肺癌日间手术患者全流程护理管理的效果评价

doi:10.3761/j.issn.0254-1769.2026.17.015

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (17): 2411-2419.DOI: 10.3761/j.issn.0254-1769.2026.17.015

肺癌日间手术患者全流程护理管理的效果评价

曹俊华¹(), 钱维明¹^,^*(), 陈盈¹, 邱青苗², 郑琼娜², 赵金凤², 黄红燕², 陈玲玲², 叶莹², 李群²

¹ 浙江大学医学院附属第二医院护理部杭州市 310009
² 浙江大学医学院附属第二医院全程管理中心杭州市 310009

收稿日期:2025-12-29 出版日期:2026-09-10 发布日期:2026-09-03
*通讯作者: 钱维明，E-mail：2191039@zju.edu.cn
作者简介:曹俊华：女，硕士，副主任护师，护士长，E-mail：2319068@zju.edu.cn
第一联系人：作者贡献声明
曹俊华：研究设计、方案实施、数据收集、论文撰写及修改；钱维明：研究指导、论文修改；陈盈、邱青苗、郑琼娜：数据收集、质量控制；赵金凤、黄红燕、陈玲玲、叶莹、李群：文献查阅、资料整理
基金资助:
国家卫生健康委医院管理研究所日间手术规范化管理研究项目(DSZ20251026)

Effectiveness evaluation of a whole-process nursing management program for lung cancer patients under-going day surgery

CAO Junhua¹(), QIAN Weiming¹^,^*(), CHEN Ying¹, QIU Qingmiao², ZHENG Qiongna², ZHAO Jinfeng², HUANG Hongyan², CHEN Lingling², YE Ying², LI Qun²

¹ Department of Nursing， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China
² Whole Process Management Center， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China

Received:2025-12-29 Online:2026-09-10 Published:2026-09-03
* Corresponding author: QIAN Weiming，E-mail：2191039@zju.edu.cn
Funding program:
Funding program Research Project on Standardized Management of Day Surgery，National Institute of Hospital Administration，National Health Commission of the People’s Republic of China(DSZ20251026)

摘要/Abstract

摘要：

目的评价肺癌日间手术患者全流程护理管理的效果，为提升其护理质量、改善患者的就医体验提供参考。方法采用便利抽样法，选取2025年4—6月在杭州市某三级甲等医院行肺癌日间手术的280例患者作为试验组，采用肺癌日间手术患者全流程护理管理方案进行干预，包括住院前护理管理、住院期间护理管理、出院后护理管理、全流程医护患沟通管理、智慧化信息管理5个部分。选取2025年1—3月在该医院进行同类型手术的280例患者作为对照组，采用常规护理措施进行干预。比较两组的术前焦虑水平、手术取消率、手术时间准确率、肺康复执行率、延迟出院率、出院后护理缺陷或不良事件发生率、住院满意度。结果最终544例患者完成研究，其中试验组273例、对照组271例。试验组术前焦虑水平、出院后护理缺陷或不良事件发生率低于对照组，试验组手术时间准确率、肺康复执行率、住院满意度高于对照组，差异具有统计学意义（均P<0.05）。结论开展肺癌日间手术患者全流程护理管理有助于减轻患者术前焦虑水平，降低出院后护理缺陷或不良事件发生率，提升手术时间准确率、肺康复执行率及住院满意度。

关键词: 肺癌, 日间手术, 全流程管理, 风险管理, 护理管理研究

Abstract:

