加速康复外科联合个案管理模式在多指患儿围手术期麻醉管理中的应用  

Application of accelerated rehabilitation surgery combined with case management model in perioperative anesthesia management of children with polydactyly

作　　者：王静洁 秦得学 印飞[1] 刘祯庆 王猛[1] 刘洋 Wang Jingjie;Qin Dexue;Yin Fei;Liu Zhenqing;Wang Meng;Liu Yang(Department of Rehabilitation,Wuxi No.9 Hospital Affiliated to Suzhou University,Wuxi 214062,China;Haidong City Minhe County People′s Hospital,Haidong 814000,China;Department of Orthopedics,the Second Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]苏州大学附属无锡九院康复科,无锡214062 [2]海东市民和县人民医院,海东814000 [3]南通大学第二附属医院骨科,南通226001

出　　处：《中华手外科杂志》2023年第4期341-344,共4页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金(82002394);海东市东西部协作重大项目(2021-HDKJ-Z2)。

摘　　要：目的探讨加速康复外科理念联合个案管理模式在多指患儿围手术期麻醉管理中的应用效果。方法采用随机抽样法选取我院自2018年1月至2020年12月收治的140例多指患儿,按照入院顺序奇偶数分为对照组和研究组各70例。对照组行常规围手术期麻醉管理,研究组基于加速康复外科理念联合个案管理模式进行围手术期麻醉管理。对比两组患儿术后各时间段疼痛程度、术后不良反应(发热、咳嗽、咳痰、腹泻、呕吐等)发生情况及术后住院时间、住院期间总费用。结果研究组术后2、6、12 h的疼痛评分及术后不良反应发生情况均明显优于对照组,差异有统计学意义(P<0.05)。研究组相对于对照组术后平均住院时间短、住院总费用低,差异均有统计学意义(P<0.05)。结论加速康复外科理念联合个案管理模式应用于多指患儿围手术期麻醉管理能有效减轻患儿术后机体应激、降低不良反应发生率,在促进机体康复的同时减少了术后住院时间及住院费用。Objective To explore the application effect of accelerated rehabilitation surgery concept combined with case management model in perioperative anesthesia management of children with polydactyly.Methods From January 2018 to December 2020,140 children with polydactyly admitted to our hospital were selected by random sampling method,and were divided into the control group and the study group with 70 cases each according to the odd and even number of admission order.The control group received routine perioperative anesthesia management,while the study group conducted perioperative anesthesia management based on the concept of accelerated rehabilitation surgery combined with case management model.The pain degree,adverse reactions(fever,cough,expectoration,diarrhea,vomiting,etc.),postoperative hospitalization,and total expenses of hospitalization were compared between the two groups at different time points after surgery.Results The pain scores at 2,6 and 12 hours after operation and the occurrence of adverse reactions in the study group were significantly better than those in the control group(P<0.05).Compared with the control group,the study group had shorter average hospitalization and lower total expenses of hospitalization,with significant differences(P<0.05).Conclusion The concept of accelerated rehabilitation surgery combined with case management model in the perioperative anesthesia management of children with polydactyly can effectively reduce the postoperative body stress of children,the incidence of adverse reactions,and the postoperative hospitalization and total expenses of hospitalization while promoting the body recovery.

关 键 词：围手术期 麻醉 加速康复外科 个案管理 

分 类 号：R726.1[医药卫生—儿科]