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《广州医药》编辑部
目的 研究基于儿童早期预警评分(PEWS)的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组(n=50)及对照组(n=50)。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程(相关指标涵盖症状持续时长及住院天数)、呼吸功能(涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量)、并发症发生情况(涵盖呼吸机相关性肺炎、肺大疱及胸膜炎)、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组(均P<0.05)。研究组各项呼吸功能指标水平均高于对照组(均P<0.05)。两组各项并发症发生率对比差异无统计学意义(P>0.05)。研究组患儿家属满意度高于对照组(96.00% vs 82.00%,P<0.05)。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。
Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score(PEWS)on the recovery process and respiratory function of children with severe pneumonia.Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed.Those children were divided into study group(n=50)and control group(n=50)according to the difference of intervention methods.Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group.The two groups were compared with each other in terms of recovery process(including duration of symptoms and length of stay),respiratory function(including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity),complications(including ventilators associated pneumonia,bullosa and pleurisy),and family member satisfaction.Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group(all P<0.05).The levels of respiratory function indexes in study group were higher than those in control group(all P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The satisfaction of family member in the study group was higher than that in the control group(96.00% vs 82.00%)(P<0.05).Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia.
目的 分析感恩拓延-建构理论在血友病患儿家庭护理中的应用效果。方法 对2021年1月—2022年1月期间在河南省儿童医院治疗的116例血友病患儿进行随机数表法分组,两组各58例。对照组给予常规临床干预,观察组给予感恩拓延-建构理论干预。比较两组患儿的负性情绪评分、家庭功能评分、自我意识评分、功能独立性评分、感恩问卷评分。结果 干预后观察组的焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)评分、各项家庭功能评分均低于对照组,干预后观察组的各项自我意识评分、各项功能独立性评分、感恩问卷评分均高于对照组,差异统计学有意义(P<0.05)。结论 感恩拓延-建构理论干预能够在一定程度上改善血友病患儿的负性情绪、家庭功能、自我意识、独立性及感恩水平。
Objective To analyze the application effect of gratitude extension-construction theory in family nursing of children with haemophilia.Methods A total of 116 children with haemophilia from January 2021 to January 2022 were randomly divided into two groups,58 children in each group.The control group received routine clinical intervention,while the observation group received gratitude extension-construction theory intervention.The negative emotional scores,family function scores,self-awareness scores,functional independence scores and gratitude questionnaire scores between the two groups were compared.Results After intervention,the SCARED,DSRSC,and family function scores of the observation group were lower than those of the control group.The self-awareness score,functional independence score,and gratitude questionnaire score of the observation group were higher than those of the control group,and the differences were significant(P<0.05).Conclusions Gratitude extension-construction theory intervention can improve the negative emotion,family function,self-consciousness,independence and gratitude level of children with haemophilia to a certain extent.
目的 研究甲泼尼龙琥珀酸钠对重症支原体肺炎(SMPP)患儿的治疗效果及安全性。方法 采用随机数表法将南华大学附属长沙中心医院2021年1月—2022年12月收治的108例SMPP患儿分为两组,对照组(54例)采用常规治疗,研究组(54例)采用常规治疗联合甲泼尼龙琥珀酸钠治疗,比较2组临床疗效。结果 治疗后研究组炎症因子水平低于对照组,肺功能指标、健康状况评分均高于对照组,发热、咳嗽、肺啰音及肺阴影消失时间均短于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 应用甲泼尼龙琥珀酸钠治疗可加快患儿症状缓解,改善机体炎症反应及肺功能,且安全性较高。
Objective To study the therapeutic effect and safety of methylprednisolone sodium succinate on children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods A total of 108 children with SMPP admitted to Changsha Central Hospital from January 2021 to December 2022 were divided into two groups by random number table method.The control group(54 cases)was treated with conventional therapy,and the study group(54 cases)was treated with conventional therapy combined with methylprednisolone sodium succinate.The clinical effects of the two groups were compared.Results After treatment,the levels of inflammatory factors in the study group were lower than those in the control group,and lung function indicators and health status scores were higher than those in the control group.The disappearance time of fever,cough,lung rales and lung shadows was shorter than that in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The application of methylprednisolone sodium succinate treatment can accelerate the relief of symptoms in children,improve the body's inflammatory response and lung function,and has high safety.
