FMEA模式在乳腺癌患者癌性伤口和术后恢复中的应用

周玉; 童宗培; 王莉; 周均凤; 李青

doi:10.16766/j.cnki.issn.1674-4152.003398

FMEA模式在乳腺癌患者癌性伤口和术后恢复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003398

周玉^1, ,,
童宗培¹,
王莉¹,
周均凤¹,
李青²

1.
滁州市中西医结合医院普外一科，安徽滁州 239000
2.
滁州市中西医结合医院普外二科

基金项目:

安徽省卫生健康科研项目 AHWJ2022c052

详细信息

通讯作者:
周玉，E-mail：Czzy0914@163.com

中图分类号: R737.9
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- 文章访问数: 199
- HTML全文浏览量: 87
- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-20
- 网络出版日期: 2024-03-27

Application of FMEA model prevention in cancer wound and postoperative recovery in patients with breast cancer

1.
Department of General Surgery, Chuzhou Combined Hospital of Traditional Chinese and Western Medicine, Chuzhou, Anhui 239000, China

摘要

摘要: 目的探究失效模式和效果分析(FMEA)模式在乳腺癌患者中的应用效果，及对患者癌性伤口和术后恢复的影响。方法选取2021年1月—2023年8月滁州市中西医结合医院收治的乳腺癌患者86例纳入研究，按照随机数字表将患者分为对照组(43例，采用常规护理干预)及FMEA组(43例，采用FMEA预防性护理干预)。比较2组干预前后癌性伤口恢复情况、疼痛、患肢功能恢复、焦虑状况及护理满意度。结果干预后，FMEA组渗液颜色正常例数显著多于对照组(χ²=4.674，P=0.031)，渗液气味显著低于对照组[(2.14±0.67)级vs. (2.58±0.74)级，t=2.890，P=0.005]，渗液量差异无统计学意义(P>0.05)。干预第1、3、7天，2组VAS评分均逐渐降低(P < 0.05)，且FMEA组各时间点评分均显著低于对照组(P < 0.05)；干预后，2组患肢活动角度均显著提高(P < 0.05)，且FMEA组显著高于对照组(P < 0.05)；干预后，2组状态焦虑量表(SAI)评分、特质焦虑量表(TAI)评分均显著降低(P < 0.05)，且FMEA组显著低于对照组(P < 0.05)。FMEA组护理满意度显著高于对照组[93.02%(40/43) vs. 76.74%(33/43)，χ²=4.440，P=0.035]。结论 FMEA模式预防可有效促进乳腺癌患者术后癌性伤口与上肢功能恢复，缓解疼痛及焦虑。
- 乳腺癌 /
- 失效模式和效果分析 /
- 癌性伤口 /
- 术后恢复
Abstract: Objective To explore the preventive effect of failure mode and effect analysis (FMEA) model in breast cancer patients, and its impact on cancerous wounds and postoperative recovery. Methods A total of 86 patients with breast cancer treated at Chuzhou Integrated Traditional and Western Medicine Hospital from January 2021 to August 2023 were selected and included as study subjects. According to the random number table method, the patients were simply randomly divided into control group (n=43, routine care intervention) and FMEA group (n=43, FMEA model preventive care intervention). The two groups were compared before and after the intervention in terms of cancer wound healing, pain status, functional recovery of the affected limb, anxiety status and nursing satisfaction. Results After intervention, the colour normality of exudate in the FMEA group was significantly higher than that in the control group (χ²=4.674, P=0.031), while the odour of exudate was significantly lower than that in the control group [(2.14±0.67) grade vs. (2.58±0.74) grade, t=2.890, P=0.005], but the exudate volume had no significant difference (P>0.05). On the 1st, 3rd, 7th day after intervention, the VAS scores in both groups were gradually decreased (P < 0.05), and the above scores in the FMEA group at different time points were significantly lower than those in the control group (P < 0.05). After intervention, the angle of movement of the affected limb was significantly increased in both groups (P < 0.05), and the above indicators were significantly higher in the FMEA group (P < 0.05). The state anxiety inventory (SAI) score and trait anxiety inventory (TAI) score in both groups were declined significantly after intervention (P < 0.05), and the two scores were significantly lower in the FMEA group compared to control group (P < 0.05). Nursing satisfaction in the FMEA group was significantly higher than in the control group [93.02% (40/43) vs. 76.74% (33/43), χ²=4.440, P=0.035]. Conclusion FMEA model prevention can effectively promote the recovery of post operative cancer wound and upper limb function, relieve the pain status and anxiety status of patients.
- Breast cancer /
- Failure mode and effect analysis /
- Cancerous wound /
- Postoperative recovery

