头颈部肿瘤患者术后康复智能化管理平台的研发及实用性研究

doi:10.3761/j.issn.0254-1769.2025.01.009

摘要/Abstract

摘要：

目的构建头颈部肿瘤患者术后康复智能化管理平台并进行应用，旨在为提高头颈部肿瘤患者术后康复护理质量提供借鉴。方法头颈部肿瘤患者术后康复智能化管理平台从下到上依次分为底层环境、平台支撑、核心数据库、分析算法以及应用平台5层，通过构建头颈部肿瘤术后并发症知识库和风险预测模型以及可穿戴设备辅助精准化预测风险，实现对头颈部肿瘤患者术后康复智能化管理。采用非同期前后对照法，便利选取杭州市某三级甲等综合医院2023年2月—12月接受手术治疗的90例头颈部肿瘤患者作为研究对象，其中2023年8月—12月收治的45例为试验组，应用康复智能化管理平台实施干预管理；2023年2月—7月收治的45例为对照组，给予常规康复管理。比较两组术后12、24、48、72 h疼痛量表得分，术后并发症发生率、术后住院时间及住院患者满意度。结果所有患者均完成研究，试验组在并发症发生率及术后12、24、48、72 h数字疼痛评分低于对照组，试验组术后住院时间短于对照组，试验组满意度高于对照组，差异具有统计学意义（均P<0.05）。结论应用康复智能化管理平台能够减少头颈部肿瘤患者术后并发症，缓解患者疼痛不适，缩短住院时间，提高患者满意度，改善护理服务质量。

关键词: 头颈部肿瘤, 人工智能, 康复管理平台, 护理

Abstract:

Objective To construct an intelligent postoperative rehabilitation management platform and evaluate its effect in patients with head and neck cancer. Methods The postoperative intelligent rehabilitation management platform of head and neck cancer patients was divided into 5 layers from bottom to top，including the underlying environment, platform support, core database, analysis algorithm and application platform. Through the construction of head and neck tumor postoperative complications knowledge base and risk prediction model and wearable device auxiliary precision prediction risk，the head and neck cancer patients with postoperative intelligent rehabilitation management was realized. A historical controlled study was conducted and 90 participants with head and neck cancer were selected who underwent the surgical treatment in a hospital in Hangzhou，Zhejiang Province. The experimental group（45 participants admitted from February to July） received the intervention by the intelligent rehabilitation management platform，while the control group（45 patients from August to December） received the routine rehabilitation management. The outcome measures including NRS scores at 12 h，24 h，48 h and 72 h after surgery，incidence of postoperative complications，postoperative length of hospital stay，and patient satisfaction were compared between the 2 groups. Results The scores of incidences of complications，postoperative hospital stay，and NRS scores at 12 h，24 h，48 h and 72 h after surgery in the experimental group were lower than those in the control group（P<0.05），while the scores of patient satisfaction in the experimental group were higher than those of the control group（P<0.05）. Conclusion The intelligent postoperative rehabilitation management platform can achieve accurate prediction of postoperative complications，reduce postoperative complications of head and neck tumors，timely intervene to relieve patients’ pain and discomfort，shorten hospital stays，improve nursing work efficiency and improve patient satisfaction.

Key words: Head and Neck Neoplasms, Artificial Intelligence, Rehabilitation Management Platform, Nursing Care

沈利凤, 陈飘飘, 钱雅芬, 徐艳, 郭海巍, 金艾香. 头颈部肿瘤患者术后康复智能化管理平台的研发及实用性研究[J]. 中华护理杂志, 2025, 60(1): 61-68.

SHEN Lifeng, CHEN Piaopiao, QIAN Yafen, XU Yan, GUO Haiwei, JIN Aixiang. Development and practicality of an intelligent management platform for postoperative rehabilitation of patients with head and neck tumors[J]. Chinese Journal of Nursing, 2025, 60(1): 61-68.

图/表 4

图1 头颈部肿瘤患者数据库

Figure 1 Head and neck cancer patient database

表1 两组一般资料比较[例（百分比，%）]

Table 1 Comparison of general data between 2 groups[case（percentage，%）]

表2 Comparison of postoperative pain scores between 2 groups of patients（分，$\bar{x} \pm s$）

Table 2

表3 两组术后并发症发生率比较[例（百分率，%）]

Table 3 Comparison of postoperative complication rates between 2 groups [case（percentage，%）]

