低体重先心病患儿围术期集束化护理效果分析

Analysis of the Effect of Perioperative Cluster Nursing in Children with Low Birth Weight Congenital Heart Disease

目的:探讨低体重先心病患儿围术期采用集束化护理效果。方法:选取2019年4月—2020年5月郑州大学附属儿童医院收治的64例低体重先心病患儿作为研究对象,按不同护理方法分成对照组和研究组,每组各32例。对照组予以常规护理,研究组予以集束化护理。比较两组患儿护理后营养指标、相关时间点及并发症发生情况。结果:(1)两组患儿手术后4 d、手术后7 d在总白蛋白、白蛋白、前白蛋白含量上较手术前均下降,差异有统计学意义(t=14.456、16.724、13.236、18.452、18.936、15.824,P<0.05)。但研究组手术后4 d、手术后7 d总白蛋白含量为(51.78±3.52)g/L、(53.45±4.31)g/L,白蛋白含量为(31.46±3.69)g/L、(33.82±4.13)g/L,前白蛋白含量为(84.26±13.26)g/L、(90.67±14.14)g/L,明显低于对照组的(55.33±3.98)g/L、(57.47±4.63)g/L、(35.63±4.13)g/L、(36.87±4.51)g/L、(93.67±13.46)g/L、(102.34±14.68)g/L,差异有统计学意义(t=7.846、8.931、9.022、8.143、7.645、8.373,P<0.05)。(2)研究组经鼻喂养持续时间为(47.82±7.89)h、呼吸机置管时间为(42.56±5.78)h、术后住院时间为(10.67±1.97)d、FLACC评分为(3.35±0.94)分,显著低于对照组的(52.56±10.41)h、(47.89±9.46)h、(13.34±2.46)d、(5.97±1.12)分,差异有统计学意义(t=5.786、7.857、8.571、9.057,P<0.05)。(3)研究组喂养不耐受、呼吸机相关性肺炎、消化道出血发生率分别为9.38%、6.25%、6.25%,显著低于对照组的28.12%、15.63%、18.75%,差异有统计学意义(χ^(2)=8.344、6.785、7.035,P<0.05)。结论:集束化护理应用于低体重先心病患儿中,能提高患儿围术期术后营养,降低其并发症发生率,缩短住院时间,值得临床推广。

Objective:To explore the effect of cluster nursing on low weight children with congenital heart disease during perioperative period.Methods:A total of 64 children with low birth weight congenital heart disease admitted to the hospital from April 2019 to May 2020 were selected as the research objects,and divided into control group and research group according to dif⁃ferent nursing methods,with 32 cases in each group.The control group received routine nursing,while the research group received cluster nursing.The nutritional indicators,relevant time points and complications after nursing were compared between the two groups.Results:(1)The contents of total albumin,albumin and prealbumin in the two groups at 4 d and 7 d after surgery were all decreased compared with those before surgery,and the differences were statistically significant(t=14.456,16.724,13.236,18.452,18.936,15.824,P<0.05).The total albumin content of the study group was(51.78±3.52)g/L,(53.45±4.31)g/L,and the albumin content was(31.46±3.69)g/L,(33.82±4.31)g/L,the prealbumin content was(84.26±13.26)g/L,(90.67±14.14)g/L 4 d and 7 d af⁃ter surgery,significantly lower than(55.33±3.98)g/L,(57.47±4.63)g/L,(35.63±4.13)g/L,(36.87±4.51)g/L,(93.67±13.46)g/L,(102.34±14.68)g/L of the control group,the difference was statistically significant(t=7.846,8.931,9.022,8.143,7.645,8.373,P<0.05).(2)The duration of nasal feeding in the study group was(47.82±7.89)h,the ventilator intubation time was(42.56±5.78)h,the postoperative hospital stay was(10.67±1.97)d,and the FLACC score was(3.35±0.94)points,which were significantly lower than(52.56±10.41)h,(47.89±9.46)h,(13.34±2.46)d,(5.97±1.12)points of the control group,and the differences were statistically significant(t=5.786,7.857,8.571,9.057,P<0.05).(3)The incidence rates of feeding intolerance,respiratory-related pneumonia,and gastrointestinal bleeding in the study group were 9.38%,6.25%,and 6.25%,which were significantly lower than 28.12%,15.63%,and 18.75%in the control group,with statistically significant differences(χ^(2)=8.344,6.785,7.035,P<0.05).Conclusion:Cluster nursing applied to children with low birth weight congenital heart disease can improve perioperative and postoperative nutri⁃tion,reduce the incidence of complications,and shorten the length of hospital stay,which is worthy of clinical promotion.