周燕秋

摘要：目的  探討医护一体化模式在甲状旁腺全切除联合前臂自体移植术患者中的应用效果。方法  选取我院2017年6月～2018年12月接受甲状旁腺全切除联合前臂自体移植术治疗的继发性甲状旁腺功能亢进症患者63例为研究对象，随机分为对照组（n=31）和试验组（n=32），对照组采用常规护理，试验组采用医护一体化模式护理。比较两组患者术后并发症发生情况，术后第1天、第2天、第3天患者低钙血症发生率及患者满意度。结果  两组患者均未出现术后呛咳、窒息、声音嘶哑症状;术后第1天、第2天、第3天，试验组低钙血症发生率分别为：87.50%、62.50%、15.62%，均低于对照组的100.00%、87.10%、32.25%，差异有统计学意义（P<0.05）;试验组患者满意度为100.00%，高于对照组的87.10%，差异统计学意义（P<0.05）。结论  医护一体化模式有利于降低甲状旁腺全切除联合前臂自体移植术患者术后低钙血症的发生率，同时可提高住院患者满意度。

关键词：甲状旁腺全切除;前臂自体移植术;医护一体化;低钙血症;满意度

中图分类号：R473.6                                   文献标识码：A                               DOI：10.3969/j.issn.1006-1959.2019.13.053

文章编号：1006-1959（2019）13-0164-03

Abstract：Objective  To explore the application effect of the integrated medical model in patients with total parathyroidectomy combined with forearm autografting. Methods  63 patients with secondary hyperparathyroidism who underwent total parathyroidectomy combined with forearm autograft in our hospital from June 2017 to December 2018 were enrolled in the study. They were randomly divided into control group （n= 31） and the experimental group （n=32）， the control group was treated with routine care， and the experimental group was treated with integrated medical care mode. The incidence of postoperative complications was compared between the two groups， and the incidence of hypocalcemia and patient satisfaction on the 1st， 2nd， and 3rd day after surgery. Results  There were no symptoms of postoperative cough， asphyxia and hoarseness in the two groups. On the 1st， 2nd and 3rd day after operation， the incidence of hypocalcemia in the experimental group was 87.50%， 62.50% and 15.62% respectively was lower than the control group's 100.00%， 87.10%， 32.25%， the difference was statistically significant （P<0.05）; the test group patient satisfaction was 100.00%， which was higher than the control group's 87.10%， the difference was statistically significant （P<0.05）.Conclusion  The integrated medical model is beneficial to reduce the incidence of postoperative hypocalcemia in patients undergoing total parathyroidectomy combined with forearm autografting， and to improve the satisfaction of hospitalized patients.

Key words：Total parathyroidectomy;Forearm autograft;Medical integration;Hypocalcemia; Satisfaction