目标管理在先天性巨结肠症患儿围手术期加速康复中的实践

Application of management by objective approach to an enhanced recovery after surgery program for children with Hirschsprung′s disease

目的探讨目标管理在先天性巨结肠症患儿围手术期加速康复中的应用效果。方法将76例先天性巨结肠症择期手术患儿按家属意愿分为对照组29例和观察组47例。对照组行常规治疗护理;观察组实施以目标管理为导向的加速康复护理。结果观察组术后疼痛评分、肛门首次排气时间、术后进食时间、住院时间、住院费用、满意度6项指标显著优于对照组(均P<0.01)。结论对先天性巨结肠症手术患儿实施以目标管理为导向的加速康复护理可促进患儿康复,减少医疗费用,提高患儿家属满意度。

Objective To explore the effects of implementing management by objective(MBO) approach on enhanced recovery after surgery(ERAS) program for children with Hirschsprung′s disease. Methods Seventy-six children with Hirschsprung′s disease undergoing elective surgery were divided into two groups according to their parents′ willingness to accept or resist the ERAS program. The control group of 29 children were given routine treatment and nursing care, while the observation group of 47 children received MBO directed ERAS. Results Compared with the control group, the observation group had milder postoperative pain, earlier first passage of flatus and oral dietary intake, shorter hospital stay length, less hospital cost and higher patient satisfaction(P〈0.01 for all). Conclusion Application of MBO approach in ERAS program for children with Hirschsprung′s disease can promote recovery of children, reduce hospital cost and enhance satisfaction of parents.