加速康复外科技术在小儿腹腔镜食道裂孔疝修补Nissen术围手术期护理中的应用  

Application of ERAS technique for pediatric laparoscopic hiatal hernia repair and Nissen fundoplication in perioperative nursing

作　　者：姚海霞[1] 周海霞[1] 王洁[1] 李水学 Yao Haixia;Zhou Haixia;Wang Jie(Department of Pediatric Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院小儿外科,乌鲁木齐830001 [2]不详

出　　处：《中华胃食管反流病电子杂志》2020年第2期124-127,共4页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

摘　　要：目的探讨加速康复外科(ERAS)在腹腔镜食管裂孔疝Nissen术围手术期护理中应用价值。方法选择2012年1月至2019年11月,新疆维吾尔自治区人民医院施行食管裂孔疝腹腔镜下Nissen手术护理的患儿42例,分别为ERAS护理组(14例)和传统护理组(28例)。比较2组患儿胃肠功能时间、住院时间及术后疼痛发生情况等多因素。结果ERAS组术后肠鸣音恢复时间(9.1±1.8)h,明显短于传统组(12.4±2.1)h(t=-3.89,P=0.000);术后首次肛门排气时间(15.4±2.7)h,明显短于传统组(20.7±4.1)h(t=-3.96,P=0.000),胃管拔除时间(16.5±2.7)h,传统组(20.6±3.4)h,(t=-4.925,P=0.000)。术后进食时间(17.5±2.0)h,传统组(36.7±2.5)h,(t=-7.672,P=0.000);术后住院时间(7.8±1.5)d。传统组(8.7±2.1)d,无统计学差异(t=-1.356,P=0.225);术后疼痛发生情况(χ^2=15.468,P=0.004)ERAS组较传统护理组疼痛明显减轻。结论ERAS理念在腹腔镜食管裂孔疝Nissen术中应用进行围手术期护理效果良好。Objective To explore the value of ERAS(enhanced recover after surgery)in perioperative nursing of pediatric laparoscopic hiatal hernia repair and Nissen fundoplication.Methods From January 2012 to November 2019,42 cases of esophageal hiatal hernia were treated under laparoscopic hiatal hernia repair and Nissen fundoplication.All patients were divided into two groups for comparison and analysis,14 cases in ERAS nursing group and 28 cases in traditional nursing group.Analysis indicators include gastrointestinal function recovery time,hospital stay,postoperative pain,etc.Results The recovery time of bowel sounds in the ERAS group was(9.1±1.8)h,which was significantly shorter than that in the traditional group(12.4±2.1)h,(t=-3.89,P=0.000).The time of the first postoperative anal exhaust was(15.4±2.7)h,significantly shorter than the traditional group(20.7±4.1)h,(t=-3.96,P=0.000).gastric tube removal time in the ERAS group was(16.5±2.7)h,traditional group was(20.6±3.4)h,(t=-4.925,P=0.000).Postoperative feeding time in the ERAS group was(17.5±2.0)h,traditional group was(36.7±2.5)h,(t=-7.672,P=0.000);postoperative hospital stay in the ERAS group was(7.8±1.5)d,Traditional group was(8.7±2.1)d,The above indicators have no statistical difference between the two groups(t=-1.356,P=0.225).postoperative pain in the ERAS group was significantly reduced compared with the traditional care group.Conclusion The ERAS concept is effective in the perioperative nursing of pediatric laparoscopic hiatal hernia repair and Nissen fundoplication.

关 键 词：加速康复外科 疝 食道裂孔 围手术期护理 Nissen术 

分 类 号：R473.72[医药卫生—护理学]