Objective To construct a whole-process nursing management program for patients undergoing day surgery for lung cancer and to evaluate its application effects，so as to provide a nursing practice reference for improving pre-hospitalization management of day surgery. Methods A convenience sampling method was used to recruit 560 patients who underwent day surgery for lung cancer in a tertiary Grade A hospital in Hangzhou from January to June 2025. According to admission time，the patients were divided into an experimental group and a control group，with 280 patients in each group. The experimental group received a whole-process nursing management program for lung cancer day surgery，including establishment of a pre-admission nursing unit for assessment of complex comorbidities，special medication management，pulmonary specialist evaluation，and examination management，multimodal perioperative prehabilitation education，in-hospital pulmonary rehabilitation supervision，specialized discharge follow-up，problematic case tracking management，and humanized whole-process communication management. The control group received routine pre-hospitalization management for lung cancer day surgery. Preoperative anxiety level，same-day surgery cancellation rate，accuracy rate of scheduled surgery time，postoperative pulmonary rehabilitation compliance rate，delayed discharge rate，incidence of post-discharge adverse events，and hospitalization satisfaction were compared between the 2 groups. Results A total of 544 patients completed the study，including 273 patients in the experimental group and 271 patients in the control group. The preoperative anxiety score，and post-discharge care deficit or adverse event rate in the experimental group were lower than those in the control group（P<0.05）. The surgery time accuracy rate，pulmonary rehabilitation compliance rate and hospitalization satisfaction rate were higher in the experimental group than those in the control group，with statistically significant differences（all P<0.05）. Conclusion The whole-process nursing management program for patients undergoing lung cancer day surgery can help reduce preoperative anxiety levels，decrease post-discharge care deficit or adverse event rates，and improve surgery time accuracy，pulmonary rehabilitation implementation，and hospitalization satisfaction.

Key words: Lung Cancer, Day Surgery, Whole-Process Management, Risk Management, Nursing Manage-ment Research

曹俊华, 钱维明, 陈盈, 邱青苗, 郑琼娜, 赵金凤, 黄红燕, 陈玲玲, 叶莹, 李群. 肺癌日间手术患者全流程护理管理的效果评价[J]. 中华护理杂志, 2026, 61(17): 2411-2419.

CAO Junhua, QIAN Weiming, CHEN Ying, QIU Qingmiao, ZHENG Qiongna, ZHAO Jinfeng, HUANG Hongyan, CHEN Lingling, YE Ying, LI Qun. Effectiveness evaluation of a whole-process nursing management program for lung cancer patients under-going day surgery[J]. Chinese Journal of Nursing, 2026, 61(17): 2411-2419.

