基于品管圈活动的集束化护理对泌尿外科 机器人单孔腹腔镜术后腹胀的影响

Effect of Quality Control Circle-Based Cluster Nursing on Postoperative Abdominal Distension after Robotic Laparoendoscopic Single-Site Surgery in Urology

摘要: 目的：研究品管圈联合多组分集束化护理对泌尿外科机器人单孔腹腔镜术后腹胀的改善作用，并探讨该整体护理方案的有效性及其局限性。方法：根据纳入和排除标准选取2025年6月~2026年1月南医大二附院泌尿外科82例机器人手术患者，分为对照组和观察组，每组41例。对照组给予术后常规护理，观察组在常规护理基础上增加品管圈联合的多组分集束化护理方案(包含14项干预措施，分为促进CO₂排出、刺激胃肠蠕动、中医特色调理、标准化气道管理四大模块)。比较两组术后首次排气时间、首次排便时间、腹胀发生率及腹胀程度。结果：观察组术后首次排气时间、首次排便时间均显著快于对照组(P < 0.001)，腹胀发生率(36.59%)显著低于对照组(58.54%)，腹胀程度也明显轻于对照组(P < 0.05)。结论：包含14项干预措施的品管圈联合多组分集束化护理方案，作为一个整体护理包，可初步降低泌尿外科机器人单孔腹腔镜术后患者腹胀发生率，缩短排气排便时间。但由于干预措施众多，无法归因核心有效成分，后续需采用析因设计进一步验证各措施独立效应。

Abstract: Objective: To study the effect of quality control circle combined with multi-component cluster nursing on abdominal distension after robotic laparoendoscopic single-site surgery in urology, and to preliminarily evaluate the effectiveness and limitations of this holistic nursing package. Methods: According to inclusion and exclusion criteria, 82 patients undergoing robotic surgery in the Department of Urology, Second Affiliated Hospital of Nanjing Medical University from June 2025 to January 2026 were selected and divided into control group (n = 41) and observation group (n = 41). The control group received routine postoperative nursing, while the observation group received quality control circle combined with a multi-component cluster nursing package (14 interventions, categorized into four modules: promoting CO₂ elimination, stimulating gastrointestinal motility, traditional Chinese medicine conditioning, and standardized airway management). The first postoperative exhaust time, first defecation time, incidence and severity of abdominal distension were compared between the two groups. Results: The first exhaust time and first defecation time in the observation group were significantly shorter than those in the control group (P < 0.001). The incidence of abdominal distension in the observation group (36.59%) was significantly lower than that in the control group (58.54%), and the severity was also milder (P < 0.05). Conclusion: The quality control circle combined with multi-component cluster nursing, as an overall care package, can preliminarily reduce the incidence of postoperative abdominal distension and shorten the time to first exhaust and defecation in patients undergoing robotic laparoendoscopic single-site urological surgery. However, due to the large number of interventions, the core effective components cannot be identified. Further factorial design studies are needed to verify the independent effects of each intervention.