肾积水患儿术前禁食禁饮多学科链式管理的实践

Practice of preoperative fasting chain management for children with hydronephrosis

目的探讨多学科协作模式下肾积水患儿术前禁食禁饮链式管理临床可行性、安全性和有效性。方法将146例肾积水患儿按时间段分组,2018年4~12月78例患儿作为对照组,2019年1~9月68例患儿作为观察组。对照组采用传统的术前禁食禁饮管理方式,观察组采用多学科协作模式下术前禁食禁饮链式管理方式,评估记录两组禁食禁饮情况及口渴、饥饿、哭闹、血糖等情况。结果观察组术前口渴、饥饿(除≥3岁患儿)和哭闹情况以及术后口渴和饥饿情况(除≥3岁患儿)显著优于对照组(P<0.05,P<0.01)。结论对肾积水患儿术前在多学科协作模式行禁食禁饮链式管理可有效缩短患儿术前禁食禁饮时间,改善患儿术前术后口渴、饥饿不适感,减少哭闹的发生,同时不增加术中呕吐误吸风险。

Objective To explore clinical feasibility,safety and effectiveness of fasting chain management in children with hydronephrosis under multidisciplinary cooperation mode.Methods A total of 146 children with hydronephrosis were divided by the admission periods:78 children admitted to hospital from April 2018 to December 2018 were assigned into the control group,who were subjected to traditional fasting management preoperatively;68 children admitted to the hospital from January 2019 to September 2019 were assigned into the intervention group,who were subjected to fasting chain management under multidisciplinary cooperation mode.The fasting status,thirst,hunger,crying,and blood glucose level of the two groups were evaluated and compared.Results The incidence rates of thirst,hunger(except in children 3 years and older)and crying before operation,and incidence rates of thirst and hunger(except in children 3 years and older)after operation in the intervention group were lower than in the control group(P<0.05,P<0.01).Conclusion Preoperative fasting chain management under multi-disciplinary cooperation mode can effectively shorten the time of fasting before operation,mitigate preoperative and post-operative thirst and hunger,reduce crying of children,and do not increase the risk of vomiting and aspiration during operation.