参考文献 28

[1]	王梦瑶, 王斌全, 王磊, 等. 头颈肿瘤幸存者护理指南汇总[J]. 护理研究, 2021, 35(1):63-66.
	Wang MY, Wang BQ, Wang L, et al. Summary of nursing guidelines for head and neck cancer survivors[J]. Chin Nurs Res, 2021, 35(1):63-66.
[2]	Turkdogan S, Roy CF, Chartier G, et al. Effect of perioperative patient education via animated videos in patients undergoing head and neck surgery:a randomized clinical trial[J]. JAMA Otolaryngol Head Neck Surg, 2022, 148(2):173-179.
[3]	Dean YE, Motawea KR, Bamousa BAA, et al. Early oral feeding and its impact on postoperative outcomes in head and neck cancer surgery:a meta-analysis[J]. Maxillofac Plast Reconstr Surg, 2024, 46(1):11.
[4]	Mesolella M, Allosso S, Di Lullo AM, et al. Postoperative infectious complications in head and neck cancer surgery[J]. Ann Ital Chir, 2022,93:637-647.
[5]	Loewen I, Jeffery CC, Rieger J, et al. Prehabilitation in head and neck cancer patients:a literature review[J]. Le J D’oto Rhino Laryngol De Chir Cervico Faciale, 2021, 50(1):2.
[6]	张奕, 陈香萍, 高卿卿, 等. 护理信息系统有效性评价及相关理论模型的研究进展[J]. 中华护理杂志, 2021, 56(11):1736-1740. DOI URL
	Zhang Y, Chen XP, Gao QQ, et al. Research progress of effectiveness evaluation of nursing information system and related theoretical models[J]. Chin J Nurs, 2021, 56(11):1736-1740. DOI URL
[7]	蒙晓红, 阙子文, 张立珍, 等. 基于微信平台的回授法健康教育在头颈肿瘤气管切开患者延续护理中的应用[J]. 护理实践与研究, 2023, 20(5):756-760.
	Meng XH, Que ZW, Zhang LZ, et al. Application of teach-back method health education based on WeChat platform in the extended care of head and neck tumour tracheotomy patients.[J]. Nurs Pract Res, 2023, 20(5):756-760.
[8]	高景宏, 翟运开, 李明原, 等. 精准医疗领域健康医疗大数据处理的研究现状[J]. 中国医院管理, 2021, 41(5):8-13.
	Gao JH, Zhai YK, Li MY, et al. Research status of health and medical big data processing in precision medicine field[J]. Chin Hosp Manag, 2021, 41(5):8-13.
[9]	中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)头颈部肿瘤诊疗指南-2019[M]. 北京: 人民卫生出版社, 2019.
	Chinese Society of Clinical Oncology Guidelines Working Committee. Guidelines of Chinese Society of Clinical Oncology (CSCO):head and neck cancer[M]. Beijing: People’s Medical Publishing House, 2019.
[10]	Dort JC, Farwell DG, Findlay M, et al. Optimal perioperative care in major head and neck cancer surgery with free flap reconstruction:a consensus review and recommendations from the enhanced recovery after surgery society[J]. JAMA Otolaryngol Head Neck Surg, 2017, 143(3):292-303.
[11]	Nekhlyudov L, Lacchetti C, Davis NB, et al. Head and neck cancer survivorship care guideline:American society of clinical oncology clinical practice guideline endorsement of the American cancer society guideline[J]. J Clin Oncol, 2017, 35(14):1606-1621. DOI PMID
[12]	张慧敏, 刘俊杰, 刘进, 等. 口腔癌患者营养风险管理的循证实践[J]. 护理学杂志, 2022, 37(12):88-91.
	Zhang HM, Liu JJ, Liu J, et al. Evidence-based practice of nutritional risk management in patients with oral cancer[J]. J Nurs Sci, 2022, 37(12):88-91.
[13]	Lee YC A, Al-Temimi M, Ying J, et al. Risk prediction models for head and neck cancer in the US population from the INHANCE consortium[J]. Am J Epidemiol, 2020, 189(4):330-342.
[14]	Smith CDL, McMahon AD, Ross A, et al. Risk prediction models for head and neck cancer:a rapid review[J]. Laryngoscope Investig Otolaryngol, 2022, 7(6):1893-1908.
[15]	苏曼曼, 周阳, 赵丹, 等. 基于SERVQUAL模型的住院患者满意度分析[J]. 中华医院管理杂志, 2021, 37(Z2):76-79.
