动态评估联合标准化护理对头颈癌患者术后口腔黏膜炎及并发症的干预效果

Intervention effect of dynamic assessment combined with standardized nursing on postoperative oral mucositis and complications in patients with head and neck cancer

  • 摘要:
    目的 探讨动态评估联合标准化护理对头颈癌患者术后口腔黏膜炎及并发症的干预效果。
    方法 对照组纳入137例头颈癌手术患者, 因术前失访3例,术后失访4例,最终纳入130例。同期干预组纳入132例头颈癌手术患者,因术前失访1例,术后失访3例,最终纳入128例。对照组接受常规护理,干预组实施循证方案(标准化操作、动态评估以及多学科协作)。比较2组术后第1、4、7天口腔黏膜炎分级情况、并发症发生率以及住院时间。
    结果 与术后第1天比较,干预组术后第4天3级和4级黏膜炎改善率分别为82.2%、72.5%。干预组术后第7天3级黏膜炎改善率为72.5%, 3级黏膜炎持续控制。术后第4、7天,干预组黏膜炎为3级者占比低于对照组,差异有统计学意义(P < 0.05)。干预组住院时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P < 0.05)。
    结论 动态评估联合标准化护理流程可系统性降低头颈癌患者术后口腔并发症风险,为围术期管理提供新范式。

     

    Abstract:
    Objective To investigate the intervention effect of dynamic assessment combined with standardized nursing on postoperative oral mucositis and complications in patients with head and neck cancer.
    Methods A total of 137 patients who underwent head and neck cancer surgery were enrolled in control group. Due to loss to follow-up (3 cases before surgery and 4 cases after surgery), 130 cases were ultimately included. During the same period, 132 patients who underwent head and neck cancer surgery were enrolled in intervention group. Due to loss to follow-up (1 and 3 cases respectively before and after surgery), 128 cases were ultimately included. The control group received routine nursing care, while the intervention group implemented evidence-based protocol (standardized operation, dynamic assessment and multidisciplinary collaboration). The grades of oral mucositis, the incidence of complications and the length of hospital stay on the 1st, 4th and 7th days after surgery were compared between the two groups.
    Results Compared with postoperative day 1, the improvement rates of grade 3 and grade 4 mucositis in the intervention group on postoperative day 4 were 82.2% and 72.5%, respectively. On postoperative day 7, the improvement rate of grade 3 mucositis in the intervention group was 72.5%, with sustained control of grade 3 mucositis. On postoperative days 4 and 7, the proportion of patients with grade 3 mucositis in the intervention group was significantly lower than that in the control group (P < 0.05). The length of hospital stay in the intervention group was shorter than that in the control group, and the incidence of complications was significantly lower than that in the control group (P < 0.05).
    Conclusion The dynamic assessment combined with standardized nursing procedures can systematically reduce the risk of postoperative oral complications in patients with head and neck cancer, providing a new paradigm for perioperative management.

     

/

返回文章
返回