集束化护理预防颈椎前路术后咽喉刺激症△（开放获取）

(Open Access) Cluster nursing for prevention of throat irritation after anterior cervical surgery

摘要:

[目的] 探讨集束化护理在预防颈椎前路术后咽喉刺激症的临床效果。[方法] 回顾性分析本院收治的172 例行颈椎前路手术患者的临床资料，其中2022 年7 月—2022 年11 月收治的83 例患者行常规护理，2022 年12 月—2023 年4 月收治的89 例患者实施集束化护理，比较两组Bazaz 吞咽困难评级、吞咽生存质量（swallowing quality of life, SWAL-QOL） 以及舒适状况（general comfort questionnaire, GCQ） 的评分。[结果] 两组均顺利手术，无严重并发症。集束组在术后第2、5 d 的Bazaz 评级[无/轻/中/重, (49/23/12/5) vs (41/18/14/10), P=0.004; (80/7/2/0) vs (50/18/10/5), P=0.015], SWAL-QOL 评分[(56.1±7.9) vs (50.6±10.0), P=0.014; (60.1±5.9) vs (52.3±9.8), P＜0.001]和GCQ 评分[(93.3±7.1) vs (89.3±10.4), P=0.003; (96.1±3.4) vs (93.5±7.5), P=0.002] 均显著优于常规组；此外，集束组的咽喉刺激症发生率显著低于常规组[例(%), 6 (6.7) vs 17 (20.0), P＜0.001]。[结论] 在颈椎前路手术后应用集束化护理对患者进行干预，有利于预防咽喉刺激症的发生，提升患者就医体验。

Abstract:

[Objective] To investigate the clinical outcomes of cluster nursing in preventing laryngeal irritation after anterior cervicalsurgery. [Methods] A retrospective study was conducted on 172 patients who underwent anterior cervical surgery in our hospital. Of them,83 patients who were admitted from July 2022 to November 2022 received routine nursing, while other 89 patients admitted from December2022 to April 2023 received cluster nursing. The Bazaz dysphagia grade, swallowing quality of life (SWAL-QOL) and general comfort ques-tionnaire (GCQ) were compared between the two groups. [Results] All patients in both groups were successfully operated on without seriouscomplications. The cluster group proved significantly superior to the routine group 2 days and 5 days after surgery in terms of Bazaz dyspha-gia grade [none/mild/medium/severe, (49/23/12/5) vs (41/18/14/10), P=0.004; (80/7/2/0) vs (50/18/10/5), P=0.015], SWALQOL score[(56.1±7.9) vs (50.6±10.0), P=0.014; (60.1±5.9) vs (52.3±9.8), P=0.001], and GCQ score [(93.3±7.1) vs (89.3±10.4), P=0.003; (96.1±3.4) vs(93.5±7.5), P=0.002]. In addition, the former was also significantly better than the latter in term of incidence of throat irritation [case (%), 6(6.7) vs 17 (20.0), P=0.001]. [Conclusion] The intervention of cluster nursing after anterior cervical surgery is beneficial to prevent throat ir-ritation and improve patients' experience to medical service.