目的 探讨软组织重建治疗儿童蟹钳指畸形的临床效果。方法 2019年1月—2022年12月对25例蟹钳指畸形或蟹钳指畸形术后出现“Z”形畸形患儿进行软组织重建治疗,观察术后1年Tada评分、并发症发生情况。结果 术后1年,25例患儿的Tada评分优16例(64%),良8例(32%),差1例(4%)。术后1年Peds QL评分(92.74±9.52)高于术前(79.25±7.43),比较差异有统计学意义(P<0.001)。指间关节伸直障碍、骨折愈合延迟各发生1例,并发症总发生率8%。结论 软组织重建治疗儿童蟹钳指畸形,患儿无需经历一期切除重复拇指,二期行截骨矫形手术或者切除多指的多次手术,只需一次手术就完成蟹钳指截骨矫形,具有治疗周期短、患儿痛苦少、家庭经济成本低,且能显著提升患儿生存质量,临床效果满意等优点。
Objective To investigate the clinical effect of soft tissue reconstruction in the treatment of crab-claw finger deformity in children.Methods From January 2019 to December 2022,soft tissue reconstruction was performed in 25 patients with crab-claw finger deformity or “Z-shaped” deformity after surgery,and Tada score and complications were observed one year after surgery.Results One year after surgery,16 of 25 children had excellent Tada scores(64%),8 of 25 had good scores(32%),and 1 had poor score(4%).The Peds QL score 1 year after operation(92.74±9.52)was significantly higher than that before operation(79.25±7.43),and the difference was statistically significant(P<0.001).Dysextension of interphalangeal joint and delayed fracture healing occurred in 1 case,the total complication rate was 8%.Conclusions In the treatment of crab-claw finger deformity and soft tissue reconstruction,children do not need to undergo one-stage resection of the repetitive thumb,second-stage osteotomy and orthopedic surgery or multiple operations to remove extra fingers,and just only one operation is needed to complete the osteotomy and orthopedic surgery of crab-claw finger,which has the advantages of short treatment cycle,less pain for children and low economic cost for families.It significantly improves the quality of life of children and has satisfactory clinical effects.
目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/(min·kg)]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/(min·kg)]及并发症比较差异均无统计学意义(P>0.05)。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。
目的 探讨计划-实施-检查-处理(PDCA)循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)]、肺功能指标[第1秒用力呼气容积(FEV1)、潮气量(VT)]、炎症免疫指标[单核细胞趋化蛋白-1(MCP-1)、可溶性髓系细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义(P<0.05)。干预前,两组患儿PaO2、SaO2、PaCO2、FEV1、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义(P>0.05);干预后,两组患儿上述指标水平均有不同程度变化(P<0.05),观察组PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg)、SaO2(93.58±3.82% vs 86.30±4.21%)、FEV1(2.66±0.46 L vs 1.97±0.34 L)、VT(11.92±1.89% vs 9.83±1.10%)水平均高于对照组,观察组PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg)、MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L)、sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)、sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)水平低于对照组,差异均有统计学意义(P<0.05)。观察组患儿家属满意度整体优于对照组(P<0.05);观察组总满意率(97.5% vs 77.5%)高于对照组,差异有统计学意义(P<0.05)。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。
Objective To explore the application effect of Plan-Do-Check-Action(PDCA)circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation.Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study.Based on the random number table method,they were divided into two groups,with 40 cases in each group.The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention.The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure(PaO2),arterial oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2)],lung function indicators [(forced expiratory volume in 1 second,FEV1),tidal volume(VT)],and inflammatory immune indicators [monocyte chemotactic protein-1(MCP-1),soluble myeloid cell trigger receptor-1(sTREM-1),soluble intercellular adhesion molecule-1(sICAM-1)] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared.Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before intervention,there was no statistically significant difference in the levels of PaO2,SaO2,PaCO2,FEV1,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children(P>0.05).After intervention,the levels of the above indicators in both groups of children showed varying degrees of change(P<0.05).The levels of PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg),SaO2(93.58±3.82% vs 86.30±4.21%),FEV1(2.66±0.46 L vs 1.97±0.34 L),VT(11.92±1.89% vs 9.83±1.10%)in the observation group were higher than those in the control group.The levels of PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg),MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L),sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)and sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)in the observation group were lower than those of the control group,with statistically significant differences(P<0.05).The overall satisfaction of the observation group was better than that of the control group(P<0.05),the total family members’ satisfaction rate of the observation group was higher than that of the control group(97.5% vs 77.5%),with a statistically significant difference(P<0.05).Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction.
