全身麻醉斜视矫正术病儿早期饮食护理干预的观察
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摘要
目的观察早期饮食护理干预在全身麻醉(全麻)下斜视矫正术病儿中的应用效果。方法将104例2015年1月至2017年6月本溪市中心医院接受全麻下斜视矫正手术病儿采用随机数字表法分为观察组与对照组,每组52例。对照组术后采取常规护理,观察组术后采取早期饮食护理干预。比较两组术后首次进饮食时间及不良反应情况评分。结果术后24 h内,观察组的饥饿、口渴、腹胀、发热及烦躁哭闹发生率依次为40.38%、28.85%、3.85%、5.77%、19.23%,显著低于对照组的96.15%、86.54%、23.08%、19.23%、40.38%(P<0.05);观察组的恶心呕吐、呛咳发生率为13.46%、5.77%,与对照组的7.69%、1.92%比较差异无统计学意义(P>0.05);观察组术后首次饮水、进食时间为(1.45±0.32)h、(1.88±0.42)h,较对照组的(4.45±0.42)h、(6.47±0.53)h明显缩短(P<0.05)。结论早期饮食护理干预有利于缩短全麻下斜视矫正术病儿术后禁饮禁食时间,降低术后不良反应发生率,减轻病儿术后不适感,改善病儿的机体营养状态。
Objective To investigate the application effect of early drinking and eating nursing intervention for children with strabismus surgery under general anesthesia. Methods A total of 104 children undergoing strabismus surgery under general anesthesia in Benxi Central Hospital from January 2015 to June 2017 were divided into observation group and control group according to random number table method, with 52 cases in each group.The children in the control group were given routine nursing, while the children in the observation group were given early drinking and eating nursing intervention.The first time into the drinking and eating after surgery, postoperative adverse reactions between the two goups were compared,Results Within post-operative 24 hours,the incidence of starvation, thirst, bloating, fever and irritability crying in the observation group was 40.38%, 28.85%, 3.85%,5.77%, 19.23% respectively, which was significantly lower than 96.15%, 86.54%, 23.08%, 19.23%, 40.38% in the control group(P<0.05);the incidence of nausea, vomiting and cough was 13.46%,5.77% in the observation group,showing no significant difference with 7.69%, 1.92% in the control group(P > 0.05).The first time into the drinking and eating after surgery in observation group was(1.45±0.32) h and(1.88±0.42) h,significantly shorter than(4.45±0.42) h,(6.47±0.53) h in the control group(P< 0.05).Conclusion Early drinking and eating nursing intervention can shorten the time of postoperative forbidden to drinking and eating for children with strabismus surgery under general anesthesia,reduce the incidence of postoperative adverse reactions and reduce the postoperative discomfort,improve children's body nutrition status.
Objective To investigate the application effect of early drinking and eating nursing intervention for children with strabismus surgery under general anesthesia. Methods A total of 104 children undergoing strabismus surgery under general anesthesia in Benxi Central Hospital from January 2015 to June 2017 were divided into observation group and control group according to random number table method, with 52 cases in each group.The children in the control group were given routine nursing, while the children in the observation group were given early drinking and eating nursing intervention.The first time into the drinking and eating after surgery, postoperative adverse reactions between the two goups were compared,Results Within post-operative 24 hours,the incidence of starvation, thirst, bloating, fever and irritability crying in the observation group was 40.38%, 28.85%, 3.85%,5.77%, 19.23% respectively, which was significantly lower than 96.15%, 86.54%, 23.08%, 19.23%, 40.38% in the control group(P<0.05);the incidence of nausea, vomiting and cough was 13.46%,5.77% in the observation group,showing no significant difference with 7.69%, 1.92% in the control group(P > 0.05).The first time into the drinking and eating after surgery in observation group was(1.45±0.32) h and(1.88±0.42) h,significantly shorter than(4.45±0.42) h,(6.47±0.53) h in the control group(P< 0.05).Conclusion Early drinking and eating nursing intervention can shorten the time of postoperative forbidden to drinking and eating for children with strabismus surgery under general anesthesia,reduce the incidence of postoperative adverse reactions and reduce the postoperative discomfort,improve children's body nutrition status.
