基于PDCA模式的手术室管理在肺癌手术患者中的应用效果

贾玉娟; 张熙泽; 李妍; 程志芳

doi:10.16766/j.cnki.issn.1674-4152.004393

基于PDCA模式的手术室管理在肺癌手术患者中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.004393

河南中医药大学第一附属医院手术室，河南郑州 450009

基金项目:

国家中医优势专科(护理学) 国中医药政函〔2024〕90号

河南省中医药重点(培育)学科中医护理学，2024

详细信息

通讯作者:
李妍，E-mail：13653710473@163.com

中图分类号: R734.2
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出版历程
- 收稿日期: 2025-02-24
- 网络出版日期: 2026-04-11

Study on the application effect of operation room management based on PDCA mode in patients with lung cancer surgery

Operating Room, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450009, China

摘要

摘要: 目的探讨将PDCA模式应用于手术室管理中，是否能够有效降低肺癌手术患者的应激反应程度及术后并发症发生率，为优化肺癌手术患者围手术期管理提供科学依据与实践参考。方法选取2022年1月—2024年1月在河南中医药大学第一附属医院接受肺癌手术治疗的96例患者，采用随机数字表法将其分为对照组与观察组，各48例。对照组采用常规手术室管理，观察组采用基于PDCA模式的手术室管理。比较2组患者术前及术后的围手术期指标、应激指标及术后并发症发生率、护理满意度。结果观察组首次下床活动时间、术中出血量、首次排尿时间、住院时间、首次肛门排气时间均明显低于对照组(P＜0.05)。术前，2组患者应激指标[肾上腺素(E)、皮质醇(Cor)、去甲肾上腺素水平(NE)]差异均无统计学意义(P＞0.05)；术后，2组患者NE、Cor、E水平均有所上升，但观察组均低于对照组(P＜0.05)。观察组术后并发症发生率为10.42%(5/48)，低于对照组的33.33%(16/48，P＜0.05)。观察组患者护理满意度为93.75%(45/48)，显著高于对照组的79.17%(38/48，P＜0.05)。结论基于PDCA模式的手术室管理能够有效改善围手术期指标，降低肺癌手术患者的应激反应，减少术后并发症发生率及提高护理满意度，值得在临床推广应用。
- PDCA模式 /
- 手术室管理 /
- 肺癌 /
- 应激反应 /
- 术后并发症
Abstract: Objective To investigate the efficacy of the PDCA model in managing operating rooms, with a specific focus on its potential to mitigate the stress response of patients undergoing lung cancer surgery, and to minimize the occurrence of postoperative complications. The findings of this study are expected to provide a scientific foundation and practical guidance for the refinement of perioperative management for patients undergoing lung cancer surgery. Methods A cohort of 96 patients who underwent surgical intervention for lung cancer at the First Affiliated Hospital of Henan University of Traditional Chinese Medicine between January 2022 and January 2024 was selected and classified into the control group and the observation group according to random number table, with 48 cases in each group. The control group was managed in accordance with conventional operating room protocols, while the observation group was managed in accordance with an operating room-based PDCA model. The preoperative and postoperative metrics, stress indexes, the postoperative complication rate, and nursing satisfaction of two groups were compared. Results The durations for initial ambulation, intraoperative blood loss, first voiding, length of hospital stay, and time to first anal gas emission in the observation group were significantly lower than those in the control group (P < 0.05). Preoperatively, there was an absence of notable disparity in the stress biomarkers, namely epinephrine (E), cortisol (Cor), and norepinephrine (NE), between the two cohorts (P>0.05). Post operatively, elevations in the concentrations of Cor, E, and NE were observed in both groups; however, the magnitudes of these increases were notably attenuated in the observation group relative to the control group (P < 0.05). The observational cohort demonstrated a postoperative complication incidence rate of 10.42% (5/48), which was substantially inferior to the 33.33% (16/48) recorded in the control cohort (P < 0.05). The satisfaction levels of patients with regard to nursing care in the observation group amounted to 93.75% (45/48), which was considerably elevated in comparison to the 79.17% (38/48) recorded in the control group (P < 0.05). Conclusion The operating room management based on the PDCA model has been shown to effectively improve the operation period index, reduce the stress response of patients undergoing lung cancer surgery, reduce the incidence of postoperative complications and improve nursing satisfaction, which is worthy of clinical application.
- PDCA mode /
- Operating room management /
- Lung cancer /
- Stress response /
- Postoperative complication

