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

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