吞咽功能评估联合生理指标判断婴幼儿先天性心脏病合并气管狭窄术后留置胃管拔管时机

Deglutition function assessment combined with physiological indicators for evaluating the time of retention of gastric tube after tracheal stenosis in infants with congenital heart disease

目的探讨婴幼儿先天性心脏病(CHD)合并气管狭窄术后留置胃管拔管的最佳时机,以早期、及时拔除导管,缩短留置管路时间,减轻患儿带管的痛苦。方法将50例CHD合并气管狭窄患儿按入院先后顺序分为对照组24例和观察组26例,对照组给予常规吞咽功能评估判断胃管的拔除时机,观察组实施吞咽功能评估联合生理指标结果判断留置胃管拔除时机。结果观察组ICU滞留时间和住院总天数分别为(4.35±0.94)、(23.15±4.92)d,对照组为(6.27±1.42)、(27.42±6.43)d,2组患儿ICU滞留时间和住院总天数比较,差异有统计学意义(Z=5.589、2.621,P<0.05)。观察组拔管时间为(2.85±0.23)d、中位数为3 d,对照组拔管时间为(4.50±0.27)d,中位数为4 d,2组拔管时间比较,差异有统计学意义(χ^2=15.595,P<0.01)。结论吞咽功能评估联合生理指标判断婴幼儿CHD合并气管狭窄术后留置胃管的拔管时机能更有效地降低其术后并发症的发生和胃管再次留置率,缩短病程,减轻患儿家属负担,提高患儿的舒适度,促进术后恢复。

Objective To explore the best time for indwelling gastric tube after tracheal stenosis in infants with congenital heart disease, so as to shorten the indwelling time and relieve the pain of children with tracheal tube. Methods A total of 50 infants with congenital heart disease combined with tracheal stenosis were divided into observation group (26 cases) and control group (24 cases) by the admission order. The observation group accepted swallowing function evaluation combined with physiological indicators to determine the timing of removal of indwelling gastric tube while the control group just conventionally evaluating swallowing function. Results The ICU retention time and total hospitalization days was (4.35±0.94), (23.15±4.92) d in the observation group, and (6.27±1.42), (27.42±6.43) d in the control group, and the difference between the two groups was statistically significant (Z=5.589, 2.621, P<0.05). The extubation time was (2.85±0.23), (4.50±0.27) days in the observation group and the control group, and the difference was statistically significant (χ^2= 15.595, P<0.01). Conclusions Deglutition function assessment combined with physiological indicators for evaluating the time of retention of gastric tube after tracheal stenosis in infants with congenital heart disease could be more effective to reduce the occurrence of secondary intubation and postoperative complications,shorten the course of the disease, improve infants comfort level,promote postoperative recovery.