	Su MM, Zhou Y, Zhao D, et al. Hospitalized patients based on SERVQUAL model satisfaction analysis[J]. Chi J Hosp Admi, 2021, 37(Z2):76-79.
[16]	张超颖, 李怡宁, 龚佳幸, 等. 2022年世界卫生组织指南头颈部肿瘤分类的解读:牙源性和颌面部骨肿瘤[J]. 国际口腔医学杂志, 2023, 50(3):263-271.
	Zhang CY, Li YN, Gong JX, et al. Interpretation of the 2022 classification of head and neck tumors by the World Health Organization:odontogenic and maxillofacial bone tumors[J]. Int J Stomatol, 2023, 50(3):263-271.
[17]	范玉霞, 曾定芬, 李桂华, 等. 甲状腺癌患者术后肩颈康复锻炼开始时间的研究[J]. 中华护理杂志, 2023, 58(16):1925-1931. DOI URL
	Fan YX, Zeng DF, Li GH, et al. Discussion on the starting time of shoulder and neck rehabilitation exercise in patients after endoscopic thyroid cancer surgery through gasless transaxillary endoscopic thyroidectomy[J]. Chin J Nurs, 2023, 58(16):1925-1931. DOI URL
[18]	Go BC, Go CC, Chorath K, et al. Nonopioid perioperative analgesia in head and neck cancer surgery:a systematic review[J]. World J Otorhinolaryngol Head Neck Surg, 2022, 8(2):107-117.
[19]	张婉, 刘洪桥, 翟蓉, 等. 近15年急性术后疼痛研究的文献计量学分析[J]. 国际麻醉学与复苏杂志, 2023, 44(7):739-743.
	Zhang W, Liu HQ, Zhai R, et al. Bibliometric analysis of acute postoperative pain research in the past 15 years[J]. Int J Anes-thesiol Resusc, 2023, 44(7):739-743.
[20]	刘洁, 闫金凤, 韩鹏, 等. 不同康复疗法对颈淋巴结清扫术后患者颈肩功能影响的网状Meta分析[J]. 中华护理杂志, 2023, 58(14):1704-1711. DOI URL
	Liu J, Yan JF, Han P, et al. Effect of different rehabilitation therapies on neck and shoulder function of patients after neck dissection:a network meta-analysis[J]. Chin J Nurs, 2023, 58(14):1704-1711.
[21]	Choi BM, Yim JY, Shin H, et al. Novel analgesic index for postoperative pain assessment based on a photoplethysmographic spectrogram and convolutional neural network:observational study[J]. J Med Internet Res, 2021, 23(2):e23920.
[22]	刘美子, 安然, 吴子童, 等. 头颈部肿瘤患者核心症状及症状群的网络分析与护理对策[J]. 中华护理杂志, 2024, 59(7):828-834. DOI URL
	Liu MZ, An R, Wu ZT, et al. A network analysis and nursing implications of core symptoms and symptom clusters in head and neck cancer patients[J]. Chin J Nurs, 2024, 59(7):828-834. DOI URL
[23]	赵力挽, 尹世全, 杨一博, 等. 胃癌患者术后住院时间延长的影响因素分析[J]. 中华肿瘤杂志, 2020, 42(2):150-154. PMID
	Zhao LW, Yin SQ, Yang YB, et al. Risk factors associated with prolonged postoperative length of stay of patients with gastric cancer[J]. Chin J Oncol, 2020, 42(2):150-154. DOI PMID
[24]	Lin YW, Wu C, He CY, et al. Effectiveness of three exercise programs and intensive follow-up in improving quality of life,pain,and lymphedema among breast cancer survivors:a randomized,controlled 6-month trial[J]. Support Care Cancer, 2022, 31(1):9.
[25]	Loh EW, Shih HF, Lin CK, et al. Effect of progressive muscle relaxation on postoperative pain,fatigue,and vital signs in patients with head and neck cancers:a randomized controlled trial[J]. Patient Educ Couns, 2022, 105(7):2151-2157.
[26]	卢明, 俞燕娟, 李中东, 等. 基于家庭医护平台延续性护理模式的构建及应用[J]. 中华护理杂志, 2019, 54(12):1851-1855. DOI URL
	Lu M, Yu YJ, Li ZD, et al. Construction and application of continuity nursing model based on family medical platform[J]. Chin J Nurs, 2019, 54(12):1851-1855. DOI URL
[27]	韩俗, 汪新建, 刘艳. 智慧病房设计与应用[J]. 医学信息学杂志, 2020, 41(12):56-59.
	Han S, Wang XJ, Liu Y. Design and application of smart wards[J]. J Med Inform, 2020, 41(12):56-59.
[28]	董婧, 庄一渝. 环境智能在护理领域中的应用进展[J]. 中华护理杂志, 2022, 57(13):1655-1659. DOI URL
	Dong J, Zhuang YY. Progress on the application of ambient intelligence in the field of nursing[J]. Chin J Nurs, 2022, 57(13):1655-1659. DOI URL