Research on the application of a specialized disease management protocol based on the ORTCC model in the perioperative period of weight loss patients

doi:10.3877/cma.j.issn.2095-9605.2026.02.003

Abstract

Abstract:

Objective

To investigate the application effect of a specialized disease management program based on the ORTCC model in perioperative care for patients with metabolic weight loss.

Methods

Eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic surgery center from July 2024 to December 2024 were selected as the control group (n=80); another eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic center from January 2025 to June 2025 were selected as the observation group (n=80). The control group received conventional nursing care, while the observation group received a specialized disease management program based on the ORTCC model. The preoperative assessment completeness rate, postoperative first ambulation time compliance rate, incidence of nausea and vomiting during hospitalization, health behavior awareness rate before discharge, and postoperative satisfaction scores were compared between the two groups.

Results

The observation group exhibited higher preoperative assessment completeness rate, postoperative first ambulation time compliance rate, health behavior awareness rate before discharge, and postoperative satisfaction scores than the control group (P<0.05). The incidence of nausea and vomiting during hospitalization was lower in the observation group than in the control group (P<0.05).

Conclusion

The specialized disease management program based on the ORTCC model can reduce postoperative adverse reactions, optimize weight loss outcomes, enhance self-management capabilities in patients undergoing bariatric surgery, improve their quality of life, and achieve higher patient satisfaction.

Key words: ORTCC model, Specialized disease management, Weight loss patients, Perioperative

Xiaoyi Yang, Xueyao Zhang, Jiewen Ji, Yan Shao, Jing Wang. Research on the application of a specialized disease management protocol based on the ORTCC model in the perioperative period of weight loss patients[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2026, 12(02): 103-107.

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References 21

[1]	Pan XF, Wang L, Pan A, et al. Epidemiology and determinants of obesity in China [J]. Lancet Diabetes Endocrinol, 2021, 9(6): 373-392.
[2]	中国医疗保健国际交流促进会营养与代谢管理分会, 中国营养学会临床营养分会, 中华医学会糖尿病学分会, 等. 中国超重/肥胖医学营养治疗指南（2021） [J]. 中国医学前沿杂志（电子版）, 2021, 13(11): 1-55.
[3]	马冠生, 张玉. 中国儿童肥胖防控面临的挑战和机遇 [J]. 中国儿童保健杂志, 2020, 28(2): 117-119.
[4]	王陇德, 陈伟. 营养与疾病预防:医学减重管理手册 [M]. 北京: 人民卫生出版社, 2021.
[5]	胥媚, 张铭烜, 张倩, 等. 减重手术与多种健康相关结局:一项伞状评价 [J]. 中国全科医学, 2021, 24(29): 3742-3750.
[6]	李梦伊, 刘雁军, 王桂琦, 等. 大中华减重与代谢手术数据库2023年度报告 [J]. 中国实用外科杂志, 2024, 44(5): 552-563.
[7]	何丽, 王璐, 朱晓萍等.减重代谢术后患者居家自我管理障碍因素的质性研究 [J]. 中华现代护理杂志, 2022, 28(1): 76-80.
[8]	吴宏彪, 赵辉. 精细化管理持续改善 [M]. 北京: 北京理工大学出版社, 2013.
[9]	余凤娇, 朱凌燕, 李萍, 等. 基于ORTCC模型的糖尿病专科联盟护理管理实践 [J]. 护理学杂志, 2022, 37(3): 45-48.
[10]	陈怿, 晏蓉, 杨赛, 等. 基于ORTCC的成人结直肠癌患者围术期口服营养补充最佳证据总结 [J]. 护理学杂志, 2022, 37(23): 87-91．
[11]	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国肥胖代谢外科研究协作组. 肥胖代谢外科个案管理术前临床路径中国专家共识（2023版） [J]. 中华消化外科杂志, 2023, 22(5): 578-587.
[12]	Bierle DM, Raslau D, Regan DW, et al. Preoperative Evaluation Before Noncardiac Surgery [J]. Mayo Clin Proc, 2020, 95(4): 807-822.
[13]	陈创奇. 加速康复外科理念中的微创手术 [J]. 中华胃肠外科杂志, 2022, 25(07): 632-635.
[14]	中国研究型医院学会糖尿病与肥胖外科专业委员会, 朱江帆.减重与代谢外科加速康复外科原则中国专家共识（2021版） [J]. 中华消化外科杂志, 2021, 20(8): 841-845.
[15]	Bataille A, Letourneulx JF, Charmeau A, et al. Impact of a prophylactic combination of dexamethasone-ondansetron on postoperative nausea and vomiting in obese adult patients undergoing laparoscopic sleeve gastrectomy during closed-loop propofol-remifentanil anaesthesia: A randomised double-blind placebo-controlled study [J]. Eur J Anaesthesiol, 2016, 33(12): 898-905.
[16]	Halliday TA, Sundqvist J, Hultin M, et al. Post-operative nausea and vomiting in bariatric surgery patients: an observational study [J]. Acta Anaesthesiol Scand, 2017, 61(5): 471-479.
[17]	Sinha AC, Singh PM, Williams NW, et al. Aprepitant's prophylactic efficacy in decreasing postoperative nausea and vomiting in morbidly obese patients undergoing bariatric surgery [J]. Obes Surg, 2014. 24(2): p. 225-31.
[18]	Therneau IW, Martin EE, Sprung J, et al. The Role of Aprepitant in Prevention of Postoperative Nausea and Vomiting After Bariatric Surgery [J]. Obes Surg, 2018, 28(1): 37-43.
[19]	Albeladi B, Bourbao-Tournois C, Huten N, et al. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity [J]. J Obes, 2013, 2013: 934653.
[20]	Sarabu N. Weight and Metabolic Outcomes 12 Years after Gastric Bypass [J]. N Engl J Med, 2018, 378(1): 93-4.
[21]	LeBlanc ES, Patnode CD, Webber EM, et al. Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force [J]. JAMA, 2018, 320(11): 1172-1191.

