摘要
目的探讨多学科融合在痛风石围手术期患者中的应用及效果。方法选取2020年5月至10月在青岛大学附属医院行痛风石手术的45例患者作为对照组, 采用常规治疗护理措施;2020年11月至2021年4月在青岛大学附属医院行痛风石手术的41例患者作为干预组, 采用多学科融合管理模式。比较2组患者术后疼痛、血尿酸值、住院费用、住院天数、患者满意度的差异。结果实施多学科融合管理模式后, 患者术后4 h、术后1 d、3 d疼痛评分较对照组下降[(3.56±1.00)与(4.1±1.0), t=2.33, P=0.022;(2.5±0.8)与(3.0±0.6), t=3.85, P<0.001;(1.8±0.5)与(2.2±0.7), t=3.52, P<0.001], 术后1个月、3个月血尿酸水平较对照组显著降低[(355±58)与(392±39), t=3.50, P=0.001;(316±48)与(366±47), t=4.84, P<0.001], 住院天数和住院费用明显下降[(8.9±2.5)d与(10.6±4.0)d, t=2.44, P=0.017;(1.00±0.13)万元与(1.11±0.17)万元, t=3.34, P=0.001], 患者满意度得到有效提高(97.6%与82.2%, χ^(2)=3.87, P=0.049)。结论痛风石围术期患者采用多学科融合管理模式可有效降低患者术后疼痛, 提升患者围术期医疗护理质量, 促进患者康复, 改善患者结局, 降低患者经济负担, 值得在临床推广应用。
Objective To explore the application and effect of multidisciplinary collaboration in patients with tophi during perioperative period.Methods Forty-five patients undergoing tophaceous gout surgery in our hospital from May to October 2020 were selected as the control group and treated with routine treatment.From November 2020 to April 2021,41 patients undergoing tophaceous gout surgery in our hospital who were treated with multidisciplinary collaboration management mode were included as the intervention group.Postoperative pain,blood uric acid level,hospitalization expenses,hospitalization days and patient satisfaction were compared between the two groups.Results After implementing the multidisciplinary integration man-agement mode,the pain score of the patients at 4 hours,1 day and 3 days after operation was lower than that of the control group[(3.6±1.0)vs(4.1±1.0),t=2.33,P=0.022;(2.5±0.8)vs(3.0±0.6),t=3.85,P<0.001;(1.8±0.5)vs(2.2±0.7),t=3.52,P<0.001],the serum uric acid level was significantly lower than that of the control group at 1 month and 3 months after operation[(355±58)vs(3928±39),t=3.50,P=0.001;(316±48)vs(366±47),t=4.84,P<0.001],the hospitalization days and hospitalization expenses were significantly decreased[(8.90±2.48)d vs(10.62±3.96)d,t=2.44,P=0.017;(1.00±0.13)ten thousand yuan vs(1.11±0.17)ten thousand yuan,t=3.34,P=0.001],and the patient satisfaction was markedly improved(97.6%vs 82.2%,χ^(2)=3.87,P=0.049).Conclusion The multi-disciplinary collaboration mode in patients with tophi during perioperative period can effectively reduce the postoperative pain,improve the quality of care,promote reha-bilitation,improve the outcome,and reduce the economic burden of patients,which is worthy of popularization and being applied in clinic.
作者
徐毅君
李振云
李长贵
潘月海
刘甜
付军桦
韩臻
陈颖
Xu Yijun;Li Zhenyun;Li Changgui;Pan Yuehai;Liu Tian;Fu Junhua;Han Zhen;Chen Ying(Department of Endocrinology and Metabolism,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Hand and Foot Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266003,China Liu Tian;Department of anesthesiology,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2022年第5期329-333,共5页
Chinese Journal of Rheumatology
基金
国家自然科学基金(81870615, 81600601)。
关键词
多学科融合
痛风石
围术期
Multi-disciplinary integration
Tophaceous gout
Perioperative period