摘要目的:构建甲状腺癌患者术后增生性瘢痕的预防管理方案，以期为临床护理实践提供科学、可行及实用的参考依据。方法:检索国内外数据库获取相关文献并结合对17例甲状腺癌手术患者的质性访谈结果，初步拟定甲状腺癌患者术后增生性瘢痕的预防管理方案初稿，于2025年6月采用德尔菲法进行2轮专家函询，确定最终的方案内容。统计函询专家的判断系数( Ca，基于实践经验、理论分析等依据赋值)和内容熟悉程度系数( Cs，按熟悉程度等级赋分)，并通过公式 Cr＝( Ca＋ Cs)/2计算专家权威系数( Cr，>0.7为可接受值)。函询专家对方案各条目从重要性与可行性维度采用利克特(Likert)5级评分法评分，采用肯德尔和谐系数(Kendall’s W值，取值0~1，数值越大协调程度越高)评价专家意见的协调程度。 结果:共13名专家完成2轮函询。2轮函询中，有效问卷回收率均为100%。2轮函询的 Ca、 Cs、 Cr值均一致，分别为0.92、0.84及0.88。第2轮函询各条目的重要性评分均数为4.38~5.00分，可行性评分均数为4.23~5.00分，两者的Kendall’s W值分别为0.40和0.47。最终形成甲状腺癌患者术后增生性瘢痕预防管理方案，包括9个一级条目、24个二级条目、66个三级条目。 结论:构建的甲状腺癌患者术后增生性瘢痕预防管理方案具有科学性、可行性并可满足个体化需求，对优化临床护理实践具有指导意义。

abstractsObjective:To construct a prevention and management plan for postoperative hypertrophic scars in patients with thyroid cancer, in order to provide a scientific, feasible and practical reference for clinical nursing practice.Methods:Relevant literatures was retrieved from domestic and international databases. Combined with qualitative interview result from 17 patients who underwent thyroid cancer surgery, a preliminary draft of a prevention and management protocol for postoperative hypertrophic scars in thyroid cancer patients was developed. In June 2025, two rounds of Delphi expert consultation were conducted to finalize the protocol. The experts’ judgment coefficient ( Ca), assigned based on factors such as practical experience and theoretical analysis, and their familiarity coefficient ( Cs), scored according to levels of familiarity with the content, were calculated. The authority coefficient ( Cr) of the experts was then determined using the formula Cr = ( Ca + Cs) / 2, with a value of Cr > 0.7 considered acceptable. Experts rated each item of the proposed scheme from the perspectives of importance and feasibility using a five-point Likert scale. The degree of agreement among experts was assessed using Kendall’s coefficient of concordance (Kendall’s W), which ranges from 0 to 1, with higher values indicating greater consensus. Results:A total of 13 experts completed the two-round consultation. The effective questionnaire recovery rate was 100% in both rounds. The Ca, Cs, and Cr values were consistent in both rounds, being 0.92, 0.84, and 0.88, respectively. The average importance scores of each indicator in the second round ranged from 4.38 to 5.00, and the average feasibility scores ranged from 4.23 to 5.00. The Kendall’s W values were 0.40 and 0.47, respectively. A prevention and management plan for postoperative hypertrophic scars in patients with thyroid cancer was ultimately formed, including 9 first-level indicators, 24 second-level indicators, and 66 third-level indicators. Conclusion:The postoperative management plan for preventing and treating hypertrophic scars in the patients with thyroid cancer that has been developed is scientific and feasible and it meets individualized needs, which has guiding significance for optimizing clinical nursing practice.