基于快速康复理念的儿童鼾症日间手术术后饮水评估流程改进的探索

Exploration on the Improvement of Water Drinking Assessment Process Based on Rapid Rehabilitation Theory among Children with Snoring after Ambulatory Surgery

目的探讨基于快速康复理念的儿童鼾症日间手术术后饮水评估流程的改进方案。方法便利抽样选取2021年4月至2022年4月在某院行儿童鼾症择期手术治疗的300例儿童为研究对象,按入院先后顺序分为对照组150例、试验组150例。对照组采用传统术后4 h饮水方案;试验组采用Aldrete评分判断麻醉苏醒情况,联合标准吞咽功能评定量表指导患儿早期饮水。结果试验组术后首次饮水时间为返回病房后0.54 h,对照组为返回病房后4.23 h;试验组术后6 h口渴、饥饿、哭闹、误吸、疼痛、日间病房转为常规住院模式的发生率均显著低于对照组(均P<0.05);两组饮水后恶心、呕吐发生率比较,差异无统计学意义(均P>0.05)。结论Aldrete评分联合标准吞咽功能评定量表在儿童鼾症日间手术快速康复中的应用具有安全性、可行性,缩短了术后禁食水时间,降低了患儿术后6 h不适以及日间病房模式转为常规住院模式的发生率。

Objective To explore the improvement of water drinking assessment process based on rapid rehabilitation theory among children with snoring after ambulatory surgery.Methods Convenient sampling was used to select 300 children with snoring who received scheduled surgery in the department from April,2021 to April,2022.The participants were divided into the control group(150 cases)and experimental group(150 cases)according to the sequence of admission.The control group received traditional 4-hour water drinking plan after surgery.The experimental group were assessed for anesthesia recovery by the Aldrete scoring,and were directed to drink water early with the guidance of Standardized Swallowing Assessment.Results The first water-drinking time after surgery in the experimental group was 0.54h after returning to the ward,and the time in the control group was 4.23h after returning to the ward.The incidences of thirst,hunger,crying,aspiration,pain,and transfer from day-care unit to routine hospitalization mode during 6 hours after surgery in the experimental group were significantly lower than those in the control group(all P<0.05).There were no significantly statistical differences in the incidences of nausea and vomiting after drinking water between the two groups(both P>0.05).Conclusions The application of Aldrete scoring and Standardized Swallowing Assessment in rapid rehabilitation among children with snoring after ambulatory surgery is safe and feasible,which can shorten the time of abstaining from food and water after surgery,and decrease the incidence of discomforts,as well as the transfer from day-care unit to routine hospitalization mode during 6 hours after surgery.