重度青少年特发性脊柱侧凸患儿全病程护理管理流程的优化及效果研究

doi:10.3761/j.issn.0254-1769.2026.16.006

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (16): 2201-2208.DOI: 10.3761/j.issn.0254-1769.2026.16.006

重度青少年特发性脊柱侧凸患儿全病程护理管理流程的优化及效果研究

陈金淮(), 史梦宇, 黄崇安, 白艳雯, 许玲梦, 王谊^*()

温州医科大学附属第二医院脊柱外科温州市 325000

收稿日期:2026-01-14 出版日期:2026-08-20 发布日期:2026-08-14
*通讯作者: 王谊，E-mail：wangyi2078@aliyun.com
作者简介:陈金淮：女，本科，护师，E-mail：405124924@qq.com
第一联系人：作者贡献声明
陈金淮：研究方案设计及实施、撰写并修订论文；史梦宇：统计分析、撰写并修订论文；黄崇安：研究设计指导、论文审阅与修改；白艳雯、许玲梦：研究实施、数据收集与整理；王谊：文章整体把控与指导、论文审阅与修改
基金资助:
浙江省卫生健康委“小而强”临床创新团队(CXTD202501045)

Optimization and effect of whole-course nursing management process for patients with severe adolescent idiopathic scoliosis

CHEN Jinhuai(), SHI Mengyu, HUANG Chong’an, BAI Yanwen, XU Lingmeng, WANG Yi^*()

Department of Spine Surgery， the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University， Wenzhou 325000， China

Received:2026-01-14 Online:2026-08-20 Published:2026-08-14
* Corresponding author: WANG Yi，E-mail：wangyi2078@aliyun.com
Funding program:
Zhejiang Clinovation Pride of Congenital Scoliosis(CXTD20501045)

摘要/Abstract

摘要：

目的对重度青少年特发性脊柱侧凸患儿全病程护理管理流程进行优化，以期保障患儿安全，改善治疗效果并提升就医体验。方法 2021年6月组建医疗失效模式与效应分析管理团队，应用医疗失效模式与效应分析对重度青少年特发性脊柱侧凸患儿全病程护理管理流程中存在的风险点进行系统挖掘和分析，拟订针对性改善措施，并于2023年6月将其应用于临床。比较优化前后护理管理流程的危害评分、护理管理成效指标、患儿临床疗效指标以及综合效益指标。结果护理管理流程优化后，全病程管理流程中20项高风险失效原因的危害评分得到改善（均P<0.05）。试验组院前筛查耗时、绿色通道办理住院耗时、Borg呼吸困难积分、脊髓神经功能快速评估耗时、术后严重并发症发生率、胸锁乳突肌压痛感、住院时长均低于对照组；围手术期功能位摆放正确率、首次离床安全率、自我形象满意度、脊柱侧凸矫正率、生活质量均高于对照组，差异有统计学意义（均P<0.05）。结论应用医疗失效模式与效应分析方法可优化重度青少年特发性脊柱侧凸患儿全病程护理管理流程，控制风险环节，改善患儿治疗效果并提高其就医体验。

关键词: 医疗失效模式与效应分析, 青少年特发性脊柱侧凸, 全病程, 护理管理

Abstract:

Objective To optimize the whole-course nursing management process for children with severe adolescent idiopathic scoliosis（AIS），so as to ensure children’s safety，improve treatment outcomes and enhance healthcare experience. Methods In June 2021，a healthcare failure mode and effect analysis（HFMEA） management team was established to systematically identify and analyze risk points in the whole-course nursing management process for children with severe AIS，and targeted improvement measures were formulated and implemented in clinical practice in June 2023. The hazard scores of nursing management process，nursing management effectiveness，clinical efficacy and comprehensive benefit indicators were compared before and after optimization. Results After optimization of the nursing management process，the hazard scores of 20 high-risk failure causes in the whole-course management process were significantly improved. The experimental group had significantly shorter pre-hospital screening time，green channel admission time，rapid spinal nerve function assessment time and hospital stay，lower Borg dyspnea score，incidence of severe postoperative complications and sternocleidomastoid tenderness，and higher correct rate of functional position placement，safety rate of first out-of-bed activity，self-image satisfaction，scoliosis correction rate and quality of life than the control group（all P<0.05）. Conclusion Application of HFMEA to optimize the whole-course nursing management process for children with severe AIS can effectively control and improve risk links，and enhance treatment outcomes and healthcare experience of children.

Key words: Healthcare Failure Mode and Effect Analysis, Adolescent Idiopathic Scoliosis, Full-Course, Nursing Management

陈金淮, 史梦宇, 黄崇安, 白艳雯, 许玲梦, 王谊. 重度青少年特发性脊柱侧凸患儿全病程护理管理流程的优化及效果研究[J]. 中华护理杂志, 2026, 61(16): 2201-2208.

CHEN Jinhuai, SHI Mengyu, HUANG Chong’an, BAI Yanwen, XU Lingmeng, WANG Yi. Optimization and effect of whole-course nursing management process for patients with severe adolescent idiopathic scoliosis[J]. Chinese Journal of Nursing, 2026, 61(16): 2201-2208.

图/表 6

图1 重度青少年特发性脊柱侧凸全病程护理管理流程注：加粗部分为关键子流程环节。

Figure 1 Flowchart of the whole-course nursing management in severe adolescent idiopathic scoliosis

表1 重度青少年特发性脊柱侧凸患儿全病程护理管理流程优化的改善行动方案

Table 1 Improvement action plan for the optimization of whole-course nursing management process in severe adolescent idiopathic scoliosis

表2 两组一般资料的比较

Table 2 Comparison of general data between 2 groups

表3 两组护理管理成效指标的比较

Table 3 Comparison of nursing management effects between 2 groups

表4 两组临床疗效指标的比较

Table 4 Comparison of clinical efficacy between 2 groups

表5 两组不同时间点生活质量的比较（分，$\bar{x}\pm s$）

Table 5 Comparison of quality of life at different time points between 2 groups（score，$\bar{x}\pm s$）

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重度青少年特发性脊柱侧凸患儿全病程护理管理流程的优化及效果研究

Optimization and effect of whole-course nursing management process for patients with severe adolescent idiopathic scoliosis

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