图/表 2

参考文献 27

[1]	Law JJ, Harris R, Long H, et al. PL03.13 survival outcome of VATS compared to open lobectomy for lung cancer:an indivi-dual patient data meta-analysis of randomised trials[J]. J Thorac Oncol, 2025, 20(10):S6-S7.
[2]	韩娜菲, 贺红, 袁华娣, 等. 日间肺癌手术患者出院后症状纵向变化及护理对策研究[J]. 中华护理杂志, 2025, 60(4):432-438. DOI
	Han NF, He H, Yuan HD, et al. Longitudinal changes of symptoms and nursing strategies of patients under daytime lung cancer surgery after discharge[J]. Chin J Nurs, 2025, 60(4):432-438. DOI
[3]	车国卫. 加速康复外科:肺癌手术日间化现状与策略[J]. 中国肺癌杂志, 2020, 23(1):1-4.
	Che GW. Current situation and strategy of day surgery in patients with lung cancer by enhanced recovery after surgery[J]. Chin J Lung Cancer, 2020, 23(1):1-4.
[4]	赵英楠, 郑鑫彤, 郑秋岗, 等. 护士主导的早期肺康复策略在老年肺癌术后患者中的应用研究[J]. 中华护理杂志, 2025, 60(23):2864-2871. DOI
	Zhao YN, Zheng XT, Zheng QG, et al. Application of nurse-led early pulmonary rehabilitation strategies in elderly postopera-tive lung cancer patients[J]. Chin J Nurs, 2025, 60(23):2864-2871.
[5]	董映显, 朱道君, 车国卫, 等. 肺癌日间手术操作流程与临床应用效果分析[J]. 中国肺癌杂志, 2020, 23(2):77-83.
	Dong YX, Zhu DJ, Che GW, et al. Clinical effect of day surgery in patients with lung caner by optimize operating process[J]. Chin J Lung Cancer, 2020, 23(2):77-83.
[6]	褚江辉, 钱文燕, 王琦, 等. 全面护理在肺癌患者围手术期的临床应用及价值分析[J]. 贵州医药, 2018, 42(1):114-115.
	Chu JH, Qian WY, Wang Q, et al. Clinical application and value analysis of comprehensive nursing in perioperative period of lung cancer patients[J]. Guizhou Med J, 2018, 42(1):114-115.
[7]	兰美娟, 宋剑平, 金静芬, 等. 大型综合公立医院护理效率管理实践与探索[J]. 中华医院管理杂志, 2021, 37(4):332-335.
	Lan MJ, Song JP, Jin JF, et al. Practice and exploration of nursing efficiency management in a large general public hos-pital[J]. Chin J Hosp Adm, 2021, 37(4):332-335.
[8]	曹俊华, 吴小燕, 陆斐, 等. 效率医疗背景下全程护理管理模式在髋膝关节置换患者中的应用[J]. 中国护理管理, 2022, 22(10):1487-1491.
	Cao JH, Wu XY, Lu F, et al. Application of whole-course nursing management mode based on efficiency medical back-ground in patients with hip and knee replacement[J]. Chin Nurs Manag, 2022, 22(10):1487-1491.
[9]	俞申妹, 兰美娟, 金静芬, 等. 院前管理单元的构建及对手术科室运行效率的影响[J]. 中华护理杂志, 2022, 57(11):1366-1370. DOI
	Yu SM, Lan MJ, Jin JF, et al. The construction of the prehospital management department and its impact on the operation efficiency of surgical departments[J]. Chin J Nurs, 2022, 57(11):1366-1370. DOI
[10]	周文僮, 关琼瑶, 王君梅. 预住院病人入院前护理管理方案的构建及应用[J]. 循证护理, 2024, 10(4):632-638.
	Zhou WT, Guan QY, Wang JM. Construction and application of pre-admission nursing management plan for pre-hospita-lized patients[J]. Chin Evid Based Nurs, 2024, 10(4):632-638.
[11]	国家卫生健康委医院管理研究所肺癌手术日间化管理专家共识组. 肺癌手术日间化管理中国专家共识(2024年版)[J]. 中国肺癌杂志, 2024, 27(6):405-414.
	Expert Consensus Group on Day Surgery Management of Lung Cancer, Hospital Management Research Institute, Natio-nal Health Commission of the People’s Republic of China. Chinese expert consensus on day surgery management of lung cancer(2024 edition)[J]. Chin J Lung Cancer, 2024, 27(6):405-414.
[12]	孙佳璐, 严越, 王中鹏, 等. 基于全国医疗质量抽样调查数据的日间手术发展分析[J]. 中国医院管理, 2023, 43(2):49-52.
	Sun JL, Yan Y, Wang ZP, et al. Analysis of the development of daytime surgery based on the national medical quality sampling survey data[J]. Chin Hosp Manag, 2023, 43(2):49-52.