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表 1 2组乳腺癌患者癌性伤口恢复情况比较

Table 1. Comparison of cancer wound recovery between the two groups of breast cancer patients

组别	例数	渗液量[例(%)]			渗液颜色[例(%)]		渗液气味 (x±s, 级)
组别	例数	少量	中量	大量	正常	非正常	渗液气味 (x±s, 级)
对照组	43	15(34.88)	15(34.88)	13(30.23)	18(41.86)	25(58.14)	2.58±0.74
FMEA组	43	21(48.84)	15(34.88)	7(16.28)	28(65.12)	15(34.88)	2.14±0.67
统计量		1.605^a			4.674^b		2.890^c
P值		0.108			0.031		0.005
注：^a为Z值，^b为χ²值，^c为t值。

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表 2 2组乳腺癌患者疼痛情况比较(x±s, 分)

Table 2. Comparison of pain between the two groups of breast cancer patients (x±s, points)

组别	例数	干预第1天	干预第3天	干预第7天
对照组	43	4.94±0.87	3.92±0.66^a	2.64±0.43^ab
FMEA组	43	4.36±0.81	3.37±0.59^a	2.19±0.37^ab
t值		3.200	4.074	5.202
P值		0.002	< 0.001	< 0.001
注：F_组间=3.284，P < 0.001；F_时间=9.860，P < 0.001；F_交互=4.224，P < 0.001。与干预第1天比较，^aP < 0.05；与干预第3天比较，^bP < 0.05。

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表 3 2组乳腺癌患者患肢功能恢复情况比较(x±s, °)

Table 3. Comparison of functional recovery of the affected limb between the two groups of breast cancer patients (x±s, °)

组别	例数	上举		内旋		外旋		水平屈曲		水平伸展
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	43	82.14±8.34	148.51±16.36^a	42.16±4.28	57.27±5.19^a	55.61±5.38	69.82±7.14^a	87.43±6.17	121.06±8.12^a	15.17±2.23	21.37±3.55^a
FMEA组	43	83.27±9.42	162.57±15.62^ab	41.29±4.73	61.57±5.28^ab	56.48±5.12	77.51±7.57^ab	89.18±6.46	125.57±7.66^ab	14.61±2.35	23.38±3.58^ab
注：与干预前比较，^aP < 0.05；与对照组比较，^bP < 0.05。

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表 4 2组乳腺癌患者焦虑状况比较(x±s, 分)

Table 4. Comparison of anxiety status of breast cancer patients in two groups (x±s, points)

组别	例数	SAI		TAI
组别	例数	干预前	干预后	干预前	干预后
对照组	43	54.15±7.64	44.88±3.76^a	53.76±6.67	42.15±4.34^a
FMEA组	43	55.23±8.17	42.69±3.68^a	52.36±7.23	39.86±4.47^a
t值		0.809	2.730	0.933	2.410
P值		0.421	0.008	0.353	0.018
注：与干预前比较，^aP < 0.05。

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表 5 2组乳腺癌患者护理满意度比较[例(%)]

Table 5. Comparison of nursing satisfaction of breast cancer patients in two groups [cases (%)]

组别	例数	非常满意	满意	不满意	总满意
对照组	43	18(41.86)	15(34.88)	10(23.26)	33(76.74)
FMEA组	43	26(60.47)	14(32.56)	3(6.98)	40(93.02)
注：2组护理总满意度比较，χ²=4.440，P=0.035。

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