主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
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中国科学引文数据库(CSCD)核心库期刊
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中国护理管理 ›› 2024, Vol. 24 ›› Issue (2): 293-299.doi: 10.3969/j.issn.1672-1756.2024.02.025

• 专科管理 • 上一篇    下一篇

前列腺癌根治术患者日间手术全程护理管理方案的构建与应用

张益曼 封秀琴 赵桃月 褚凝萍   

  1. 浙江大学医学院附属第二医院护理部,310009 杭州市
  • 出版日期:2024-02-15 发布日期:2024-02-15
  • 通讯作者: 封秀琴,硕士,主任护师,护理部常务副主任,E-mail:fengxiuqin@zju.edu.cn
  • 作者简介:张益曼,硕士在读,主管护师
  • 基金资助:
    浙江省医药卫生科技计划一般项目(2023KY752)

Construction and application of a comprehensive nursing management program for day surgery in patients undergoing robotic-assisted radical prostatectomy

ZHANG Yiman, FENG Xiuqin, ZHAO Taoyue, CHU Ningping   

  1. Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
  • Online:2024-02-15 Published:2024-02-15
  • Contact: E-mail:fengxiuqin@zju.edu.cn

摘要: 目的:构建前列腺癌根治术患者日间手术全程护理管理方案并分析其应用效果,以期促进患者快速、优质康复,为临床提供参考。方法:采用便利抽样法,选取2021年1月—12月入院的患者作为对照组,选取2022年1月—12月入院的患者作为实验组。实验组采用全程护理管理方案,对照组采用常规围手术期加速康复外科护理方案。比较两组患者48?h内出院占比、术后首次下床活动时间、术后直立不耐受发生率、手术并发症发生率、出院后30?d内非计划再入院率及术后1个月中重度尿失禁发生率的差异。结果:实验组共纳入62例患者,对照组共纳入64例患者,实验组患者术后首次下床活动时间早于对照组(P<0.05),且实验组患者48?h内出院占比及术后直立不耐受发生率优于对照组(P<0.05),实验组患者术后1个月中重度尿失禁发生率低于对照组(P<0.05),实验组出院30?d内非计划再入院率低于对照组(P<0.05),两组手术并发症差异无统计学意义(P>0.05)。结论:前列腺癌根治术患者日间手术全程护理管理方案可促进患者快速、优质康复,保证日间手术治疗顺利进行,并且能够降低患者术后1个月中重度尿失禁的发生率,实现前列腺癌根治术患者日间手术的高质量管理。

关键词: 机器人辅助腹腔镜前列腺癌根治术;日间手术;全程护理;加速康复;延续性护理;护理管理

Abstract: Objective: To construct a comprehensive nursing management program for day surgery in patients undergoing robotic-assisted radical prostatectomy and evaluate its safety and feasibility. Methods: According to the inclusion and exclusion criteria, we recruited patients admitted from January to December, 2021, as the control group, and patients admitted from January to December, 2022, as the experimental group, respectively. The experimental group adopted the comprehensive rehabilitation nursing scheme, while the control group received routine nursing care. Indicators including the proportion of patients discharged within 48 hours, the time needed to have the first ambulation, the incidence of orthostatic intolerance and surgical complications, unplanned readmission within 30d after discharge and incidence of moderate to severe urinary incontinence 1 month after surgery, were compared and analyzed. Results: A total of 126 patients were included in the experimental (n=62) and the control group (n=64), respectively. The time needed to have the first ambulation after surgery in the experimental group was significantly shorter than that in the control group (P<0.05). The incidence of patients' discharge within 48h and the occurrence of postoperative orthostatic intolerance were smaller in the experimental group when compared to the control group (P<0.05). Also, the incidence of moderate and severe urinary incontinence and the unplanned readmission rate within 30d of discharge were significantly lower in the experimental group (P<0.05). The difference between the two groups in terms of surgical complications was not statistical significant (P>0.05). Conclusion: The comprehensive nursing management program for day surgery in patients undergoing robotic-assisted radical prostatectomy can ensure the success of day surgery for robotic-assisted radical prostatectomy and promote patient recovery after surgery. Also, by applying the mode, the incidence of severe urinary incontinence in the first month after surgery is decreased and the patients' life quality is enhanced. The approach facilitates the high-quality management of day surgery for robotic-assisted radical prostatectomy.

Key words: robotic-assisted radical prostatectomy; day surgery; prerehabilitation; enhanced recovery after surgery; transitional care; nursing management

中图分类号:  R47;R197