摘要
目的评价骨科患儿全麻术后早期进食进水的安全性和可行性。方法选取北京市某三级甲等医院小儿骨科的638例全麻手术患儿,按病区分为试验组(n=315)和对照组(n=323),患儿术后返回病房时予评估意识状态及吞咽功能恢复情况,试验组评估合格即指导其进食进水;对照组在回病房6 h后方可进食进水。结果试验组术后首次进水、进食和进普食的时间为返回病房后0.63 h、1.03 h和3.07 h,对照组为返回病房后6.42 h、6.88 h和8.79 h,两组比较,差异有统计学意义(P<0.001);两组返回病房后6 h内和24 h内恶心呕吐的发生率、严重程度和发生次数比较,差异均无统计学意义(P>0.05);在返回病房后6 h时,试验组中度及以上程度口渴、饥饿的发生率均低于对照组(P<0.001),3分及以上疼痛的发生率低于对照组(P=0.002)。结论在评估机制和预防措施完善的条件下,骨科全麻手术患儿返回病房后1 h内进水并在返回病房后3 h进普食,不会加剧恶心呕吐的发生,且能够缓解患儿术后口渴、饥饿及疼痛的程度。
Objective To evaluate the safety and feasibility of early feeding in children after orthopaedic surgery. Methods Totally 638 children with general anesthesia after orthopaedic surgery in a tertiary hospital in Beijing were recruited and divided into two groups. Children in the experimental group （n=315） started water drinking and feed- ing if they passed the postoperative assessment on consciousness and digestive function,while children in the con- trol group （n=323） adhered to the conventional protocol of 6h fasting postoperatively. Results The average initial time of water drinking,liquid food feeding and general diet in the experimental group were 0.63 h, 1.03 h and 3.07 h, while they were 6.42 h,6.88 h and 8.79 h in the control group,and the differences were statistically significant （P〈 0.001）. There were no significant differences in the incidence,severity and frequency of postoperative nausea and vomiting between two groups in 6h and 24h after returning to wards（P〉0.05）. At 6h after returning to wards,the incidences of moderate-to-severe thirst and hunger in the experimental group were significantly lower than those in the control group（P〈0.001）,and pain scored over 3 marks was lower than the control group（P=0.002）. Conclusion Children after orthopaedic surgery with general anesthesia are likely to drink water lh after returning to wards and then take general diet 2h later while comprehensive prevention measures being adopted. Early feeding would not aggravate postoperative nausea and vomiting and can alleviate the extent of postoperative thirst,hunger and pain.
作者
覃倩
王志稳
董秀丽
QIN Qian;WANG Zhiwen;DONG Xiuli
出处
《中华护理杂志》
CSCD
北大核心
2018年第4期399-403,共5页
Chinese Journal of Nursing
关键词
骨科
儿童
手术
麻醉
全身
手术后医护
进食
Orthopaedics
Child
Surgery
Anesthesia, General
Postoperative Care
Eating
