摘要
目的应用快速康复理论探讨婴幼儿及儿童全身麻醉下行非胃肠道择期手术后早期进饮食的安全性及可行性。方法选择240例骨科择期手术患儿，按随机数字表法分为观察组与对照组各120例。观察组患儿术后麻醉清醒、意识清楚后实施早期饮食指导，即无胃肠道和咽喉部不适，有进饮食需求，先少量饮水，无呛咳、恶心、呕吐再进食。对照组按常规术毕4h进饮食。分别于术后2h和进食后1h评估患儿口渴、饥饿、恶心、呕吐、呛咳、疼痛等情况，并进行比较。结果两组患儿术后麻醉清醒及意识清楚时间比较,差异无统计学意义（P〉0.05）。观察组有90.0％的患儿术后2h内饮水，77.5％的患儿术后2h内进食。术后2h观察组患儿口渴、饥饿感的发生率分别为10.8%和22.5%，明显低于对照组的95.0%和99.2%，差异有统计学意义（χ2值分别为66.5,47.0；P〈0.01），观察组术后2h疼痛评分为（4.73±0.13）分，低于对照组（5.70±0.13）分，差异有统计学意义（t=1.86,P〈0.05）。观察组与对照组患儿术后2h和进食后1h恶心、呕吐和呛咳发生情况比较，差异无统计学意义（P〉0.05）。结论小儿骨科全身麻醉手术患儿术后4h进食的常规可修改，评估患儿术后麻醉清醒、意识清楚后，根据患儿需求术后早进饮食是可行的。
Objective Application of fast track surgery to study the safety and feasibility of early drinking and eating of infants and children after non-gastrointestinal surgery under general anesthesia. Methods Totals of 240 cases of children with orthopedic surgery were randomly assigned into experimental group and control group. In experimental group, consciousness of sober and clear implementation of postoperative anesthesia of children were received early dietary guidance. While in control group, children were albert 4 hours and then received diet. Respectively, 2 hours after operation and l h after eating, the hunger, thirst, nausea, vomiting, cough, pain of children were assessed and compared. Results There was no significant difference in the time of consciousness of sober and the time of clear implementation of postoperative anesthesia of two groups （P 〉0.05）. There were 90.0% children had drinking and 77.5% children had eating in 2 hours after operation in the experimental group. The incidence of the sense of thirst and hunger in the postoperative 2 hours of experimental group respectively were 10. 8% and 22.5% significantly lower than 95.0% and 99.2% of control group （ χ2 = 66.5,47.0, respectively; P 〈 0.01 ）. The post-operation pain score of experimental group in 2 hours was （4.73 ± 0. 13 ）, and that of control group was （4.73 ± 0. 13 ）, and the difference was statistically significant （t = 1.86 ,P 〈 0.05 ）. No significant difference was found in the incidence of cough, nausea and vomiting in the 2 hours after operation and 1 hour after eating between two groups （ P 〉 0.05）. Conclusions The regular of paediatric orthopaedic surgery under general anesthesia after surgery in children with 4 hours eating need to amend. It is feasibility to develope early drinking and eating for postoperation children under general anesthesia on the basis of assessing sober and clear of the children.
出处
《中华现代护理杂志》
2012年第23期2755-2758,共4页
Chinese Journal of Modern Nursing
基金
深圳市科技计划项目（医疗卫生类）（201003144）
关键词
儿童
全身麻醉
快速康复理论
早期进饮食
children
General anaesthesia
Fast track-surgery
Early drinking and eating
