摘要
目的观察儿童医疗游戏辅导在儿童腹腔镜阑尾切除术后加速康复外科(ERAS)中的应用效果。方法纳入2021年11月至2024年11月在遵义医科大学附属医院接受腹腔镜阑尾切除术治疗的208例急性阑尾炎患儿,按随机数字表法分为对照组(n=105)和观察组(n=103)。对照组采用传统常规护理干预,观察组在传统常规护理的基础上予儿童医疗游戏辅导。通过简化版改良耶鲁术前焦虑量表(mYPAS-SF)、状态焦虑量表(S-AI)比较两组干预前后患儿焦虑程度、患儿家属焦虑程度;通过Wong-Baker脸部表情量表和视觉模拟量表评估两组患儿术后疼痛程度;比较两组患儿ERAS相关指标及家属满意度。结果观察组干预后患儿焦虑评分、患儿家属焦虑评分以及术后6 h、12 h、24 h疼痛评分得分均低于对照组,差异有统计学意义(P<0.05)。观察组患儿术后首次排气时间早于对照组[(16.01±2.33)h vs(19.70±3.76)h],术后首次进食时间早于对照组[(17.44±2.33)h vs(21.03±3.85)h],住院时间短于对照组[(6.18±0.79)d vs(8.47±2.44)d],患儿家属满意度评分高于对照组[(98.04±1.26)分vs(93.30±2.46)分],差异有统计学意义(P<0.05)。两组患儿术后并发症发生率比较差异无统计学意义(P>0.05)。结论儿童医疗游戏辅导在儿童腹腔镜阑尾切除术后ERAS中的应用效果显著,能有效降低患儿及家属的焦虑程度,减轻患儿术后疼痛,促进患儿术后排气及早期进食,缩短患儿住院时间,提高患儿家属满意度。
Objective To observe the application effect of Child Life Specialist in enhanced recovery after surgery(ERAS)after laparoscopic appendectomy in children.Methods A total of 208 pediatric patients with acute appendicitis who underwent laparoscopic appendectomy in Affiliated Hospital of Zunyi Medical University from November 2021 to November 2024 were included in this study.These patients were divided into control group(n=105)and observation group(n=103)according to random number table method.The control group was given traditional routine nursing intervention.The observation group received a special medical pattern of Child Life Specialist on the basis of the traditional routine nursing intervention.The pediatric patients′anxiety scores and their family members′anxiety scores were compared between the two groups by using modified Yale Preoperative Anxiety Scale⁃Short Form(mYPAS⁃SF)and State Anxiety Inventory(S⁃AI)before and after the interventions.The degrees of postoperative pain of the pediatric patients in the two groups were evaluated by using Wong⁃Baker FACES Pain Rating Scale(WBS)and Visual Analogue Scale(VAS).The ERAS⁃related indicators and satisfaction degrees of the pediatric patients′family members were compared between the two groups.Results The pediatric patients′anxiety scores and their family members′anxiety scores after interventions,and the pain scores at 6 hours,12 hours and 24 hours after operation in the observation group were lower than those in the control group,with statistically significant differences between the two groups(P<0.05).After the operation,the time to first anal exhaust in the observation group was earlier than that in the control group[(16.01±2.33)h vs(19.70±3.76)h],and the time to first food intake in the observation group was earlier than that in the control group[(17.44±2.33)h vs(21.03±3.85)h].The length of hospital stay in the observation group was shorter than that in the control group[(6.18±0.79)d vs(8.47±2.44)d].The satisfaction degree scores of the pediatric patients′family members in the observation group were higher than those in the control group[(98.04±1.26)points vs(93.30±2.46)points].There were significant differences in the above indicators between the two groups(P<0.05).There was no statistically significant difference in the incidence of the pediatric patients′postoperative complications between the two groups(P>0.05).Conclusion The application effect of Child Life Specialist is significantly effective in ERAS for the pediatric patients undergoing laparoscopic appendectomy.It can effectively reduce the anxiety levels of the pediatric patients and their family members,alleviate the postoperative pain of the pediatric patients,promote the postoperative anal exhaust of the pediatric patients,shorten the time to first food intake and the length of hospital stay of the pediatric patients,and improve the satisfaction degrees of the pediatric patients′family members.
作者
赵庆
常丽
谭先群
金祝
郑泽兵
ZHAO Qing;CHANG Li;TAN Xianqun;JIN Zhu;ZHENG Zebing(Department of Pediatric Surgery,Affiliated Hospital of Zunyi Medical University,Guizhou Children′s Hospital,Zunyi 563000,China)
出处
《中国临床新医学》
2025年第6期637-641,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
遵义市科技计划项目[编号:遵市科合HZ字(2024)275号]
遵义医科大学博士科研启动基金项目[编号:院字(2023)11号]。
关键词
医疗游戏辅导
急性阑尾炎
加速康复外科
儿童
腹腔镜
Child Life Specialist
Acute appendicitis
Enhanced recovery after surgery(ERAS)
Children
Laparoscope
作者简介
第一作者:赵庆,大学本科,学士学位,主管护师,研究方向:儿外科临床护理工作及管理。E⁃mail:775963142@qq.com;通信作者:郑泽兵,医学博士,主任医师,硕士研究生导师,遵义医科大学附属医院小儿外科教研室副主任。任中国医师协会小儿外科医师分会肝胆学组委员,中国妇幼保健协会妇幼微创专业委员会新生儿外科微创学组委员、小儿普外学组委员,贵州省小儿外科学会常务委员。擅长儿童普通外科及新生儿外科急危重症救治及儿童肝移植治疗,尤其擅长腹腔镜微创技术及达芬奇机器人手术。对儿童先天性结构畸形有丰富的治疗经验,成功在省内开展多项手术,填补省内空白。主持及完成先天性巨结肠领域科研项目5项,在国内中文核心期刊发表论文6篇,发表SCI论文11篇,获贵州省科技进步奖三等奖1项。研究方向:先天性消化道发育畸形。E⁃mail:zebing1988@sina.com。