目的 分析早期活动康复对机械通气患儿肌力的影响,探讨影响肌力的相关因素。方法 采取回顾性研究,选择2021年4月—2023年4月医院收治的104例机械通气患儿临床资料,根据康复方法分为两组,其中采取常规康复训练的52例患儿为对照组,采取早期活动康复的52例患儿为观察组。两组均连续干预至出院,比较两组患儿的机械通气、住ICU、总住院时间、不同时点(转出ICU时、出院时、出院1个月)的肌力及Barthel日常生活能力(Barthel)评分;参照《中国重症肌无力诊断和治疗指南(2015年简版)》中诊断标准,评估机械通气患儿获得性肌无力(AW)发生情况。统计并比较两组基线资料,采用二元Logistic回归分析机械通气患儿AW发生的影响因素。结果 观察组的机械通气、住ICU及总住院时间[(7.28±2.47)d、(15.27±3.64)d、(27.08±5.68)d]均短于对照组[(10.64±3.39)d、(17.74±3.55)d、(32.57±6.14)d](P<0.05);与转出ICU时、出院时相比,两组出院1个月时英国医学研究委员会(MRC)肌力评定法评分升高,且观察组转出ICU时、出院时MRC评分[(53.57±5.13)分、(56.84±2.16)分]均高于对照组[(50.13±4.57)分、(53.67±2.42)分],两组组间·时点交互比较差异有统计学意义(P<0.05);与转出ICU时、出院时相比,两组出院1个月时Barthel评分升高,且观察组转出ICU时、出院时Barthel评分[(65.03±12.47)分、(90.58±7.59)分]均高于对照组[(55.25±11.12)分、(84.13±9.62)分],两组组间·时点交互比较差异有统计学意义(P<0.05);住院期间104例机械通气患儿发生AW 31例,发生率29.81%,AW组机械通气时间、营养风险筛查量表2002(NRS)评分[(11.84±4.19)d、(3.07±1.04)分]高于非AW组[(8.18±2.26)d、(1.61±0.75)分],且有创机械通气模式、使用罗库溴铵患儿[77.42%(24/31)、32.26%(10/31)]占比均高于非AW组[53.42%(39/73)、13.70%(10/73)](P<0.05);二元Logistic回归分析结果显示,机械通气时间长、有创机械通气模式、使用罗库溴铵、NRS评分高是机械通气患儿AW发生的危险因素(OR>1,P<0.05)。结论 早期活动康复能够有效缩短机械通气患儿患儿通气时间及住院时间,改善肌力,提高生活自理能力,同时机械通气时间、创机械通气模式、使用罗库溴铵、NRS评分与机械通气患儿肌力下降有关。
Objective To analyze the effect of early mobilization and rehabilitation on muscle strength in children with mechanical ventilation and to explore the risk factors affecting muscle strength.Methods A retrospective study was conducted on 104 children with mechanical ventilation admitted to the hospital from April 2021 to April 2023.According to the rehabilitation methods,they were divided into two groups.The clinical data of children with routine rehabilitation training were included in the control group(52 cases),and the clinical data of children with early mobilization and rehabilitation were included in the observation group(52 cases).Both groups were continuously intervened until discharged.The mechanical ventilation time,ICU stay and total hospital stay were compared between the two groups.Muscle strength and self-care ability at different time points(transfer out of ICU,discharge,1 month after discharge),the incidence of acquired weakness(AW)in children with mechanical ventilation were evaluated according to the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis. Baseline data was collected and compared between the two groups.Binary logistic regression was used to analyze the risk factors of AW in children with mechanical ventilation.Results The mechanical ventilation time,ICU and total hospitalization time in the observation group[(7.28±2.47)d,(15.27±3.64)d,(27.08±5.68)d] were shorter than those in the control group[(10.64±3.39)d,(17.74±3.55)d,(32.57±6.14)d](P<0.05).Compared with those at the time of transfer out of ICU and discharge,the Medical Research Council(MRC)scores of the two groups increased at 1 month after discharge,and the MRC scores of the observation group at the time of transfer out of ICU and discharge[(53.57±5.13),(56.84±2.16)] were higher than those of the control group[(50.13±4.57),(53.67±2.42)].There were significant differences between the two groups,time points and between groups · time points(P<0.05).Compared with those at the time of transferring out of ICU and at discharge,the Barthel scores of the two groups increased at 1 month after discharge,and the Barthel scores of the observation group at the time of transferring out of ICU and at discharge[(65.03±12.47),(90.58±7.59)] were higher than those of the control group[(55.25±11.12),(84.13±9.62)].There