引文
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[19]章庆华,姚祥根.非肠道手术患儿全麻术后进食时间的探讨[J].实用临床医药杂志,2013,17(22):168-169.
[20]KAMATH AA,LIMBRICK DL,SMYTH MD.Characterization of postoperative fevers after hemispherotomy[J].Childs Nerv Syst,2015,31(2):291-296.
[2]从金菊,宁宏.屈光性调节性内斜视屈光参差对弱视及远期立体视觉的影响[J].安徽医药,2017,21(5):834-837.
[3]王媛,刘春民,宋桂婷,等.不同麻醉方式下斜视手术中眼心反射相关因素的研究[J].中外医疗,2015,34(28):19-21,47.
[4]王文军,曾璐.三种麻醉方法在小儿眼科手术中的效果比较[J].临床医学研究与实践,2017,2(12):107-108.
[5]林薇,蓝敏凤,冯伟平.口腔颌面手术患者全麻清醒后缩短禁食时间对术后恢复的意义[J].中国实用护理杂志,2016,32(25):1966-1969.
[6]郑刚,赵晶.欧美国家麻醉后恢复病房患者评估及转出指南的解读[J].中华麻醉学杂志,2015,35(3):269-273.
[7]SUITER DM,LEDER SB,KARAS DE.The 3-ounce(90-cc)water swallow challenge:a screening test for children with suspected oropharyngeal dysphagia[J].Otolaryngol Head Neck Surg,2009,140(2):187-190.
[8]冷芸坤,付凌敏,易华容.护理流程对人工耳蜗植入术后患儿早期进食的影响[J].中国实用护理杂志,2015,31(35):2682-2684.
[9]张尧明,陈应军,韩少霞.眼科全麻术后患者首次进食时间探讨[J].海南医学,2017,27(8):1367-1368.
[10]LAI YH,HSU HT,WANG HZ,et al.The oculocardiac reflex during strabismus surgery:its relationship to preoperative clinical eye findings and subsequent postoperative emesis[J].J AAPOS,2014,18(2):151-155.
[11]包小红,叶宏武,陈莉,等.右美托咪定对小儿扁桃体合并腺样体手术全麻苏醒期躁动的影响[J].安徽医药,2014,18(5):944-946.
[12]廖理芳,蒋美丽,张梅,等.加速康复外科术前两种口服葡萄糖溶液方法的比较[J].安徽医药,2014,18(7):1397-1398.
[13]谭璇,江霞,刘义兰,等.人文关怀现代护理模式在儿童斜视矫正术后疼痛护理中的应用[J].护理研究,2016,30(32):4068-4070.
[14]王方,曹红军,蒋凌雁,等.缩短择期手术患儿术前禁食禁饮时间对术前并发症影响的meta分析[J].川北医学院学报,2015,30(4):568-573.
[15]罗敏,曾丽文,程茂华,等.腹部非胃肠道手术后患者肠道功能恢复判定方式的改进[J].护理学杂志,2015,30(4):9-11.
[16]章宏美,张庆宁.小儿全麻斜视矫正术100例护理体会[J/CD].全科口腔医学电子杂志,2016,3(10):108,110.DOI:10.3969/j.issn.2095-7882.2016.10.061.
[17]秦尚够,李素芳,刘丹,等.快速康复理论在小儿全身麻醉术后早期进饮食中的应用[J].中华现代护理杂志,2012,18(23):2755-2758.
[18]谈慧静,黄晓云.循证护理在小儿斜视全身麻醉手术后早期进食中的应用[J].江苏医药,2016,42(6):739-740.
[19]章庆华,姚祥根.非肠道手术患儿全麻术后进食时间的探讨[J].实用临床医药杂志,2013,17(22):168-169.
[20]KAMATH AA,LIMBRICK DL,SMYTH MD.Characterization of postoperative fevers after hemispherotomy[J].Childs Nerv Syst,2015,31(2):291-296.