基于区域专科联盟的联盟医院淋巴水肿专科干预小组建立与实践

doi:10.20223/j.cnki.1000-8535.2025.10.017

广州医药 ›› 2025, Vol. 56 ›› Issue (10): 1433-1439.DOI: 10.20223/j.cnki.1000-8535.2025.10.017

基于区域专科联盟的联盟医院淋巴水肿专科干预小组建立与实践

孙娟¹, 王小为¹, 曹雪梅¹, 李丹¹, 邓小娇¹, 邓晓蓉², 段秀丽³, 杨正君⁴, 马俊⁵, 陈国英⁶, 陶晨⁷

1 德阳市人民医院乳腺外科（四川德阳 618000）
2 中江妇幼保健院护理管理（四川德阳 618300）
3 广汉市人民医院护理管理（四川广汉 618300）
4 罗江区人民医院普外科（四川德阳 618500）
5 广汉妇幼保健院普外科（四川广汉 618300）
6 德阳肿瘤医院护理管理（四川德阳 618000）
7 什邡市妇幼保健院普外科（四川什邡 618400）

收稿日期:2024-11-27 出版日期:2025-10-20 发布日期:2025-11-28
基金资助:
四川省基层卫生事业发展研究中心课题（SWFZ24-C-105）

Establishment and practice of a lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance

SUN Juan¹, WANG Xiaowei¹, CAO Xuemei¹, LI Dan¹, DENG Xiaojiao¹, DENG Xiaorong², DUAN Xiuli³, YANG Zhengjun⁴, MA Jun⁵, CHEN Guoying⁶, TAO Chen⁷

1 Breast Surgery Department,Deyang City People’s Hospital,Deyang 618000,China
2 Nursing Management,Zhongjiang Maternal and Child Health Hospital,Deyang 618300,China
3 Nursing Management,Guanghan People’s Hospital,Guanghan 618300,China
4 General Surgery Department,Luojiang People’s Hospital,Deyang 618500,China
5 General Surgery Department,Guanghan Maternal and Child Health Hospital,Guanghan 618300,China
6 Nursing Management,Deyang Tumor Hospital,Deyang 618000,China
7 General Surgery Department,Shifang Maternal and Child Health Hospital,Shifang 618400,China

Received:2024-11-27 Online:2025-10-20 Published:2025-11-28

摘要/Abstract

摘要： 目的探讨基于区域专科联盟模式,在联盟医院内建立淋巴水肿专科干预小组的有效策略及其对患者干预效果的影响。方法对区域医联体内7家联盟医院（包括德阳市人民医院、广汉市人民医院、罗江区人民医院、广汉妇幼保健院、德阳肿瘤医院、中江妇幼保健院、什邡市妇幼保健院）20名医护人员进行淋巴水肿知识及干预技能培训,建立区域性淋巴水肿专科干预小组,制定小组工作职责、实施专科质量控制。选取2024年5—8月淋巴水肿专科干预小组干预模式开展期间作为观察组,选取2024年1—4月淋巴水肿专科干预小组干预模式开展前作为对照组。对比两组医护人员淋巴水肿相关知识掌握合格率、住院患者淋巴水肿风险筛查率、淋巴水肿高风险患者措施落实率、出院随访患者上肢功能评定评分及患者就医满意度。结果干预后,护理人员淋巴水肿知识各维度得分[基础知识（17.36±2.54）、诊断与评估（25.66±4.34）、治疗与管理（25.08±4.73）、预防与康复（15.36±2.53）、总分（85.36±8.52）]均高于干预前[基础知识（11.35±2.29）、诊断与评估（17.87±3.18）、治疗与管理（18.28±3.85）、预防与康复（10.39±2.24）、总分（55.35±7.56）]（t=7.859,P<0.001;t=6.475,P<0.001;t=4.986,P<0.001;t=6.578,P<0.001;t=11.782,P<0.001）;观察组住院患者淋巴水肿风险筛查率高于对照组（80.72% vs 61.24%）,对比差异有统计学意义（χ²=31.454,P<0.001）;观察组患者出院时及出院后1月上肢功能评定（DASH）量表评分[（23.36±8.63）（20.16±7.34）分]低于对照组[（25.32±9.16）（22.25±7.67）分],对比差异有统计学意义（t=2.884,P=0.004;t=3.646,P=0.001）;观察组患者出院时患者就医满意度评分（83.36±8.63）高于对照组（71.37±10.33）,对比差异有统计学意义（t=16.460,P<0.001）。结论基于区域专科联盟体的联盟医院淋巴水肿专科干预小组能够有效地实现三级医院优质干预资源下沉,在联盟内可实现淋巴水肿防治同质化、专科人才培训基地建设,整体提升区域内淋巴水肿防控效果,提高患者就医满意度。

