集束化护理在肺移植术后患者中的应用
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张梓春，杜杨，谭瑞香，范素云，郭锦云
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南方医科大学附属广东省人民医院器官移植科，广东广州，510080
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摘要：目的 探讨集束化护理在肺移植术后患者中的临床应用效果。方法 选取2020 年8 月8 日~2025年8 月8 日行肺移植手术的70 例患者为研究对象，依据区组随机法分为对照组35 例和研究组35 例；对照组接受常规肺移植护理管理，研究组接受集束化护理。比较两组术后肺部感染发生情况，分析患者是否有发热，多重耐药菌感染, 术后康复指标，生活自理能力质量[ADL]，第三方护理满意度调查结果。结果 研究组术后肺部感染发生率低于对照组（P<0. 05）；多重耐药菌感染率低于对照组（P<0.05）；术后康复指标：包括下地活动时间、VTE 评分从高危到低危时间和治疗费用研究组均少于对照组（P<0. 05）。干预后，两组ADL 评分均升高（P<0. 05），且研究组各维度评分均高于对照组（P<0.05）；研究组第三方护理满意度高于对照组（P<0.05）。结论 集束化护理并非单一护理措施的叠加，而是基于循证医学证据的“系统化、标准化、个性化”护理模式。其通过精准防控感染风险、协同推进多维度康复、优化就医全流程体验，形成了“降低并发症-加速康复-提升生活质量”的良性循环，为肺移植术后护理提供了可推广的标准化方案，同时也体现了现代护理从“疾病护理”向“整体健康管理”的转型。
关健词：肺移植；肺部感染；集束化护理；护理
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Implementing an Evidence-Based Care Bundle in Patients Following Lung Transplant Surgery
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Zichun Zhang,Yang Du,Ruixiang Tan,Suyun Fan,Jinyun Guo
Department of Organ Transplantation, Guangdong Provincial People's Hospital Affiliated to Southern Medical University, Guangzhou Guangdong 510080, China
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Abstract: Objective To investigate the clinical application effect of cluster nursing in patients after lung transplantation. Methods Seventy patients who underwent lung transplantation between August 8, 2020, and August 8, 2025, were selected as the study subjects and divided into a control group (35 cases) and a study group (35 cases) using block randomization. The control group received routine lung transplantation nursing management, while the study group received cluster nursing. The incidence of postoperative pulmonary infections, presence of fever, multidrug-resistant organism infections, postoperative recovery indicators, activities of daily living (ADL) quality, and third-party nursing satisfaction survey results were compared between the two groups. Results The study group had a lower incidence of postoperative pulmonary infections than the control group (P < 0.05), a lower rate of multidrug-resistant organism infections (P < 0.05), and better postoperative recovery indicators, including shorter time to ambulation, shorter time for VTE risk score reduction from high to low, and lower treatment costs (P < 0.05). After the intervention, the ADL scores of both groups increased (P < 0.05), with the study group showing higher scores across all dimensions than the control group (P < 0.05). The study group also had higher third-party nursing satisfaction than the control group (P < 0.05). Conclusion Cluster nursing is not merely the superposition of individual nursing measures but a "systematic, standardized, and personalized" nursing model based on evidence-based medicine. By precisely preventing and controlling infection risks, synergistically promoting multidimensional recovery, and optimizing the entire healthcare experience, it creates a virtuous cycle of "reducing complications-accelerating recovery-improving quality of life." This approach provides a replicable standardized solution for post-lung transplantation nursing and reflects the transition of modern nursing from "disease-centered care" to "holistic health management."
Keywords : Lung transplantation; Pulmonary infection; Bundled nursing; Nursing care
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