加速康复外科护理模式应用于早产儿肠造瘘围术期的探讨

Investigation on the application of enhanced recovery after surgery nursing model in perioperative period of enterostomy in premature infants

目的探讨加速康复外科(ERAS)护理模式应用于新生儿肠造瘘围术期的效果。方法选取我科2015年5月至2020年2月行肠造瘘手术的早产儿,采用传统围术期管理的为对照组(n=26),采用ERAS护理模式的为观察组(n=24)。比较两组早产儿原发疾病、造瘘部位以及手术时间,观察两组拔除气管导管时间、开始进食时间、达到全肠道喂养时间、住院时间、住院费用、并发症等指标。结果两组患儿造瘘部位、原发疾病以及手术时间比较,差异均无统计学意义(P>0.05)。观察组拔除气管导管时间、开始进食时间、吗啡使用时间、达到全肠道喂养时间、住院时间以及住院费用明显低于对照组(P<0.05)。在并发症方面,对照组出现5例造口周围刺激性皮炎,观察组有2例,在VAP方面,对照组出现1例,观察组未出现,两组比较差异无统计学意义(P>0.05)。结论加速康复外科护理模式应用于早产儿肠造瘘围术期,可以减少住院时间,降低住院费用,具有明显优越性,且安全可行。

Objective To investigate the application of enhanced recovery after surgery(ERAS)nursing model in perioperative period of enterostomy in premature infants.Methods The premature infants treated with enterostomy and admitted to our department from May 2015 to February 2020 were selected and divided into the control group(n=26)and the observation group(n=24).The control group was treated with conventional perioperative management,while the observation group was treated with ERAS nursing model.The two groups of premature infants were compared in terms of primary disease,fistula site and operation duration.Meanwhile,the indexes such as the time of extubating of endotracheal tube,the time of starting eating,the time of achieving whole intestinal eating,the time of hospitalization,the hospitalization expenses and complications,etc.were observed.Results There was no statistically significant difference in fistula site,primary disease and operation duration between the two groups(P>0.05).The observation group were significantly lower than the control group in terms of time of extubating of endotracheal tube,time of starting eating,time of using morphine,time of achieving whole intestinal eating,the time of hospitalization and hospitalization expenses(P<0.05).In terms of complications,there were 5 cases of peristomal dermatitis in the control group,2 cases in the observation group.Meanwhile,in terms of VAP,there was 1 case in the control group,but none in the observation group,without statistically significant differences between the two groups(P>0.05).Conclusion The application of ERAS nursing model in perioperative period of enterostomy in premature infants can reduce hospitalization duration and hospitalization expenses,which has obvious advantages and is safe and applicable.