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表 1 2组肺癌手术患者基本资料比较

Table 1. Basic information between the two groups of patients undergoing lung cancer surgery

组别	例数	性别[例(%)]		年龄(x±s, 岁)	病程(x±s, 年)	病理分型[例(%)]		转移[例(%)]		临床分期[例(%)]
组别	例数	男性	女性	年龄(x±s, 岁)	病程(x±s, 年)	鳞癌	腺癌	无	有	Ⅰ/Ⅱ期	Ⅲ期
对照组	48	26(54.17)	22(45.83)	57.65±5.46	2.38±0.55	23(47.92)	25(52.08)	30(62.50)	18(37.50)	33(68.75)	15(31.25)
观察组	48	25(52.08)	23(47.92)	57.43±5.26	2.45±0.52	27(56.25)	21(43.75)	31(64.58)	17(35.42)	35(72.92)	13(27.08)
统计量		0.042^a		0.201^b	0.641^b	0.668^a		0.045^a		0.202^a
P值		0.838		0.841	0.523	0.414		0.832		0.653
注：^a为χ²值，^b为t值。

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表 2 2组肺癌手术患者围手术期指标比较(x±s)

Table 2. Comparison of intraoperative indicators between the two groups of patients undergoing lung cancer surgery (x±s)

组别	例数	术中出血量(mL)	首次肛门排气时间(h)	首次排尿时间(h)	首次下床活动时间(h)	住院时间(d)
对照组	48	226.42±22.75	19.45±2.94	14.29±2.57	32.18±4.79	10.50±2.50
观察组	48	206.85±21.69	14.88±2.76	12.61±2.75	25.13±4.22	7.50±1.50
t值		4.313	7.852	3.092	7.651	7.129
P值		＜0.001	＜0.001	0.003	＜0.001	＜0.001

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表 3 2组肺癌手术患者应激指标比较(x±s)

Table 3. Comparison of stress indicators between the two groups of patients undergoing lung cancer surgery (x±s)

组别	例数	Cor(nmol/L)		E(pmol/L)		NE(pmol/L)
组别	例数	术前	术后	术前	术后	术前	术后
对照组	48	33.14±4.42	49.25±6.84^b	275.22±28.68	406.07±51.08^b	366.63±39.44	488.13±50.38^b
观察组	48	34.96±5.26	41.87±4.93^b	279.13±44.86	371.48±43.38^b	364.37±38.53	456.72±50.13^b
统计量		1.837^a	33.222^c	0.508^a	12.651^c	0.285^a	9.219^c
P值		0.069	＜0.001	0.612	0.001	0.776	0.003
注：^a为t值，^c为F值；与同组术前比较，^bP＜0.05。

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表 4 2组肺癌手术患者术后并发症发生率比较[例(%)]

Table 4. Comparison of postoperative complication rates between the two groups of patients undergoing lung cancer surgery [cases (%)]

组别	例数	胸腔积液	肺不张	肺部感染	漏气≥3 d	总发生
对照组	48	4(8.33)	4(8.33)	5(10.42)	3(6.25)	16(33.33)
观察组	48	1(2.08)	2(4.17)	1(2.08)	1(2.08)	5(10.42)
注：2组术后并发症总发生率比较，χ²=7.375，P=0.007。

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表 5 2组肺癌手术患者护理满意度比较[例(%)]

Table 5. Comparison of satisfaction degrees between the two groups of patients undergoing lung cancer surgery [cases (%)]

组别	例数	非常满意	满意	不满意	护理满意度
对照组	48	20(41.67)	18(37.50)	10(20.83)	38(79.17)
观察组	48	27(56.25)	18(37.50)	3(6.25)	45(93.75)
注：2组护理满意度比较，χ²=4.360，P=0.037。

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