围术期个性化护理在患儿扁桃体腺样体切除术中的应用

Application of perioperative personalized nursing in pediatric tonsil adenoidectomy surgery

目的探讨围术期个性化护理在患儿扁桃体腺样体切除术中的应用效果，寻找最佳的临床护理方法。方法选取北京大学第三医院2015年9月-2016年9月收治的180例扁桃体腺样体切除术患儿作为研究对象，采取随机数字表法分为对照组与观察组，每组各90例，对照组给予围术期常规护理，观察组给予围术期个性化护理，比较两组患儿手术时间、术中出血量、术后住院时间、术后视觉模拟评分（VAS）、术后并发症发生率、术后主要临床症状消失时间。结果观察组术后住院时间为（3．52±1．24）d，VAS评分为（2．89±1．07）分，对照组术后住院时间为（5．63±1．05）d，VAS评分为（4．25±1．13）分，差异有统计学意义Q值分别为5．69、6．25；P〈0．05）。仅对照组出现了2例出血，两组均未发生发热、创面感染、肺部感染及喉痉挛的情况，并发症发生率差异无统计学意义（x2=0．89，P〉0．05）。观察组鼻塞、流涕、鼻翼煽动及睡眠呼吸粗重症状消失时间短于对照组，差异有统计学意义（P〈0．05）。结论围术期个性化护理应用于患儿扁桃体腺样体切除术能够缩短术后住院时间，缓解疼痛感。

Objective To explore the application effects of perioperative personalized nursing in pediatric tonsil adenoidectomy surgery, so as to find the optimum clinical nursing method. Methods A total of 180 eases of pediatric patients who underwent tonsil adenoidectomy surgery in Peking University Third Hospital from September 2015 to September 2016 were selected as the research objects, and divided into control group and observation group by random number table method, with 90 cases in each group. The control group was given routine perioperative nursing care, while the observation group was given perioperative personalized nursing care. Operation time, intraoperative blood loss, postoperative hospitalization time, postoperative visual analogue scale （VAS） score, the incidence of postoperative complications and major postoperative clinical symptoms disappearing time were compared between the two groups. Results In the observation group, the hospitalization time was （3.52 ± 1.24） days, and VAS score was （2.89 ±1.07）, which were both significantly lower than those of the control group （5.63 ± 1.05） days and （4.25 ±1.13） respectively. The differences were statistically significant （t=5.69, 6.25 ; P 〈 0.05）. There were 2 cases of bleeding in the control group, and no fever, wound infection, pulmonary infection and laryngospasm in both groups. There was no statistical difference in the incidence of complications （ x2=0.89, P 〉 0.05）. The disappearing time of nasal congestion, runny nose, nasal voice and sleep breathing symptoms of the observation group was shorter than those of the control group, and the difference was statistically significant （P 〈 0.05）. Conclusions The application of perioperative personalized nursing in pediatric tonsil adenoidectomy surgery can shorten the time of postoperative hospitalization and relieve the pain.