[13]	Burton D, King A, Bartley J, et al. The Surgical Anxiety Que-stionnaire(SAQ):development and validation[J]. Psychol Health, 2019, 34(2):129-146. DOI URL
[14]	李蕊, 王志敏, 唐鑫, 等. 术前焦虑量表的汉化及信效度检验[J]. 护理研究, 2022, 36(7):1149-1153.
	Li R, Wang ZM, Tang X, et al. The Chinesization of the Sur-gical Anxiety Questionnaire and its reliability and validity test[J]. Chin Nurs Res, 2022, 36(7):1149-1153.
[15]	King A, Bartley J, Johanson DL, et al. Components of preope-rative anxiety:a qualitative study[J]. J Health Psychol, 2019, 24(13):1897-1908. DOI PMID
[16]	张云霄, 李宗超, 陈冀衡, 等. 术前焦虑对胸腔镜肺癌根治术后患者早期预后的影响[J]. 中国肺癌杂志, 2019, 22(11):714-718.
	Zhang YX, Li ZC, Chen JH, et al. Effect of preoperative anxiety on early prognosis of patients after thoracoscopic lung cancer resection[J]. Chin J Lung Cancer, 2019, 22(11):714-718.
[17]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA A Cancer J Clin, 2021, 71(3):209-249.
[18]	张祎, 乔路, 应美欣, 等. 肺癌患者术前焦虑现状及影响因素的横断面研究[J]. 当代护士, 2026, 33(10):120-126.
	Zhang Y, Qiao L, Ying MX, et al. Cross-sectional study on preoperative anxiety of lung cancer patients and its influen-cing factors[J]. Mod Nurse, 2026, 33(10):120-126.
[19]	O’Riordan B, Reynolds IS, Hechtl D, et al. Short notice can-cellations:an insight into Irish surgical waiting lists[J]. Ir J Med Sci 1971,2023, 192(2):807-810. DOI
[20]	袁华娣, 贺红. “互联网+”日间手术肺癌患者健康教育模式的构建及应用[J]. 中国护理管理, 2023, 23(6):921-925.
	Yuan HD, He H. Construction and application of “Internet+” health education model for lung cancer patients at day sur-gery ward[J]. Chin Nurs Manag, 2023, 23(6):921-925.
[21]	车国卫. 加速康复外科:临床应用加减之间[J]. 中国肺癌杂志, 2019, 22(11):681-686.
	Che GW. Enhanced recovery after surgery:addition or subtra-ction in clinical application[J]. Chin J Lung Cancer, 2019, 22(11):681-686.
[22]	贺红, 庹汪阳, 袁华娣, 等. 肺癌患者日间手术后延迟出院的危险因素研究[J]. 中华急危重症护理杂志, 2022, 3(3):203-207.
	He H, Tuo WY, Yuan HD, et al. Analysis of risk factors of delayed discharge among lung cancer patients after day sur-gery[J]. Chin J Emerg Crit Care Nurs, 2022, 3(3):203-207.
[23]	国际日间手术学会. 日间手术手册[M]. 中国日间手术合作联盟,译. 北京: 人民卫生出版社, 2015.
	International Society of Day Surgery. Ambulatory surgery hand-book[M]. China Day Surgery Cooperation Alliance,trans. Beijing: People’s Medical Publishing House, 2015.
[24]	王建芦, 赵汝楠, 郭晓宇, 等. 肝胆外科日间手术管理流程优化的应用效果分析[J]. 齐鲁护理杂志, 2020, 26(16):32-35.
	Wang JL, Zhao RN, Guo XY, et al. Application effect analysis of day surgery management process optimization in hepatobi-liary surgery[J]. J Qilu Nurs, 2020, 26(16):32-35.
[25]	叶小云, 章莉丽, 陈维娅, 等. 基于提升患者就医体验的门诊服务融合实践[J]. 中华医院管理杂志, 2024, 40(10):809-812.
	Ye XY, Zhang LL, Chen WY, et al. Exploration of integrating outpatient services in improving patients’ medical experience[J]. Chin J Hosp Adm, 2024, 40(10):809-812.
[26]	陈淑萍, 谢宝缘, 陈绵绵, 等. 淋巴瘤患者化疗随访方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(6):725-733. DOI
	Chen SP, Xie BY, Chen MM, et al. Development and applica-tion of a follow-up protocol for lymphoma patients undergoing chemotherapy[J]. Chin J Nurs, 2026, 61(6):725-733.
[27]	毛文平, 骆金铠, 王力华, 等. 智能交互出院随访平台的构建与应用研究[J]. 中华护理杂志, 2024, 59(15):1812-1817. DOI
	Mao WP, Luo JK, Wang LH, et al. Construction and applica-tion of an intelligent interactive discharge follow-up platform[J]. Chin J Nurs, 2024, 59(15):1812-1817.

