围术期护理在先天性小耳畸形全耳再造术中的应用

Application of Perioperative Nursing in Total Ear Reconstruction of Congenital Microtia Malformation

目的:探究围手术期护理对先天性小耳畸形全耳再造术患儿配合度、情绪及并发症的影响。方法:将80例接受全耳再造术治疗的患儿随机分为实验组(40例)和对照组(40例)。实验组实行围手术期护理,对照组进行常规护理。比较两组患儿不良事件、术后并发症、手术期心理及家长手术期心理状态。结果:护理后,实验组不良事件及术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。术前及出院前,两组患儿改良耶鲁围手术期焦虑量表(mYPAS)评分无统计学差异(P>0.05);术后1d及术后7d实验组患儿mYPAS评分均低于对照组,差异有统计学意义(P<0.05)。护理后,实验组家长症状自评量表(SCL-90)各指标得分(躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其它及总分)均低于对照组,差异有统计学意义(P<0.05)。结论:围手术期护理可有效缓解患儿及家长的负性情绪,提高患儿配合度,降低术后并发症,改善预后,值得临床推广应用。

Objective To explore the effect on coordination, emotion and complications in children with reconstruction of congenital microtia by using perioperative nursing. Methods Eighty children with total ear reconstruction were randomly divided into the experimental group(n=40) and the control group(n=40). The experimental group received perioperative nursing and the control group received routine nursing. The adverse events, postoperative complications, psychology of children during operation and psychological status of parents during operation were compared between the two groups. Results After nursing, the total incidence of adverse events and postoperative complications in the experimental group were lower than that in the control group(P<0.05). Before discharge and preoperative, there was no significant difference in the score of modified Yale perioperative anxiety scale(mYPAS) between the two groups(P>0.05). The score of mYPAS in the experimental group was lower than that in the control group on the 1 st day and 7 th day after operation, with significant difference(P<0.05). After nursing, the scores of SCL-90(somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety,hostility, phobia, paranoid ideation, psychosis, other and total score) in the experimental group were lower than those in the control group(P<0.05). Conclusion Perioperative nursing can effectively relieve the negative emotion of the children and their parents, improve the cooperation degree of the children, reduce the occurrence of postoperative complications, and then improve the prognosis of the children, which is worthy for clinical promotion.