基于临床护理路径的精细化护理在小儿腹股沟疝围术期中的应用

Application of intensive nursing based on clinical nursing pathway in perioperative of pediatric inguinal hernia

目的探究基于临床护理路径的精细化护理在小儿腹股沟疝围手术期的应用效果。方法选取2020年2月至2021年11月在南京医科大学附属淮安第一医院行腹腔镜经腹腹膜前疝修补术的84例腹股沟疝患儿,按照随机数字表法随机分为2组,每组患儿42例。对照组患儿给予常规护理,试验组患儿给予精细化护理。观察2组患儿的手术时间、下床活动时间、住院时间、应激指标[促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)]、术后疼痛情况、护理满意度及并发症发生率。结果2组患儿在手术时间比较,差异无统计学意义(P>0.05);下床活动时间及术后住院时间比较,差异有统计学意义(P<0.05)。术前及苏醒后,试验组患儿ACTH、NE水平均低于对照组(P<0.05);2组患儿术后疼痛程度比较,试验组患儿总体疼痛程度低于对照组(P<0.05);试验组患儿术后并发症发生率明显低于对照组(P<0.05);试验组患儿护理满意度高于对照组(P<0.05)。结论腹股沟疝患儿在围手术期实施精细化护理,可减轻患儿应激反应,改善患儿的不良情绪,降低患儿的总体疼痛程度,降低患儿并发症发生率。

Objective To explore the application effect of fine nursing based on the clinical nursing path in the perioperative period of pediatric inguinal hernia.Methods The 84 children with inguinal hernia undergoing transperitoneal hernia repair in our hospital from February 2020 to November 2021 were selected and divided into control and observation groups with 42 per group.The children in the control group received routine care,and the children in the observation group received refined care to observe the operation time,implantation activity time and hospitalization time of the two groups;the stress index at admission,before surgery and after awakening[adreno-cortico-tropic-hormone(ACTH),norepinephrine(NE)];postoperative pain;nursing satisfaction;incidence of complications.Results The difference between the two children was not in the operation time(P>0.05),and the activity time and hospital time(P<0.05);Before and after surgery,the levels of ACTH and noradrenaline(NE)were lower than those in the control group(P<0.05);The degree of postoperative pain was compared between the two groups,and the overall pain degree of the observation group was lower than that of the control group(P<0.05);The incidence of postoperative complications was significantly lower in those observed than in the control group(P<0.05);Nursing satisfaction in the children was higher in the observation group than in the control group(P<0.05).Conclusion The implementation of fine care for children with inguinal hernia in the perioperative period can reduce the stress response,improve the bad mood,reduce the overall pain degree,and reduce the incidence of complications.