不同时期导尿对先天性小耳畸形耳廓再造患儿的影响

Effects of catheterization at different stages on children with congenital microtia undergoing auricle reconstruction

目的探讨不同时期导尿对先天性小耳畸形耳廓再造患儿的影响。方法本研究为随机对照试验。选取2022年1月至12月期间广东省第二人民医院整形美容激光中心的64例先天性小耳畸形耳廓再造术(皮肤扩张法耳廓再造术1期)患者,纳入研究患者年龄(9.3±2.8)岁,男性44例,女性20例。按随机数字表法将其分为对照组和研究组,每组32例。对照组于常规术前在病房行导尿术,研究组于全麻后在手术室行导尿术。分析比较两种护理模式的应用效果,比较不同时期导尿患者的血压、心率变化以及导尿管成功率、疼痛不适感、焦虑恐惧感、尿道损伤发生例数、麻醉复苏时躁动情况。采用χ^(2)检验、t检验。结果对照组导尿前、后收缩压[(16.10±1.96)kPa比(18.14±1.83)kPa]、舒张压[(10.10±1.70)kPa比(10.97±1.64)kPa]、心率[(98.09±1.58)次/min比(120.41±3.90)次/min]比较差异均有统计学意义(t=4.303、2.083、30.006,均P<0.05)。研究组导尿前、后收缩压[(16.39±1.80)kPa比(16.66±2.06)kPa]、舒张压[(10.10±1.70)kPa比(10.50±1.57)kPa]、心率[(98.14±1.61)次/min比(98.93±6.43)次/min]比较差异均无统计学意义(t=0.558、0.978、0.674,均P>0.05)。研究组一次性置入导尿管成功、疼痛不适感、焦虑恐惧、麻醉复苏时躁动患者分别为30、0、8、1例,对照组分别为24、26、30、28例,两组比较差异均有统计学意义(均P<0.05)。结论对先天性小耳畸形耳廓再造患儿采取全麻后行导尿术的全程护理方式,能减轻患儿的心理负担和并发症,提高导尿舒适度,值得在护理临床中推广及应用。

Objective To explore the effect of catheterization at different stages on children with congenital microtia undergoing auricle reconstruction.Methods This was a randomized controlled trial.From January to December 2022,64 patients with congenital microtia undergoing auricular reconstruction(phase 1 auricular reconstruction by skin expansion method)in Plastic and Cosmetic Laser Center of Guangdong Second People's Hospital were selected and were divided into a control group and a study group according to the random number table method,with 32 cases in each group.The included patients were(9.3±2.8)years old,with 44 boys and 20 girls.The control group underwent routine catheterization in the ward before surgery,and the study group underwent catheterization in the operating room after general anesthesia.The application effects of the two nursing models were analyzed and compared,and the changes of blood pressure and heart rate,success rate of catheterization,pain and discomfort,anxiety and fear,number of cases of urethral injury,and agitation during anesthesia resuscitation were compared between the patients with catheterization at different stages.χ^(2) test and t test were used.Results There were statistically significant differences in the systolic blood pressure[(16.10±1.96)kPa vs.(18.14±1.83)kPa],diastolic blood pressure[(10.10±1.70)kPa vs.(10.97±1.64)kPa],and heart rate[(98.09±1.58)beats/min vs.(120.41±3.90)beats/min]in the control group before and after catheterization(t=4.303,2.083,and 30.006;all P<0.05).There were no statistically significant differences in the systolic blood pressure[(16.39±1.80)kPa vs.(16.66±2.06)kPa],diastolic blood pressure[(10.10±1.70)kPa vs.(10.50±1.57)kPa],or heart rate[(98.14±1.61)beats/min vs.(98.93±6.43)beats/min]in the study group before and after catheterization(t=0.558,0.978,and 0.674;all P>0.05).In the study group,there were 30,0,8,and 1 cases of one-time successful catheterization,pain and discomfort,anxiety and fear,and agitation during anesthesia resuscitation,and there were 24,26,30,and 28 cases in the control group,with statistically significant differences between the two groups(all P<0.05).Conclusion The whole-process nursing method of urethral catheterization after general anesthesia can reduce the psychological burden and complications in children with congenital microtia undergoing auricle reconstruction,and improve the comfort of urethral catheterization,which is worthy of widespread promotion and application in nursing clinic.