加速康复外科在体外循环下小儿先天性心脏病围手术期护理中的应用

Application of Accelerated Rehabilitation Surgery in Perioperative Nursing of Children with Congenital Heart Disease Under Extracorporeal Circulation

目的探讨加速康复外科(ERAS)对体循环下小儿先天性心脏病围手术期的影响。方法纳入86例体循环下行先天性心脏病手术治疗的患儿为研究对象,手术时间在2020年1月至2022年1月。通过随机数字表法将患儿分为两组,其中围手术期实施常规护理的43例患儿收入对照组,其余围手术期实施ERAS的43例患儿收入研究组,比较两组护理效果。结果研究组患儿气管插管时长、术后引流时长、术后进食时间、下床活动时间、监护室留观时长、住院时长均短于对照组,差异有统计学意义(P<0.05)。两组患儿术后6 h疼痛评分比较差异无统计学意义(P>0.05);研究组术后12 h和术后24 h疼痛评分低于对照组,差异有统计学意义(P<0.05)。研究组患儿家长术前和术后焦虑水平评分均低于对照组,差异有统计学意义(P<0.05)。研究组患儿术后并发症发生率(4.65%)低于对照组(20.93%),差异有统计学意义(P<0.05)。结论ERAS可以有效缩短体循环下先天性心脏病患儿插管和引流时长,减轻患儿术后疼痛的同时缓解患儿家长的焦虑情绪,减少术后并发症的发生,促进患儿术后早期康复,临床应用效果显著。

Objective To investigate the enhanced recovery after surgery(ERAS)in the perioperative period of congenital heart disease in children with subsystemic circulation.Methods A total of 86 children with congenital heart disease under systemic circulation who underwent surgery from January 2020 to January 2022 were included in the study.The children were divided into two groups by random number table method,among which 43 children receiving perioperative routine nursing were included in the control group,and the other 43 children receiving perioperative ERAS were included in the research group.The nursing effects of the two groups were compared.Results The duration of tracheal intubation,postoperative drainage time,postoperative feeding time,bed activity time,and the time of observation and hospitalization in the ICU of the study group were shorter than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in pain score 6 h after surgery between the two groups(P>0.05).The pain score of the study group at 12 h and 24 h after surgery was lower than that of the control group,and the difference was statistically significant(P<0.05).The anxiety scores of parents in the study group were lower than those in the control group before and after surgery,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the study group(4.65%)was lower than that in the control group(20.93%),and the difference was statistically significant(P<0.05).Conclusion ERAS can effectively shorten the duration of intubation and drainage in children with congenital heart disease under systemic circulation,reduce postoperative pain,relieve the anxiety of parents,reduce postoperative complications,and promote early postoperative recovery of children,with significant clinical effects.