加速新生儿肠道手术后康复膏摩法方案的构建与应用效果评价  

Construction and application effect evaluation of ointment massage for postoperative rehabilitation of newborn after intestinal surgery

作　　者：阮景[1] 麦嘉轩[2] 陈凌华 覃李姣[1] 陈灵 陈嘉颖 钟雪梅 代坤 Ruan Jing;Mai Jiaxuan;Chen Linghua;Qin Lijiao;Chen Ling;Chen Jiaying;Zhong Xuemei;Dai Kunt(Department of Nursing,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Neonatal Surgery,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Neonatology,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院护理部,广州511400 [2]广东省妇幼保健院新生儿外科,广州511400 [3]广东省妇幼保健院新生儿科,广州1511400

出　　处：《中国实用护理杂志》2024年第14期1058-1065,共8页Chinese Journal of Practical Nursing

基　　金：广东省中医药局科研项目(20222022)。

摘　　要：目的构建新生儿肠道术后膏摩方案,探讨膏摩法对新生儿肠道术后恢复的效果,丰富加速康复外科(ERAS)在新生儿领域的内容。方法应用德尔菲专家函询法构建加速新生儿肠道术后康复的膏摩法方案;选取2022年5月至2023年5月在广东省妇幼保健院新生儿外科接受肠道手术患儿64例作为研究对象进行随机对照研究,按照随机数字表法分为常规组34例和膏摩组30例。常规组患儿接受术后常规治疗与护理措施,包括胃肠减压、循序渐进喂养、发展性照顾等;膏摩组患儿除了接受常规治疗与护理,还接受膏摩法辅助治疗。比较2组患儿术后胃肠引流量、禁食天数、术后首次喂养时间、住院时间情况,并比较2组术后呕吐、腹胀发生情况。结果共函询16名专家,年龄(38.93±5.13)岁,男6名,女10名。2轮专家函询有效问卷回收率分别为16/16和15/16,专家权威系数均≥0.80,Kendall协调系数分别为0.117和0.107,差异均具有统计学意义(均P<0.05)。确定了包含8个穴位及7种中药组成的膏摩方案。常规组男19例,女15例,胎龄(268.47±11.27)d。膏摩组男20例,女10例,胎龄(271.93±10.36)d。膏摩组患儿的术后胃肠引流量、禁食天数、术后首次喂养时间及住院时间的中位数分别为74.0ml、6.0d、158.5h、13.0d,与常规组的184.5ml、7.5d、192.0h、16.5d比较,差异均有统计学意义(Z值为2.07~2.45,均P<0.05)。膏摩组患儿呕吐、腹胀发生例数均为8例,常规组患儿则分别为19例和18例,差异均有统计学意义(Х^(2)=5.58、4.56,均P<0.05)。结论本研究构建的中药膏穴位按摩方案具有较高的可靠性,对新生儿肠道术后的恢复产生积极影响,安全性高,符合快速康复外科理念,值得推广。Objective To explore the effect of ointment massage on the postoperative recovery of newborns who had intestinal tract operation,aim to construct an effective post-operative ointment and massage scheme and to enrich the content of enhanced recovery after surgery in the field of newborns.Methods Delphi expert inquiry method was used to construct the ointment message scheme.A total of 64 newborns undergone intestinal surgery from May 2022 to May 2023 in Guangdong Women and Children Hospital were selected as study subjects and divided into routine group(34 cases)and ointment group(30 cases)by random number table method.In addition to routine treatment and nursing,the newborns in the ointment group also received ointment massage.The postoperative gastrointestinal drainage volume,fasting days,the first feeding time,hospital stay and the number of cases of vomiting and abdominal distension between the two groups were compared.Results A total of 16 experts with(38.93+5.13)years old were inquired,6 males and 10 females.The ffective questionnaire response rates for the two rounds of expert inquiry were 16/16 and 15/16,the expert authority coefficients were both≥0.80,the Kendall's W coefficients were 0.117 and 0.107,with statistically significant differences(both P<0.05).A ointment message scheme consisting of 8 acupoints and 7 kinds of traditional Chinese medicines was determined.In the routine group,there were 19 males and 15 females with(268.47±11.27)gestational age.In the ointment group,there were 20 males and 10 femles with(271.93±10.36)gestational age.The postoperative gastrointestinal drainage volume,fasting days,the first feeding time and the hospital stay in the ointment group were 74.0 ml,6.0 d,158.5 h and 13.0 d,which had significant differences with the 184.5 ml,7.5 d,192.0 h,16.5 d in the routine group(Z values were 2.07-2.45,all P<0.05).The incidence of vomiting and abdominal distension in the ointment group were both 8 cases,which were lower than the 19 and 18 cases in the routine group with a statistica

关 键 词：胃肠道 新生儿 手术后期间 外治疗法 术后加速康复 

分 类 号：R473.72[医药卫生—护理学]