Abstract:

Objective To develop a whole course management information system for breast cancer and verify its effect in disease management of breast cancer patients. Methods An integrated service plan and system construction of "screening-diagnosis-treatment-rehabilitation" was developed，and then an information system was developed. The method of historical control was used to conveniently sample 260 cases of breast cancer patients diagnosed in a tertiary A hospital. 130 cases diagnosed from May 1 to December 31，2022 were taken as a test group，and 130 cases diagnosed from May 1 to December 31，2021 were taken as a control group. The test group was managed by the whole course management information system，and the control group was managed by conventional disease management. The relevant indicators of the screening and diagnosis period of patients，the completion rate of treatment，the incidence of treatment related side effects and the cancer care satisfaction of the 2 groups were compared. Results There was a statistically significant difference in puncture waiting time，admission waiting time，and screening admission time between the 2 groups（P<0.05），while there was no statistically significant difference in pathological waiting time（P>0.05）. The treatment completion rate of the test group was higher（P<0.05）. The incidence of lymphedema，chest obstruction and abnormal sensation of upper limbs，subcutaneous hydrops within 6 months after operation and bone marrow suppression，liver function damage，radiation dermatitis and radiation pneumonia in the test group were lower than those in the control group（P<0.05）. The cancer care satisfaction of the test group after surgery and 6 months after surgery were higher than those of the control group（P<0.05）. Conclusion The whole course management information system for breast cancer can optimize the diagnosis and treatment process，raise the diagnosis and treatment efficiency，ensure the treatment completion rate，reduce the treatment complications and improve the cancer care satisfaction.

Key words: Breast Neoplasms, Case Management, Whole Course Management, Internet-Based Intervention, Nursing Care

摘要：

目的 开发乳腺癌患者全病程管理信息系统并验证其在患者疾病管理中的应用效果。 方法 制订“筛查-诊断-治疗-康复”为一体的整合型服务方案，开发可供全病程管理的信息系统。采用历史对照研究，便利抽取南京市某三级甲等医院确诊的乳腺癌患者260例作为应用对象，将2022年5月1日—12月31日确诊的130例作为试验组，采用全病程管理信息系统进行管理；2021年5月1日—12月31日确诊的130例作为对照组，采用常规疾病管理。比较两组筛查诊断期相关指标、治疗完成率、治疗相关副作用发生率及患者癌症照护满意度情况。 结果 试验组脱落4例，对照组脱落7例。两组穿刺等待时间、入院等待时间、筛查-入院时间比较，差异有统计学意义（P<0.05），两组病理等待时间比较，差异没有统计学意义（P>0.05）。试验组的治疗完成率高于对照组，差异具有统计学意义（P<0.05）；且试验组术后6个月内患侧上肢淋巴水肿、胸痹及上肢感觉异常、皮下积液情况以及辅助治疗骨髓抑制、肝功能损害、放射性皮炎、放射性肺炎的发生率均小于对照组，差异具有统计学意义（P<0.05）；试验组术后及术后6个月的癌症照护满意度均高于对照组，差异具有统计学意义（P<0.05）。 结论 应用乳腺癌患者全病程管理信息系统可优化诊疗流程、提高诊疗效率，保障乳腺癌患者治疗完成率，减少其治疗并发症，提高其癌症照护满意度。

关键词: 乳腺癌, 个案管理, 全病程管理, 互联网干预, 护理