马红梅　黄晓燕　费霞

【摘要】 目的：探讨品管圈活动用于腹腔镜全子宫切除术患者术后加速康复的临床效果。方法：2019年7月笔者所在医院手术室成立“康复圈”品管圈，选定以“促进患者术后加速康复”为主题，经现状把握、目标设定、原因分析、对策拟定与实施、对策检讨、标准化等，比较实施品管圈活动前后有形成果与无形成果。结果：实施QCC活动后，患者首次肛门排气时间、住院时间均短于实施前，SAS评分、SDS评分均低于实施前，差异均有统计学意义（P<0.05）;实施QCC活动后，全体圈员QCC手法、自信心、沟通能力、凝聚力、拓展思维能力、合作能力、学习能力、发现及解决问题能力评分均高于实施前，差异均有统计学意义（P<0.05）。结论：品管圈活动促进腹腔镜全子宫切除术患者的术后身心快速康复，提高圈员能力。

【关键词】 品管圈活动 腹腔镜全子宫切除术 术后加速康复 效果

doi：10.14033/j.cnki.cfmr.2020.18.067 文献标识码 B 文章编号 1674-6805（2020）18-0-04

Clinical Effect of Quality Control Circle Activity on Enhanced Recovery in Patients after Laparoscopic Hysterectomy/MA Hongmei， HUANG Xiaoyan， FEI Xia. //Chinese and Foreign Medical Research， 2020， 18（18）： -160

[Abstract] Objective： To explore the clinical effect of quality control circle （QCC） activity on enhanced recovery in patients after laparoscopic hysterectomy. Method： In July 2019， the “rehabilitation ring” quality control circle was established in the operating room in our hospital. The theme of QCC was “accelerating enhanced recovery after operation”. After grasping the current situation， settinggoals， analyzing the causes， formulating and implementing countermeasures， reviewing countermeasures and standardizing measures， the formed and intangible results of QCC activities were compared before and after implementation of QCC. Result： After the implementation of QCC activity， the first anal exhaust time and hospital stay time of the patients were shorter than those before the implementation， SAS scores and SDS scores were lower than those before the implementation， the differences were statistically significant （P<0.05）. After the implementation of QCC activity， the scores of QCC technique， confidence， communication ability， cohesion， expanding thinking ability， cooperation ability， learning ability， problem finding and solving ability were all higher than those before the implementation， the differences were statistically significant （P<0.05）. Conclusion： The activity of quality control circle promotes the rapid recovery of body and mind after laparoscopic total hysterectomy and improves the ability of the circle members.

[Key words] Quality control circle activity Laparoscopic total hysterectomy Postoperative enhanced recovery Effect

First-authors address： The Affiliated Jiangyin Hospital of Southeast University Medical College， Jiangyin 214400， China

加速康復外科（enhanced recovery after surgery，ERAS）是在循证医学基础上应用多种优化措施，以降低生理、心理等创伤应激反应，促进术后加速康复[1]。ERAS最早在结直肠外科应用，后因效果显著逐步应用到其他外科，目前在妇科也取得一定效果[2]，但有观点认为其理念大于实践[3]。ERAS核心是以患者为中心，实施关键是以问题为导向的措施优化，这与现代护理理念不谋而合，故护理干预在ERAS实施中占有重要地位。品管圈（quality control circle，QCC）活动是相近、相同或者互补性质的人员自发集结在一起，集思广益，通力合作，依照活动程序，运用统计工具及品管法解决关键问题[4]，是提高护理质量的有效方法。QCC活动在手术室护理应用中取得一定成果，但对腹腔镜全子宫切除术患者术后加速康复的研究鲜有报道。本研究拟评价QCC活动对腹腔镜全子宫切除术患者术后加速康复效果的影响，为手术室护理提供参考，具体如下。……