基于4C模式的延续性护理对于下肢静脉曲张日间手术后老龄患者的应用效果

Application Effect of Continuity of Care Based on the 4C Model for Elderly Patients after Day Surgery for Varicose Veins of the Lower Extremities

摘要: 目的：探索基于4C模式的延续性护理对于下肢静脉曲张日间手术后老龄患者的应用效果。方法：回顾性分析2022年6月至2024年6月于重庆医科大学附属第一医院日间服务中心接受下肢曲张静脉射频消融手术的229例年龄 ≥ 65岁患者的临床资料。对于纳入患者的基线资料使用倾向性评分匹配(propensity score matching, PSM)调整患者特征后，比较普通护理模式与4C延续性护理模式干预后的随访预后指标。结果：4C护理模式组的睡眠质量显著提高(P = 0.002)；静脉临床严重度下降更为明显(P < 0.001)；阿伯丁静脉曲张问卷分数下降更明显(P < 0.001)；出院后6个月内，4C护理模式组的出血(P = 0.001)和感染(P = 0.059)发生率低于普通护理组。但两组患者通过视觉模拟评分法(VAS)疼痛评分无统计学差异(P = 0.988)。结论：4C延续性护理模式在下肢静脉曲张日间手术后老龄患者中具有显著优势，可有效改善睡眠质量、降低临床症状严重程度及并发症风险，从而提升患者生活质量。

Abstract: Objective: To explore the effect of continuity of care based on the 4C model for elderly patients after daytime surgery for varicose veins of the lower extremities. Methods: Clinical data of 229 patients aged ≥ 65 years who underwent radiofrequency ablation of varicose veins of the lower limbs at the Day Service Center of the First Affiliated Hospital of Chongqing Medical University from June 2022 to June 2024 were retrospectively analyzed. After the baseline data of the included patients were adjusted for patient characteristics using propensity score matching (PSM), the follow-up prognostic indicators after the intervention of the ordinary care model and the 4C continuity of care model were compared. Results: Sleep quality was significantly better in the 4C care model group (P = 0.002); venous clinical severity decreased more significantly (P < 0.001); Aberdeen Varicose Vein Questionnaire scores decreased more significantly (P < 0.001); and the incidence of hemorrhage (P = 0.001) and infections (P = 0.059) was lower in the 4C care model group than the usual care group at 6 months after discharge. However, there was no statistically significant difference in pain scores by visual analog scale (VAS) between the two groups (P = 0.988). Conclusion: The 4C continuity of care model has significant advantages in elderly patients after day surgery for varicose veins of the lower extremities, which can effectively improve sleep quality, reduce the severity of clinical symptoms and the risk of complications, and thus enhance the quality of life of patients.