围手术期程序化综合干预在小儿肾母细胞瘤中的应用效果

Application of perioperative procedural comprehensive intervention in pediatric Wilms tumor

目的分析围手术期程序化综合干预在小儿肾母细胞瘤中的应用效果。方法选取81例肾母细胞瘤患儿为研究对象,按照入院时间的先后顺序将患儿分为对照组(n=42)和研究组(n=39),两组患儿均接受开腹肾脏切除术,对照组患儿围手术期予以传统护理干预,研究组患儿在对照组的基础上予以程序化综合干预。比较两组患儿的肛门排气时间、恢复进食时间、住院天数、应激指标、视觉模拟评分(VAS)、不良反应发生情况及满意度。结果研究组患儿的肛门排气时间、恢复进食时间及住院天数均明显短于对照组(P<0.01)。干预后,两组患儿的皮质醇(Cor)、促肾上腺皮质激素(ACTH)、白细胞介素-6(IL-6)水平及VAS评分均较本组干预前升高(P<0.05);干预后,研究组患儿的Cor、ACTH、IL-6水平及VAS评分均明显低于对照组(P<0.01)。两组患儿均有切口感染、发热不良反应发生,研究组患儿的不良反应发生率低于对照组(P<0.05)。研究组患儿的满意率高于对照组(P<0.05)。结论围手术期程序化综合干预在小儿肾母细胞瘤中的应用效果肯定,能够减轻患儿围手术期的应激反应,减轻疼痛,降低不良反应发生率,促进患儿恢复。

Objective To evaluate the application effect of using perioperative procedural comprehensive intervention in pediatric Wilms tumor. Method 81 cases of pediatric Wilms tumor were analyzed. According to admission time,those patients were assigned into control group（n=42） or study group（n=39）, and both groups were treated with open abdominal nephrectomy, while the control group was given traditional perioperative nursing care, and the study group was administered with procedural comprehensive intervention based on the nursing care of control group. The anal exhaust time, diet recovery time, hospital stay, stress indicators, visual analogue scores（VAS）, adverse reactions and degree of satisfaction between two group were compared. Result The anal exhaust time, diet recovery time and hospital stay in study group were obviously shorter than those in control group（P〈0.01）. After intervention, the levels of cortisol（Cor）, adrenocorticotropic hormone（ACTH）, interleukin-6（IL-6） and VAS in both groups were higher compared with before intervention（P〈0.05）; and were lower in study group than in control group after intervention（P〈0.01）. Incision infection and fever were observed in both groups of children, though the incidence of adverse reactions in study group was lower than that in control group（P〈0.05）. The satisfaction rate in study group was higher than that in control group（P〈0.05）. Con Conclusion Application of perioperative procedural intervention in pediatric Wilms tumor is with confirmative effect, which can alleviate the stress response of children in perioperative period, reduce pain, lower the incidence of complications,and promote postoperative recovery.