品管圈对原发性肝癌围手术期患者营养支持的研究

目的：我国肝癌病人多合并乙肝及肝硬化,患者一般状况较差,术后极易发生水电解质紊乱、肝功能及凝血功能异常以及术后感染等并发症。本研针对患者肝癌术后营养支持问题设立品管圈管理,旨在改善患者围手术期康复进程。方法：本研究的研究对象为2019年1月-2019年6月期间于我科住院,行手术治疗、符合纳入标准的肝癌患者。由我院肝肿瘤外科病区10名护理人员组成QCC小组后进行现状调查,经小组讨论后,针对存在的问题制定有效的干预措施,并实施干预。结果：QCC干预组患者对营养状况及饮食认知正确率明显提升(88.5% vs 34.2%, P<0.01)、营养相关并发症发生率显著降低(25.6% vs 43.4%, P<0.01)。同时,QCC干预组患者术后住院时间明显缩短(6.6±1.1 vs 8.2±1.3, P<0.01),住院费用降低(42.5±8.0 vs 46.7±9.6, P<0.01)。结论：我们的QCC干预策略有效地提高了医务人员对术后患者的营养干预效率及患者的依从性,改善患者的营养状态,提升了患者围手术期预后及生存质量。

Efficiency of Quality Control Circle for Nutritional Support on Perioperative Liver Cancer PatientsZHOU Qing, WEI Li, PAN Ting, YU Jing-Xian *

Objective: Most patients with liver cancer in China are associated with hepatitis B and liver cirrhosis. The general condition of patients is poor, and complications such as water and electrolyte disturbance, abnormal liver function and coagulation function, and postoperative infection are often occurs after surgery. This study aimed to improve the perioperative recovery process of patients with liver cancer by establishing quality control circle management for patients with liver cancer after surgery. Methods: Patients with liver cancer who were admitted to our department from January 2019 to June 2019 and underwent surgical treatment and met the inclusion criteria was included in this study. The QCC team was formed by 10 nurses in the liver surgery department wards of our hospital, and the current situation was investigated. After the group discussion, effective intervention measures were formulated for the existing problems, and the intervention was implemented. Results: The QCC intervention group had significantly improved nutritional status and dietary awareness (88.5% vs 34.2%, P <0.01), and significantly reduced the incidence of nutrition-related complications (25.6% vs 43.4%, P <0.01). At the same time, the postoperative hospital stay of patients in the QCC intervention group was significantly reduced (6.6 ± 1.1 vs 8.2 ± 1.3, P <0.01), and hospitalization costs were reduced (42.5 ± 8.0 vs 46.7 ± 9.6, P <0.01). Conclusion: Our QCC intervention strategy has effectively improved the nutritional status of patients, the perioperative prognosis and quality of life of patients.