods A total of 180 TBT patients in Songgang People's Hospital of Baoan District of Shenzhen City from October 2014 to March 2016 as the research objects were randomly di-vided into the observation group and the control group according to the Envelope Method, with 90 cases in each group. Routine nursing was given to the patients in the control group during the perioperative period, and the patients in the ob-servation group established CNP under the guidance of FTS. The clinical indicators during the perioperative period, health knowledge mastering and nursing satisfaction between the two groups were compared. Results In the observa-tion group, the preoperative waiting time, postoperative HOMA-IR, pain scoreⅡ~Ⅲrate, postoperative hospitalization time, postoperative complications incidence, and postoperative hospitalization costs were (2.4±0.6) d, (1.2±0.4), 8.89%, (7.2 ± 3.5) h, (6.4 ± 2.9) h, (3.2 ± 0.9) d, 0, (7.5 ± 0.8) × 103 yuan, which were lower than (3.7 ± 0.9) d, (1.9 ± 0.7), 18.89%, (43.4±13.2) h, (12.3±4.9) h, (5.1±1.4) d, 4.44%, (8.4±0.9)×103 yuan in the control group, showing statistically significant differences (P<0.05). The excellent rate of the health knowledge score and nursing satisfaction rate in observation group were 88.89% and 94.44%, respectively, which were significantly higher than 76.67% and 83.33% in the control group, showing statistically significant differences (P<0.05). Conclusion The application of FTS combined with CNP in TBT patients can reduce the perioperative stress response and operative complications, optimize the clinical indicators during the perioperative period, which is conducive for rapid postoperative recovery, reduction of the patients' economic burden, and improvement of nursing satisfaction.