方丽敏 程丽萍

[摘要]目的 探讨改良快速康复外科（FTS）理念在甲状腺术围术期应用效果。方法 选取2018年5月～2019年7月我院收治的60例甲状腺术患者，随机分为观察组和对照组，每组各30例。对照组采用常规护理措施，观察组在对照组的基础上给予FTS理念干预。比较两组围术期指标、心理状态及并发症发生率。结果 观察组引流管留置时间、下床活动时间、进食时间、住院时间均短于对照组，差异有统计学意义（P<0.05）;观察组干预后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分低于对照组，差异有统计学意义（P<0.05）;观察组术后并发症发生率为6.670%，低于对照组的26.67%，差异有统计学意义（P<0.05）。结论 FTS理念能加快甲状腺手术患者术后康复进程，改善患者心理状态，降低术后并发症的发生率。

[关键词]甲状腺手术;改良快速康复外科理念;护理;应用效果

[中图分类号] R473.73          [文献标识码] A          [文章编号] 1674-4721（2020）3（a）-0240-03

Application of improved rapid rehabilitation surgery concept in perioperative period of thyroid surgery

FANG Li-min   CHENG Li-ping

Department of Surgical Nail and Breast Burn， Jingdezhen First People′s Hospital， Jiangxi  Province， Jingdezhen   333000， China

[Abstract] Objective To explore application effect of modified fast-track surgery （FTS） concept on thyroid surgery during perioperative period. Methods A total of 90 patients undergoing thyroid surgery who were admitted to the hospital from May 2018 to July 2019 were enrolled. They were randomly divided into observation group and control group， 30 cases in each group. The control group was given routine nursing measures. On the basis of control group， observation group was given nursing intervention of modified FTS concept. Perioperative indexes， psychological status and incidence of complications were compared between the two groups. Results The indwelling time of drainage tube， leaving bed time， eating time and the total hospitalization time in observation group were shorter than those of the control group， the differences were statistically significant （P<0.05）. After intervention， scores of self-rating anxiety scale （SAS） and self-rating depression scale （SDS） in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. The incidence of postoperative complications in observation group was lower than that in control group （6.670% vs. 26.67%）， the difference was statistically significant （P<0.05）. Conclusion The modified FTS concept can speed up postoperative rehabilitation process of patients undergoing thyroid surgery， improve their psychological status， and  reduce incidence of postoperative complications.

[Key words] Thyroid surgery; Modified fast-track surgery concept; Nursing; Application effect

甲状腺为人体最大内分泌腺，在维持机体内环境的稳定中具有关键作用[1]。甲狀腺手术操作区域解剖复杂，血管丰富，在麻醉状态下气管插管可能导致患者心率及血压水平发生大幅度波动，同时由于麻醉恢复时气管导管的刺激，拔管后可造成呛咳，使电凝血管再开放，手术创面渗血增加，引发一系列严重并发症[2-3]。快速康复外科（FTS）理念以一系列循证医学验证的护理干预降低手术应激反应，充分体现了“循证”“快速康复”“多学科合作”理念，围术期采取一系列有效措施，减轻围术期创伤，加快患者术后康复[4-5]。FTS理念在原有理念的基础上进一步细化，进行综合评价，并应用循证医学方法进行客观分析，目的为最大程度减少损伤，达到快速康复的目的[6-7]。本研究将FTS理念应用到甲状腺手术围术期护理中，取得了良好的效果，现报道如下。

1资料与方法

1.1一般资料

选取2018年5月～2019年7月我院收治的60例甲状腺手术患者，随机分为观察组和与对照组，每组各30例。……