【摘要】 目的 探讨全程医护一体个体化护理对经腋窝入路腔镜甲状腺肿瘤患者术后生活质量的影响及临床效果。方法 选取2019年10月—2022年4月在医院头颈外科行腔镜下甲状腺肿瘤切除术的200例患者，按照组间基线资料可比的原则分为对照组和观察组，各100例，对照组采取常规护理；观察组采取全程医护一体个体化护理，包括实施激励式个体化心理干预、术前精细化专科评估、单侧肢体渐进式体位训练、路径式阶梯式康复训练、延续居家护理、多模态随访。对比分析两组患者干预后并发症发生率和生活质量。结果 采取全程医护一体个体化护理后，观察组患者术后饮水呛咳、声嘶、切口感染等并发症发生率为5.0%，明显低于对照组的18.0%，组间差异有统计学意义（P<0.05）；观察组患者的拔除引流管时间、平均住院天数、住院费用等临床指标均优于对照组，差异有统计学意义（P<0.05）。护理干预后，QLQ-C30五个维度中，角色功能和社会功能评分观察组患者高于对照组，疲倦评分观察组患者低于对照组，组间差异均有统计学意义（P<0.05），表明干预后，观察组患者的生活质量水平优于对照组。结论全程医护一体个体化护理在腋窝路径腔镜甲状腺肿瘤患者中的应用降低了患者并发症发生率，促进了患者康复，改善了患者的生活质量。更多还原

【Abstract】 Objective To explore the influence and clinical effect of full medical and nursing individualised care on the postoperative quality of life of patients with luminal thyroid tumour via axillary approach. Methods200 patients who underwent laparoscopic thyroid tumour resection in the Head and Neck Surgery Department of the hospital from October 2019 to April 2022 were selected and divided into 100 cases of the observation group and 100 cases of the control group according to the comparability of basic data between groups, the control group adopting conventional nursing care, the observation group adopting the whole process of individualized nursing care with integrated medical care, including the implementation of motivational individualized psychological intervention, preoperative refinement of speciality assessment, unilateral limb progressive postural training,pathway-type stepped rehabilitation training, continuation of home care, and multimodal follow-up. The complication rate and quality of life of the two groups were compared and analysed after the intervention. Results After adopting the whole process of individualized nursing care, the complication rate of postoperative choking on drinking water, hoarseness, and incision infection in the observation group was 5.0%, which was significantly lower than that of the control group of 18.0%, and the difference between the groups was statistically significant(P<0.05), and the clinical indexes of the observation group such as the time of removing the drainage tube, the average number of days of hospitalization, and hospitalization costs were better than those of the control group,and the difference was statistically significant(P<0.05). After nursing intervention, among the five dimensions of QLQ-C30, the patients in the observation group had higher role function and social function scores than those in the control group, and the patients in the observation group had lower fatigue scores than those in the control group, with statistically significant differences between the groups(P<0.05), which indicated that the quality of life level of the patients in the observation group was better than that of the control group after the intervention.Conclusion The application of total medical care individualised nursing in patients with axillary pathway luminal thyroid tumour reduces the incidence of patient complications, promotes patient recovery and improves the quality of life of patients.更多还原