快速康复外科理念在小儿先天性巨结肠围术期护理中的应用

Application of fast-track surgery concept in perioperative nursing of laparoscopic operations for the treatment of hirschsprung disease

目的:探究快速康复外科理念在腹腔镜治疗小儿先天性巨结肠围手术期护理中的应用效果。方法:收集医院新生儿外科2014年7月-2016年8月行传统围术期护理的38例巨结肠患儿为对照组,2016年9月-2018年10月行FTS围手术期护理的39例巨结肠患儿为观察组,对比两组患儿术后导管留置时间、进食时间、住院时间、并发症发生情况,以及术后4、12、24、48 h疼痛行为评分和家属满意度。结果:观察组患儿术后尿管、胃管留置时间、术后进食时间、术后住院时间、住院总时间及住院费用均低于对照组,差异均有统计学意义(P<0.05)。观察组患儿疼痛行为评分均低于对照组,差异具有统计学意义(P<0.001)。观察组患儿术后并发症发生率略低于对照组,患儿家属总体满意度略高于对照组,但差异均无统计学意义(P>0.05)。结论:FTS理念应用于腹腔镜小儿先天性巨结肠围手术期护理可加速机体恢复,降低疼痛刺激,缩短住院时间,增加家属满意度,具有较好的临床应用效果。

Objective:To explore the application of Fast-Track Surgery concept in perioperative nursing of laparoscopic operations for the treatment of Hirschsprung disease.Methods:A collection of 38 children with Hirschsprung's disease who underwent traditional laparoscopic perioperative nursing in the neonatal surgery of Anhui Children's Hospital from July 2014 to August 2016 as the control group(n=38),and 39 children with Hirschsprung's disease who underwent FTS concept perioperative nursing from September 2016 to October 2018 were the observation group(n=39).To analyze and compare the postoperative catheter retention time,feeding time,hospital stay,complications,pain behavior scores at 4,12,24 and 48 hours after surgery and parental satisfaction between the two groups.Results:The retention time of urinary tube and gastric tube,postoperative feeding time,postoperative hospital stay,total hospital stay and hospitalization cost in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).Pain behavior scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001).The rate of postoperative complications in the observation group was lower than those in the control group,and the overall satisfaction of family members was higher than that in the control group,but the differences were not statistically significant(P>0.05).Conclusion:The concept of FTS was effective in the perioperative nursing of laparoscopic congenital Hirschsprung disease,which can effectively improve the perioperative rencovery of patients,reduce postoperative pain stimulation,shorten the length of hospital stay,and increase family satisfaction.It has a good clinical application effect.