目的 评估甲状腺癌术后患者的疲劳状况及其相关影响因素,并通过精准护理干预措施,减轻术后疲劳感,提升患者生活质量。方法 收集2019年11月至2021年10月期间,于我院行甲状腺癌手术治疗的患者400例,随机分为试验组和对照组（各200例）。试验组术后接受包括焦虑管理、渐进式颈肩功能锻炼、甲状腺功能随访、营养调整和睡眠改善在内的精准护理干预,对照组接受术后常规护理。使用简明围术期疲劳评测量表（Identity-Consequence Fatigue Scale-10,ICFS-10） 评估疲劳状况,使用Constant-Murley肩关节评分系统评估肩颈功能,并通过医院焦虑抑郁量表（Hospital Anxiety and Depression Scale,HADS）、匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index,PSQI）、视觉模拟量表（Visual Analog Scale,VAS）和健康调查简表（36-Item Short Form Health Survey,SF-36） 评估焦虑、睡眠、咽部不适及生活质量,在术后第1 d、第3 d、1个月和3个月进行上述评估的结果分析。结果 实验组的疲劳评分在术后1个月和3个月较对照组明显下降;实验组的肩颈功能评分在术后3个月较对照组明显提升。术后3个月的HADS及PSQI评分试验组较对照组均有明显下降。结论 精准护理干预显著改善了甲状腺癌术后患者的疲劳状况、焦虑水平和睡眠质量,证明其在术后康复中的有效性,建议在临床推广应用。

Objective To assess the fatigue status and its related influencing factors in patients after thyroid cancer surgery, and to alleviate postoperative fatigue and improve their quality of life through precision nursing interventions. Methods A total of 400 patients who underwent thyroid cancer surgery in our hospital from November 2019 to October 2021 were enrolled and randomly divided into an experimental group and a control group (200 patients in each group). The experimental group received precision nursing interventions including anxiety management, progressive neck and shoulder functional exercises, thyroid function follow-up, nutritional adjustment, and sleep improvement after surgery, while the control group received routine postoperative care. The fatigue status was assessed using the Improved Chronic Fatigue Syndrome Scale (ICFS-10), the shoulder and neck function was evaluated using the Constant-Murley Shoulder Score System, and anxiety, sleep, pharyngeal discomfort, and quality of life were assessed using the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Visual Analogue Scale (VAS), and Short Form-36 Health Survey (SF-36). The results of these assessments were analyzed on postoperative day 1, day 3, 1 month, and 3 months. Results The fatigue scores in the experimental group were significantly lower than those in the control group at 1 month and 3 months after surgery; the shoulder and neck function scores in the experimental group were significantly higher than those in the control group at 3 months after surgery. The HADS and PSQI scores in the experimental group were significantly lower than those in the control group at 3 months after surgery (all P<0.05). Conclusion Precision nursing interventions significantly improved the fatigue status, anxiety levels, and sleep quality of patients after thyroid cancer surgery, demonstrating their effectiveness in postoperative rehabilitation. It is recommended for clinical application.