were significant differences in Barthel scores between the two groups,time points and groups · time points(P<0.05).AW occurred in 31 of 104 children with mechanical ventilation during hospitalization,with an incidence of 29.81%.The mechanical ventilation time and Nutritional Risk Screening(NRS)score in the AW group[(11.84±4.19)d,(3.07±1.04)] were higher than those in the non-AW group[(8.18±2.26)d,(1.61±0.75)].The proportion of children with invasive mechanical ventilation mode and the use of rocuronium[77.42%(24/31),32.26%(10/31)] were higher than those in the non-AW group[53.42%(39/73),13.70%(10/73)](P<0.05).Binary logistic regression analysis showed that long mechanical ventilation time,invasive mechanical ventilation,use of rocuronium and high NRS score were risk factors for AW in children with mechanical ventilation(OR>1,P<0.05).Conclusions Early mobilization and rehabilitation can effectively shorten the ventilation time and hospitalization time of patients with mechanical ventilation,improve muscle strength and improve the ability of self-reliance.At the same time,mechanical ventilation time,mechanical ventilation mode,use of rocuronium and NRS score are related to the decrease of muscle strength in children with mechanical ventilation.
目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表(MoCA)评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高(P<0.05);住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少(P<0.05);护理后,联合组MoCA评分高于对照组(P<0.05)。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。
Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children.Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected.They were divided into two groups according to the nursing method,with 58 cases in each group.The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention.The satisfaction,the compliance rate and MoCA score were compared between two groups.Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group(P<0.05).Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group(P<0.05).After nursing,the MoCA score of the combined group was higher than that of the control group(P<0.05).Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction.
目的 探讨俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果。方法 选取泉州市儿童医院2020年9月—2023年9月收治的72例脓毒症合并急性肺损伤患儿,应用抽签法将其分为观察组与对照组,均为36例。对照组患儿实施常规仰卧位机械通气与对应护理,观察组患儿在常规护理基础上增加俯卧位通气与对应护理。对比两组患儿机械通气时间,干预前和干预3 d后气道平台压和心率水平,动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2),并计算动脉血氧分压与吸入气中的氧浓度分数比值(PaO2/FiO2),评价两组患儿预后及不良事件发生情况。结果 观察组机械通气时间明显低于对照组(P<0.05),干预后两组患儿气道平台压、心率均降低,且观察组低于对照组(P<0.05);干预后两组患儿PaO2/FiO2、PaO2水平升高,观察组高于对照组,PaCO2降低,观察组低于对照组(P<0.05);干预后两组患儿全身性感染相关性器官功能衰竭评分(SOFA)、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分均降低,观察组低于对照组(P<0.05);两组患儿呼吸机管路折管、管路滑脱、压力性损伤等不良事件发生率对比差异无统计学意义(P>0.05)。结论 俯卧位通气在脓毒症合并急性肺损伤患儿的应用效果显著,可降低患儿气道平台压及心率,缩短机械通气时间,改善患儿通气功能,有助提升预后水平。
Objective To explore the application effect of prone position ventilation in children with sepsis complicated with acute lung injury.Methods From September 2020 to September 2023,72 children with sepsis and acute lung injury admitted to Quanzhou Children's Hospital were selected and divided into observation group and control group by drawing lots,both with 36 cases.The children in the control group received routine supine mechanical ventilation and corresponding nursing,and the children in the observation group added prone ventilation and corresponding nursing on