标记奖励法结合精细化围术期干预对先天性胆总管囊肿患儿的影响

Effect of Token-reward Method Combined with Meticulous Perioperative Intervention on Children with Congenital Choledochal Cyst

目的:探讨标记奖励法结合精细化围术期干预对先天性胆总管囊肿患儿术后营养状态及胃肠功能恢复的影响。方法:选取2021年1月1日~2023年1月1日103例先天性胆总管囊肿患儿作为研究对象,采用随机数字表法分为观察组52例和对照组51例,对照组实施精细化围术期干预,观察组实施标记奖励法结合精细化围术期干预,比较两组患儿营养状态、胃肠功能恢复情况、并发症发生率、家属满意度、首次经口进食时间、住院时间、疼痛程度(采用Wong-Baker面部表情疼痛量表)、血气分析指标[包括动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]。结果:干预后,两组营养状态优于干预前(P<0.05),且观察组优于对照组(P<0.05);干预后,观察组胃肠功能恢复情况、首次经口进食时间、住院时间、家属满意度均优于对照组(P<0.05);观察组术后并发症发生率、Wong-Baker评分均低于对照组(P<0.05);干预后,两组PaO_(2)水平高于干预前(P<0.05)、PaCO_(2)水平低于干预前(P<0.05),但两组比较差异无统计学意义(P>0.05)。结论:标记奖励法结合精细化围术期干预,可改善先天性胆总管囊肿患儿营养状态,加快患儿胃肠功能恢复,降低术后并发症发生率,提高家属满意度,缩短住院时间。

Objective:To explore the effect of token-reward method combined with meticulous perioperative intervention on postoperative nutritional status and gastrointestinal function recovery in children with congenital choledochal cyst.Methods:103 children with congenital choledochal cyst,admitted from January 1,2021 to January 1,2023,were selected as the research objects and divided into an observation group(52 cases)and a control group(51 cases)by the random number table method.The control group was given meticulous perioperative intervention,and the observation group was provided token-reward method based on meticulous perioperative intervention.The nutritional status,recovery of gastrointestinal function,incidence of complications,family satisfaction,the time of first oral feeding,length of hospital stay,pain degree using Wong-Baker facial expression pain scale,and blood gas analysis indexes including PaO_(2) and PaCO_(2) were compared between the two groups.Results:After intervention,the nutritional status of the two groups was better than that before intervention(P<0.05),and the nutritional status of the observation group was better than that in the control group(P<0.05),the recovery of gastrointestinal function,the time of first oral feeding,hospitalization time and family satisfaction of the observation group were better than those of the control group after intervention(P<0.05).The incidence of postoperative complications and Wong-Baker score in the observation group were lower than those in the control group(P<0.05).After intervention,PaO_(2) of the two groups was higher than that before intervention(P<0.05),and PaCO_(2) was lower than that before intervention(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Conclusion:The token-reward method combined with meticulous perioperative intervention can improve the nutritional status,accelerate the recovery of gastrointestinal function and reduce the incidence of postoperative complications of children with congenital choledochal cyst,which can improve family satisfaction and reduce the length of hospital stay.