项目	例数	性别（例）		年龄（岁, ±s）	受教育程度（例）
项目	例数	男	女	年龄（岁, ±s）	初中及以下	高中或中专	大专及以上
对照组	80	38	42	33.4±7.24	9	35	36
观察组	80	39	41	32.6±6.91	8	37	35
t/χ²值	-	0.025^1）		0.506^2）	0.128
P值	-	>0.05		>0.05	>0.05

项目	例数	性别（例）		年龄（岁, ±s）	受教育程度（例）
项目	例数	男	女	年龄（岁, ±s）	初中及以下	高中或中专	大专及以上
对照组	80	38	42	33.4±7.24	9	35	36
观察组	80	39	41	32.6±6.91	8	37	35
t/χ²值	-	0.025^1）		0.506^2）	0.128
P值	-	>0.05		>0.05	>0.05

组别	例数	术前评估完整率	术后首次下床时间达标率	出院前健康行为知晓率	在院期间恶心呕吐发生率
观察组	80	78（97.5）	68（85.0）	76（95.0）	42（52.5）
对照组	80	70（87.5）	54（67.5）	64（80.0）	61（76.3）
χ²值	-	5.766	6.764	8.229	9.838
P值	-	<0.05	<0.01	<0.01	<0.01

组别	例数	术前评估完整率	术后首次下床时间达标率	出院前健康行为知晓率	在院期间恶心呕吐发生率
观察组	80	78（97.5）	68（85.0）	76（95.0）	42（52.5）
对照组	80	70（87.5）	54（67.5）	64（80.0）	61（76.3）
χ²值	-	5.766	6.764	8.229	9.838
P值	-	<0.05	<0.01	<0.01	<0.01

项目	例数	满意度评分（分, ±s）	满意度情况[例（%）]
项目	例数	满意度评分（分, ±s）	非常满意	基本满意	不满意	满意度
观察组	80	89.2±9.22	47（58.75）	33（41.25）	0（0）	80（100.00）
对照组	80	82.3±10.50	31（38.75）	49（61.25）	0（0）	80（100.00）
t值	-	8.622	-
P值	-	<0.01	-

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