FTS—CNP护理模式在甲状腺良性肿瘤手术患者围术期的应用研究

柯丹纯++++++叶小惠++++++黄素华++++++肖勇++++++杨仲新

[摘要]目的 探讨快速康复外科理念结合临床护理路径护理管理模式（FTS-CNP）在甲状腺良性肿瘤患者围术期的临床应用效果。方法 选取2014年8月～2016年1月于我院治疗的160例甲状腺良性肿瘤患者，采用信封法分为观察组和对照组，各80例，观察组采用FTS-CNP护理模式，对照组采用传统护理方法，比较两组患者围术期应激指标水平、术后恢复指标、健康知识认知度、护理满意度及术后疼痛程度。结果 术后1 d，对照组患者的平均动脉压（MAP）、心率（HR）、胰岛素抵抗（IR）指数水平均高于同组术前及同时间段观察组水平；观察组患者术后首次进食时间、术后首次下床活动时间、住院时间均短于对照组，并发症发生率低于对照组；观察组患者的健康知识认知度和护理满意度均高于对照组；疼痛程度低于对照组，差异均有统计学意义（P<0.05）。结论 对甲状腺良性肿瘤患者围术期采用FTS-CNP护理模式，能减轻患者的痛苦、加速康复进程、降低并发症的发生率、减少平均住院日、提高了患者对护理工作的满意度。

[关键词]快速康复外科理念；临床护理路径；甲状腺良性肿瘤；围术期

[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2017）03（c）-0173-04

[Abstract]Objective To explore the application of FTS-CNP nursing model in perioperative period of patients with benign thyroid tumor.Methods 160 cases of patients with benign thyroid tumor in our hospital from August 2014 to January 2016 were selected and divided into the observation group and the control group，with 80 cases in each group according to the envelope method.Patients in the observation group were treated with FTS-CNP nursing mode while patients in the control group were treated with traditional nursing methods.The levels of perioperative stress indexes，postoperative recovery indicators，health knowledge awareness，patient satisfaction with nurses and the level of pain were compared between the two groups.Results 1 day after operation，the levels of MAP，HR and IR of patients in the control group were higher than those before operation and than those in the observation group；the time of first eating，firse activity out of bed and hospitalization in the observation group were shorter than that in the control group；the incidence of complications was lower than that in the control group；the levels of health knowledge awareness，patient satisfaction with nurses were higher than those in the control group，the level of pain was lower than that in the control group，and the differences were all statistically significant （P<0.05）. Conclusion Perioperative nursing mode by FTS-CNP for patients with enign thyroid tumor could reduce the painness of patients，reduce the incidence of complications，reduce the average hospitalization time，and improve patient satisfaction with nursing work.

[Key words]FTS；CNP；Benign thyroid tumor；Perioperative period

快速康復外科理念（fast track surgery，FTS），是通过优化围术期处理措施，减轻患者手术创伤应激反应，从而减少术后并发症、缩短住院时间，加快患者康复进程的一种护理理念[1]。临床护理路径（clinical nursing pathway，CNP）是一种标准化的临床诊疗护理行为计划，可有效减少护理工作的盲从性和健康教育的低效性，缩短住院时间[2]。快速康复外科理念结合临床护理路径（FTS-CNP）是一种先进的护理新模式，将FTS的核心与CNP的要求紧密结合互相渗透，以循证医学为依据，更加优化组合围术期各种治疗护理措施[3-4]。……