Application of PDCA cycle management in microwave ablation treatment of benign thyroid nodules
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摘要:
目的 探讨PDCA循环管理在微波消融治疗甲状腺良性结节中的临床应用效果。 方法 选取我院2015年1月~2016年6月收治的65例甲状腺结节的患者为治疗组，并采取微波消融治疗，另外选取2015年1月之前采用传统手术治疗的65例经术后病理证实甲状腺良性结节患者作为传统手术组；微波消融组实施PDCA循环，传统手术组患者未实施PDCA 循环。术后随访6月，统计患者术后治疗满意度和并发症发生率。 结果 微波消融治疗组消融率为95.38%，并发症发病率是7.77%，术后6月随访满意度为98.5%。传统手术组完全切除率为85.54%，并发症发生率为16.6%，术后6月随访满意度为81.5%。两组患者满意度差异具有统计学意义（χ2=8.547，P=0.003）。 结论 PDCA循环管理可提高微波消融甲状腺良性结节患者术后满意度，减少微波消融治疗甲状腺良性结节并发症的发生，提高护理满意度。 Abstract:Objective To explore the clinical effect of PDCA cycle management in the treatment of benign thyroid nodules by microwave ablation. Methods 65 patients with thyroid nodules admitted to our hospital from January 2015 to January 2016 were selected as the treatment group and were treated with microwave ablation; other 65 patients with benign thyroid nodules confirmed by postoperative pathology were included to the traditional operation group and were treated by traditional surgery before January 2015.The PDCA cycle was performed in the microwave ablation group, while not implemented in the traditional operation group. After 6 months of postoperative follow-up, the patients’ satisfaction with postoperative treatment and incidence rate of complications were systematically analyzed. Result The ablation rate, incidence rate of complications, and patients’ satisfaction rate during the six-month follow-up of the microwave ablation group were 95.38%, 7.77% and 98.5% respectively, while the rate of complete resection, incidence rate of complications and patients’ satisfaction rate during the six-month follow-up of the traditional operation group were 85.54%, 16.6%, and 81.5%. Conclusion PDCA cycle management can improve the postoperative satisfaction of patients with benign thyroid nodules after microwave ablation treatment, and reduce the incidence rate of benign nodule complications and improve nursing satisfaction. -
Key words:
- PDCA cycle management /
- benign thyroid nodules /
- microwave ablation /
- nursing
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表 1 两组患者并发症的发生情况及患者满意度对比（n, %）
组别 非常满意 满意 不满意 患者满意度 并发症率 微波消融组 44 20 1 98.5 7.77 传统手术组 32 21 12 81.5 16.6 P - - - 0.003 0.182 
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[1] 方国恩, 李 莉. 甲状腺结节的诊断和处理[J]. 中国实用外科杂志, 2003, 23(3): 135-7. [2] Ghervan C. Thyroid and parathyroid ultrasound[J]. Med Ultrason, 2011, 13(1): 80-4. [3] Rastogi A, Bhadada SK, Bhansali A. Nodular goiter with multiple cystic and solid swellings[J]. Indian J Endocrinol Metab, 2012, 16(4): 651-3. [4] 徐 荣, 安 媛, 梁秦龙, 等. 腔镜辅助微创手术治疗甲状腺良性肿瘤[J]. 现代肿瘤医学, 2011, 19(5): 868-70. [5] 王 瑜, 林 晨, 张再重, 等. 腔镜辅助下与全腔镜甲状腺切除术的对比分析[J]. 中国现代普通外科进展, 2009, 12(6): 500-4. [6] 刘金涛, 郭文斌, 杨世财, 等. 超声引导下射频消融治疗结节性甲状腺肿46 例报告[J]. 中国微创外科杂志, 2012, 12(8): 701-3. [7] 李继平. 护理管理学[M]. 北京: 人民卫乍出版社, 2006: 185-7. [8] 王淑荣, 岳雯雯, 张永林, 等. 超声引导下经皮微波消融治疗甲状腺良性结节的疗效观察[J]. 中华超声影像学杂志, 2015, 24(8): 675-9. [9] Korkusuz Y, Gröner D, Raczynski N, et al. Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods[J]. Eur Radiol, 2018, 28(3): 929-35. [10] Yan J, Qiu T, Lu J, et al. Microwave ablation induces a lower systemic stress response in patients than open surgery for treatment of benign thyroid nodules[J]. Int J Hyperthermia, 2018, 34(5): 606-10. [11] 何志忠, 李 霞, 陈俊君. 超声引导甲状腺消融的应用与进展[J]. 影像研究与医学应用, 2017, 6(1): 62-3. [12] Yue W, Wang SR, Wang B, et al. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: Safety and imaging follow-up in 222 patients[J]. Eur J Radiol, 2013, 82(1): E11-6. [13] 刘艳丽, 任梦薇. PDCA循环在我国护理管理领域应用中的新进展[J]. 中国医药指南, 2014, 27(6): 44-6. [14] 徐 斌, 张梅香, 章建全. 超声引导下甲状腺良性结节经皮热消融的临床研究[J]. 第二军医大学学报, 2011, 32(11): 1189-92. [15] 李 晨, 殷晶晶, 王加林. 甲状腺结节微创治疗现状[J]. 山东医药, 2016, 56(26): 111-3. [16] Galata G, Schulte KM. Management of the thyroid nodule[J].Endocr Surg, 1994, 29(9): 51-2. [17] 高 力. Miccoli内镜术式与甲状腺手术操作的微创化[J]. 中华外科杂志, 2006, 4(1): 10-3. [18] Lewandowski RJ, Salem R. Microwave or radiofrequency ablation:clinically equivalent[J]. Lancet Gastroenterol Hepatol, 2018,45(7): 259-62. [19] 刘 娟, 吴凤林, 隋 洋, 等. 超声引导下经皮激光消融甲状腺良性实性结节[J]. 南方医科大学学报, 2013,33(10): 1529-32. [20] 杜大军, 丁小崇, 刘洋洋. 超声引导下微波消融甲状腺结节的临床应用疗效观察[J]. 河南外科学杂志, 2015,24(5): 28-9. [21] Wu W, Gong X, Zhou Q, et al. Ultrasound-Guided percutaneous microwave ablation for solid benign thyroid nodules: comparison of MWA versus control group[J]. Int J Endocrinol, 2017,40(5): 9724090-8. -
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