the basis of routine nursing.By comparing the duration of mechanical ventilation,airway plateau pressure and heart rate level,PaCO2,PaO2,PaO2/FiO2,the prognosis and occurrence of adverse events in the two groups were evaluated.Results The mechanical ventilation time in the observation group was significantly shorter than that in the control group(P<0.05).After intervention,the airway plateau pressure and heart rate levels of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).After the intervention,the levels of PaO2/FiO2 and PaO2 in the two groups of children increased,with the observation group higher than the control group,while the level of PaCO2 was lower,with the observation group lower than the control group(P<0.05).After the intervention,the SOFA and APACHE II scores of the two groups of children decreased,and the observation group was lower than the control group(P<0.05).There was no difference in the incidence of adverse events such as ventilator tube folding,tube slip and pressure injury between the two groups(P>0.05).Conclusions The application of prone position ventilation in children with sepsis combined with acute lung injury has a significant effect,which can reduce airway plateau pressure,lower heart rate,shorten mechanical ventilation time,improve ventilation function,and assist in improving prognosis.
目的 探讨快速康复理念联合腹腔镜手术治疗对小儿腹股沟疝疗效观察。方法 选取焦作市妇幼保健院2021年1月—2023年1月收治的86例腹股沟疝患儿进行分析与研究,应用随机数字表法将其分为观察组与对照组,各组均为43例。所有患儿均采取腹腔镜手术治疗,对照组采取常规护理,观察组采取快速康复理念护理。对比两组围术期恢复情况,术后4、12、24、48 h疼痛程度,并发症及护理满意度情况。结果 观察组首次下床时间、首次肛门排气时间、进食时间、住院时间短于对照组(P<0.05);两组患儿术后4、12、24、48 h视觉模拟量表(VAS)评分逐渐降低,观察组低于对照组(P<0.05);两组恶心呕吐、尿潴留、腹胀腹痛、感染并发症发生率对比差异无统计学意义(P>0.05);观察组患儿及家长健康教育、住院环境、专科护理、检查指导、病情观察相关护理满意度评分高于对照组(P<0.05)。结论 快速康复理念联合腹腔镜手术治疗小儿腹股沟疝效果显著,可进一步促进患儿早日康复,缩短住院时间,术后疼痛水平低,同时可提升患儿及家长护理满意度。
Objective To explore the therapeutic effect of rapid rehabilitation concept combined with laparoscopic surgery on pediatric inguinal hernia.Methods A total of 86 children with inguinal hernia admitted to Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected for analysis and study,and divided into observation group and control group by random number table method,with 43 cases in each group.All patients were treated with laparoscopic surgery,while the control group received routine care,while the observation group received rapid recovery concept care.The perioperative recovery,pain level,complications,and nursing satisfaction at 4,12,24,and 48 hours after surgery were compared.Results The first discharge time,first anal exhaust time,feeding time,and hospitalization time were shorter than the control group(P<0.05).The VAS scores decreased after 4 h,12 h,24 h and 48 h,and the observation group was lower than the control group(P<0.05).The incidences of nausea and vomiting,urinary retention,abdominal distension,abdominal pain and infectious complications between the two groups were significantly insignificant(P>0.05).The health education,inpatient environment,specialized care,nursing examination guidance and condition observation were significantly higher than that of the observation group(P<0.05).Conclusions The combination of rapid recovery concept and laparoscopic surgery for the treatment of inguinal hernia in children has a significant effect,which can further promote early recovery,shorten hospital stay,lower postoperative pain levels.At the same time,it can improve the nursing satisfaction of children and parents.