目的 观察快速康复外科理念(fast track surgery concept, FTS)在乳腺癌术后基层医院-社区管理模式中的应用效果。方法 将我院收治的78例乳腺癌患者随机分为观察组和对照组,每组39例。手术治疗出院后对照组患者行常规社区管理护理服务,观察组则在社区管理护理服务中应用FTS。比较两组患者社区管理干预后1个月,评价肩关节活动度(ROM),包括肩后伸、肩前屈、肩内收、肩外展4个锻炼项目。结果 观察组治疗依从性为100%,对照组为76.92%,观察组明显高于对照组,差异有统计学意义(P<0.05)。社区管理干预1个月后,观察组肩后伸、肩前屈、肩内收、肩外展锻炼项目ROM平均评分均高于对照组,差异有统计学意义(P<0.05);且干预后3个月和6个月两组患者SF-36量表评分下心理健康、社会功能、生命活力、总体健康各维度平均评分较干预前均提高,差异具有统计学意义(P<0.05),但观察组各维度提高幅度均大于对照组,差异有统计学意义(P<0.05)。结论 在乳腺癌术后基层医院-社区管理模式中应用FTS能有效提高患者治疗依从性,提高功能锻炼效果及生活质量。

Objective To observe the applicability of fast track surgery concept (FTS) in a mode in which the community shares the work of a grassroots hospital after breast cancer surgery.Methods Seventy-eight cases of breast cancer treated in our hospital were randomly divided into the observation group and the control group (n=39 cases). After surgery, the patients in the control group received the routine community-managed nursing service, while the observation group underwent FTS in the community-managed nursing service.Results The compliance of the observation group was 100%, while that of the control group was 76.92%. After one month of community-managed interventions, the average ROM scores of four types of physical exercise - shoulder extension, shoulder flexion, shoulder adduction and shoulder abduction-were higher in the observation group than in the control group(P<0.05), and the average scores of mental health, social function, life vitality and overall health three months and six months after nursing were significantly increased in both groups (P<0.05), especially in the observation group(P<0.05).Conclusions The application of FTS in a mode where the community takes over the work of a grass-roots hospital after breast cancer surgery can effectively improve the compliance of patients, the effect of functional exercise and the patients’ quality of life.