关键词: 区域专科联盟, 淋巴水肿, 专科干预小组, 建立, 实践

Abstract: Objective To explore effective strategies for establishing a lymphoedema specialty nursing team within alliance hospitals based on a regional specialty alliance and assess its impact on patient care outcomes．Methods A regional lymphedema specialty nursing team was established by training 20 healthcare professionals from 7 hospitals（Deyang City People’s Hospital,Guanghan People’s Hospital,Luojiang People’s Hospital,Guanghan Maternal and Child Health Hospital,Deyang Tumor Hospital,Zhongjiang Maternal and Child Health Hospital,and Shifang Maternal and Child Health Hospital）in a regional medical consortium,focusing on lymphedema knowledge and intervention skills．The team’s responsibilities and nursing quality control protocols were standardized．The observation group included data from May to August in 2024（post-intervention period）,while the control group comprised data from January to April in 2024（pre-intervention period）．Comparisons were made between the two groups regarding healthcare professionals’qualification rate in lymphedema knowledge,inpatients’ lymphedema risk screening rate,implementation rate of preventive measures for high-risk patients,upper extremity function assessment scores（using the Disabilities of the Arm,Shoulder and Hand[DASH] scale）at discharge and 1-month post-discharge,and patient satisfaction．Results After the intervention,healthcare professionals’ lymphedema knowledge scores significantly improved across all domains：basic knowledge（17.36±2.54 vs 11.35±2.29）,diagnosis/assessment（25.66±4.34 vs 17.87±3.18）,treatment/management（25.08±4.73 vs 18.28±3.85）,prevention/rehabilitation（15.36±2.53 vs 10.39±2.24）,and total score（85.36±8.52 vs 55.35±7.56）（t=7.859,P<0.001;t=6.475,P<0.001;t=4.986,P<0.001;t=6.578,P<0.001;t=11.782,P<0.001）．The observation group demonstrated a higher lymphedema risk screening rate（80.72% vs 61.24%,χ²=31.454,P<0.001）．DASH scores in the observation group were significantly lower than the control group at discharge（23.36±8.63 vs 25.32±9.16）and 1-month post-discharge（20.16±7.34 vs 22.25±7.67）（t=2.884,P=0.004;t=3.646,P=0.001）．Patient satisfaction scores at discharge were higher in the observation group（83.36±8.63 vs 71.37±10.33,t=16.460,P<0.001）．Conclusions The lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance effectively facilitates the high-quality nursing resources homogenization in primary hospitals．Within the alliance,it achieves homogenization of lymphoedema prevention and treatment,establishes a training base for specialty talents,and overall enhances lymphoedema prevention and control within the region,thereby improving patient satisfaction with healthcare．

Key words: regional specialty alliance, lymphoedema, specialty nursing team, establishment, practice

孙娟, 王小为, 曹雪梅, 李丹, 邓小娇, 邓晓蓉, 段秀丽, 杨正君, 马俊, 陈国英, 陶晨. 基于区域专科联盟的联盟医院淋巴水肿专科干预小组建立与实践[J]. 广州医药, 2025, 56(10): 1433-1439.

SUN Juan, WANG Xiaowei, CAO Xuemei, LI Dan, DENG Xiaojiao, DENG Xiaorong, DUAN Xiuli, YANG Zhengjun, MA Jun, CHEN Guoying, TAO Chen. Establishment and practice of a lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance[J]. Guangzhou Medical Journal, 2025, 56(10): 1433-1439.

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基于区域专科联盟的联盟医院淋巴水肿专科干预小组建立与实践

Establishment and practice of a lymphoedema specialty nursing team in alliance hospitals based on a regional specialty alliance

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