周燕芳 兰莹莹

【摘要】目的：探討品管圈管理模式在提高永久起搏器置入术后患者早期功能锻炼中效果的作用。方法：选取2021年3月—2022年4月到医院心内科接受永久起搏器置入手术治疗的100例患者，将患者分为品管圈活动实施前为对照组（即2021年3月—2021年11月永久起搏器置入术患者，n=50），品管圈活动实施后为实验组（即2021年12月—2022年4月永久起搏器置入术患者，n=50），两组护理观察时间为3个月。结果：实验组护理3个月期间的早期功能锻炼执行率为98.00%，对照组为82.00%，实验组明显高于对照组（P<0.05）。护理3个月后的两组的SPADI评分都低于护理前（P<0.05），护理3个月后实验组的SPADI评分明显低于对照组（P<0.05）。护理3个月期间实验组的肩部疼痛、伤口出血、穿刺部位疼痛等并发症发生率为10.00%、32.00%、4.00%，与对照组的16.00%、64.00%、64.00%对比有显著降低（P<0.05）。结论：品管圈能提高永久起搏器置入术后患者早期功能锻炼执行率，降低并发症发生率，也可促进改善患者的临床症状。

【关键词】品管圈；永久起搏器置入术；早期功能锻炼；并发症；SPADI评分

The value of quality control circles in improving the implementation rate of early functional exercise in patients after permanent pacemaker placement

ZHOU Yanfang， LAN Yingying

Peoples Hospital of Ningxia Hui Autonomous Region， Yinchuan， Ningxia 750001， China

【Abstract】Objective： To investigate the role of the quality control circle management model in improving the outcome of early functional exercise in patients after permanent pacemaker insertion. Methods： 100 patients who came to the cardiology department of the hospital from March 2021 to April 2022 for permanent pacemaker placement surgery were selected， and the patients were divided into a control group （i.e.， patients with permanent pacemaker placement from March 2021 to November 2021， n=50） before the implementation of the QC circle activity and an experimental group （i.e.， patients with permanent pacemaker placement from December 2021 to April 2022， n=50） after the implementation of the QC circle activity， and the nursing observation time for both groups was 3 months. Results： The implementation rate of early functional exercise during 3 months of care was 98.00% in the experimental group and 82.00% in the control group， which was significantly higher than the control group （P<0.05）. The SPADI scores of both groups after 3 months of care were lower than those before care （P<0.05）， and the SPADI scores of the experimental group after 3 months of care were significantly lower than those of the control group （P<0.05）. The complication rates of shoulder pain， wound bleeding， and puncture site pain were 10.00%， 32.00%， and 4.00% in the experimental group during the 3-month period of care， which were significantly lower compared with 16.00%， 64.00%， and 64.00% in the control group （P<0.05）. Conclusion： The QC circle can improve the execution rate of early functional exercise and reduce the complication rate in patients after permanent pacemaker placement， and also promote the improvement of patients clinical symptoms.

【Key Words】Quality control circle； Permanent pacemaker placement； Early functional exercise； Complications； SPADI score

心脏起搏器是一种通过发放一定形式的电脉冲，刺激心脏，模拟正常心脏的冲动形成和传导，使之激动和收缩，以治疗由于某些心率失常所致的心脏功能障碍的医用电子仪器，永久人工心脏起搏器置入是目前治疗严重缓慢型心律失常的重要手 段[1]。随着心电生理技术的发展和人们对自身健康状况的关注，起搏器适应症的范围越来越广，永久起搏器置入的患者也越来越多[2]。不过由于各种因素的影响，目前永久起搏器置入术患者肩部疼痛和肩部活动受限的发生率仍然较高，可能与患者对永久起搏器早期功能锻炼认知的缺乏和护士的监督不到位有关[3-4]。品管圈是为了应对在工作中发现的问题，在同一场所内自发组成的一个小团队，应用统计方法进行分析，找出解决方式并实施的持续质量改进方法[5]。本文具体探讨与分析了品管圈在提高永久起搏器置入术后患者早期功能锻炼执行率中的应用价值，现报道如下。……