基于eCASH理念的营养支持在先天性心脏病术后小儿机械通气中的应用效果  

Application effect of early enteral nutrition support based on the eCASH concept in children with congenital heart disease managed by postoperative mechanical ventilation

作　　者：黄云 韩霞[1] 付会敏[1] 胡琼 Huang Yun;Han Xia;Fu Huimin;Hu Qiong(ICU,Wuhan Asia Heart Hospital,Wuhan 430022,China;Department of Nursing,Wuhan Asia General Hospital,Wuhan 430056,China)

机构地区：[1]武汉亚洲心脏病医院ICU,武汉430022 [2]武汉亚心总医院护理部,武汉430056

出　　处：《中华小儿外科杂志》2025年第2期138-144,共7页Chinese Journal of Pediatric Surgery

基　　金：武汉市卫生健康科研基金资助(WX21B34);武汉市卫生健康科研基金资助(WX21D13)。

摘　　要：目的探讨基于eCASH理念(优先镇痛、最小化镇静、最大化人文关怀)的早期肠内营养支持在先天性心脏病(congenital heart disease,CHD)术后小儿机械通气中的应用效果。方法收集2020年10月至2022年10月武汉亚洲心脏病医院ICU收治CHD外科术后气管插管行机械通气100例患儿的临床资料,其中男53例,女47例,年龄为(3.55±1.60)岁,体重为(17.4±1.6)kg。根据入院时间按照数字随机法分为对照组和干预组各50例。对照组采用外科术后常规镇静镇痛护理措施,干预组实施eCASH理念的早期肠内营养支持治疗与护理。比较两组患儿机械通气时间、停镇静药清醒时间、转机械通气治疗率、ICU留观时间等临床指标。结果干预组与对照组在机械通气时间[(8.54±1.58)h比(16.34±2.25)h,P<0.001]、停镇静药清醒时间[(1.33±0.86)h比(2.39±1.09)h,P<0.001]、转机械通气治疗率(4%比24%,P=0.004)、ICU留观时间[(59.71±7.49)h比(94.51±9.04)h,P<0.001]的差异具有统计学意义。结论eCASH理念下的早期肠内营养支持治疗与护理有利于患儿早期胃肠功能恢复,可以有效改善患儿的临床结局,提升患儿生活质量。ObjectiveTo explore the application effect of early enteral nutrition support based on the eCASH(Early Comfort using Analgesia,minimal Sedatives and maximal Humane care)concept in children with Congenital heart disease(CHD)managed by postoperative mechanical ventilation.MethodsClinical data of 100 children with CHD who were mechanically ventilated after surgery in Intensive Care Unit(ICU)from October 2020 to October 2022 were retrospectively collected.There were 53 boys and 47 girls,with a mean age of 3.55±1.6 years,and body weight of 17.4±1.6 kg.They were randomly divided into a control group and an intervention group according to their admission time,with 50 cases per group.Patients in the control group received routine postoperative sedation and analgesia nursing measures,while those in the intervention group received early enteral nutrition support treatment and nursing based on the eCASH concept.Clinical indicators,such as mechanical ventilation time,sedative cessation time,conversion rate to mechanical ventilation treatment,and ICU observation time were compared between the two groups.ResultsCompared to the control group,patients in the intervention group had significantly shorter mechanical ventilation time(8.54±1.58 h vs 16.34±2.25 h,P<0.001),shorter sedative cessation time(1.33±0.86 h vs 2.39±1.09 h,P<0.001),lower rate of transferring to mechanical ventilation(4%vs 24%,P=0.004),and shorter ICU observation time(59.71±7.49 h vs 94.51±9.04 h,P<0.001).ConclusionsEarly enteral nutrition support treatment and nursing under the concept of eCASH is conducive to the early recovery of gastrointestinal function in children,which is capable of effectively improving the clinical outcome and the quality of life of children.

关 键 词：营养支持 先天性心脏病 eCASH理念 机械通气 临床护理 

分 类 号：R47[医药卫生—护理学]