经口腔前庭入路腔镜甲状腺手术患者护理方案的构建

doi:10.3761/j.issn.0254-1769.2021.06.012

摘要/Abstract

摘要：

目的构建经口腔前庭入路腔镜甲状腺手术患者的护理方案。方法结合文献及临床经验,构建经口腔前庭入路腔镜甲状腺手术患者护理方案。2020年3月—5月邀请来自北京市、天津市、山东省、河北省、广东省5个省市的15名甲状腺外科医生、甲状腺外科护理专家、外科学护理教师等进行德尔菲专家咨询。结果共开展2轮专家咨询,问卷有效回收率均为100%;2轮咨询专家权威系数分别为0.81、0.87;第1轮咨询中,一、二、三级指标的肯德尔和谐系数为0.156~0.360,具有统计学意义（均P<0.001）;第2轮咨询中,一、二、三级指标的肯德尔和谐系数为0.501~0.646,具有统计学意义（均P<0.001）;第2轮咨询各条目变异系数为0.05~0.11,满分率为26.7%~93.3%。最终确定的经口腔前庭入路腔镜甲状腺手术患者护理方案包括5个一级指标（一般护理、心理疏导、保持呼吸道通畅、舒适管理、并发症的预防及处理）,19个二级指标和57个三级指标。结论构建的经口腔前庭入路腔镜甲状腺手术患者护理方案具有科学性、针对性、实用性及可行性。

关键词: 甲状腺肿瘤, 经口腔前庭入路腔镜甲状腺手术, 围手术期护理, 方案, 构建

Abstract:

Objective In order to construct a perioperative nursing scheme for transoral endoscopic thyroidectomy vestibular approach（TOETVA）. Methods We combined the literature and clinical experience to construct a perioperative nursing scheme. 15 thyroid surgeons,thyroid surgical care specialists,surgical care teachers,etc. from Shandong Province,Beijing,Tianjin,Hebei Province,and Guangdong Province were invited to conduct Delphi expert consultation from March to May 2020. Results 2 rounds of expert consultations were carried out,and the effective recovery rate of the questionnaire is 100%.Expert authority coefficients of 2 rounds are 0.81,0.87.The Kendall harmony coefficients of the first,second,and third-level indicators in the first round were 0.156~0.360,which were statistically significant（all P<0.001）;the Kendall harmony coefficients of the first,second and third levels in the second round were 0.501~0.646 with statistically significant（all P<0.001）;the coefficient of variation of each item in the second round is 0.05~0.11,and the full score is 26.7%~93.3%.The ultimately determined TOETVA perioperative nursing scheme includes 5 first-level indicators（general care,psychological counseling,maintaining a smooth respiratory tract,comfortable management,complications,processing）,19 secondary indicators and 59 third-level indicators.Conclusion The TOETVA perioperative nursing scheme constructed in this study is scientific,specific,practical and feasible.

Key words: Thyroid Neoplasms, Transoral Endoscopic Thyroidectomy Vestibular Approach, Perioperative Nursing, Scheme, Construct

秦发伟,刘美凤,陈洪元. 经口腔前庭入路腔镜甲状腺手术患者护理方案的构建[J]. 中华护理杂志, 2021, 56(6): 873-879.

QIN Fawei,LIU Meifeng,CHEN Hongyuan. Construction of a perioperative nursing scheme for transoral endoscopic thyroidectomy vestibular approach[J]. Chinese Journal of Nursing, 2021, 56(6): 873-879.

图/表 2

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