肺癌日间手术患者全流程护理管理的效果评价

Effectiveness evaluation of a whole-process nursing management program for lung cancer patients under-going day surgery

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 2

参考文献 27

相关文章 15

编辑推荐

Metrics

[1]	梁和静, 许鹊, 史云霞, 祖金美, 黄文静, 杨春旭, 郭明华, 王磊. 颈动脉内膜剥脱术围手术期护理质量评价指标的构建[J]. 中华护理杂志, 2026, 61(9): 1237-1244.
[2]	谭远俏, 刘伟宸, 王露秀, 张乐, 衡清漪, 凌瑛. 肺癌患者化疗前后社会支持变化对身体活动的影响研究[J]. 中华护理杂志, 2026, 61(8): 1088-1094.
[3]	王丹丹, 吕会力, 李付华, 李慧, 张侠, 史小艳, 张苇. 三级医院硕士学历护士工作重塑的影响因素及路径分析[J]. 中华护理杂志, 2026, 61(7): 973-978.
[4]	付海炜, 朱晓菊, 毕建静, 黎美娴, 张小迪, 王宗华. 肺癌患者癌症相关认知障碍核心症状与生活质量的相关性研究[J]. 中华护理杂志, 2026, 61(6): 783-789.
[5]	中华护理学会人文护理专业委员会, 中华护理学会急诊护理专业委员会, （执笔：刘义兰, 汪唯, 甘秀妮, 朱陈萍, 杨霞, 熊莉娟, 朱丽辉, 徐翠荣, 郭舒婕, 张洁, 金晓燕, 李君, 李丽, 黄素芳, 王晓洁, 周晨曦, 李映兰. 对急诊科护士的人文关怀策略专家共识[J]. 中华护理杂志, 2026, 61(5): 612-615.
[6]	中国抗癌协会肿瘤康复整合护理专业委员会, （执笔：钟就娣, 王影新, 刘飞, 潜艳, 康璐, 颜红艳, 杨明雪, 廖洋洋, 刘群红. 老年肺癌患者术后分级运动的专家共识[J]. 中华护理杂志, 2026, 61(5): 616-621.
[7]	徐晓静, 尚茜, 李娟, 张培培, 史素玲. 中青年肺癌化疗患者家庭参与式多模态运动干预方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(5): 622-629.
[8]	关锐, 赵亚莎, 张士变, 李巧丽, 郭清洁, 李亚楠, 韩箫笛. 姿势调节训练在ICU肌肉骨骼损伤护士中的应用研究[J]. 中华护理杂志, 2026, 61(4): 543-548.
[9]	盛旭, 丛胜楠, 张娟, 凌秀凤, 朱珠, 陈声容, 赵静. 辅助生殖专科护理质量评价指标体系的构建及验证[J]. 中华护理杂志, 2026, 61(3): 293-301.
[10]	巩晓珊, 林安琪, 秦玉, 王玲. 术前虚拟现实场景模拟训练对老年肺癌患者术后谵妄的干预效果研究[J]. 中华护理杂志, 2026, 61(3): 332-339.
[11]	陈元元, 刘扣英, 汤婷, 屈明叶, 杨澜, 蔡昊, 王晨, 汪璐璐, 李祥硕. 国内提升患者就医体验相关政策的文本分析及护理启示[J]. 中华护理杂志, 2026, 61(3): 385-393.
[12]	连蕊, 郑福雪, 田君叶, 谭艳芬, 宋亚静, 韩宁, 李妍, 蒙景雯, 曾镇罡. 供应-加工-配送模式下低值医用耗材智能管理的研究[J]. 中华护理杂志, 2026, 61(3): 394-400.
[13]	曾晗月, 彭寅森, 陈腾霞, 李韵, 朱守淋, 黄乐娇, 王彩莲, 毛世芳. 《成人有创机械通气气道内吸引技术操作》团体标准临床实践现状及影响因素分析[J]. 中华护理杂志, 2026, 61(2): 198-204.
[14]	兰星, 刘婷, 李勍, 柯稳, 李鑫, 张转运, 翟洁, 刘佳佳. 700所医疗机构麻醉科专科护士工作及管理现状的调查研究[J]. 中华护理杂志, 2026, 61(2): 237-243.
[15]	陈琳琳, 林以扬, 罗文婷, 陈付红. 肺癌患者失志综合征相关因素的计算机模拟网络分析及护理启示[J]. 中华护理杂志, 2026, 61(17): 2404-2410.