围术期精细化液体管理联合细节护理在小儿室间隔修补术中的综合效果评价

doi:10.3969/j.issn.1674-490X.2025.05.006

医学研究与教育 ›› 2025, Vol. 42 ›› Issue (5): 40-46.DOI: 10.3969/j.issn.1674-490X.2025.05.006

• 护理学 • 上一篇

围术期精细化液体管理联合细节护理在小儿室间隔修补术中的综合效果评价

连亚帅¹,邱永升¹,高瑞玲²,王文华¹

1.郑州大学附属儿童医院麻醉与围术期医学科, 河南郑州 450018;
2.郑州市第一人民医院关节创伤骨科, 河南郑州 450018

收稿日期:2025-03-11 发布日期:2025-10-28
通讯作者: 邱永升(1981—),男,河南永城人,主任医师,硕士,硕士生导师,主要从事儿童围术期医学研究。E-mail: qysh66@126.com
作者简介:连亚帅(1991—),男,河南禹州人,主管护师,在读硕士,主要从事儿童手术室护理。 E-mail: 13838226866@163.com
基金资助:
2023年度河南省引进国外智力专项(外国专家项目)(HNGD2023040);2021年河南医学科技攻关计划联合共建项目(LHGJ20210686)

Received:2025-03-11 Published:2025-10-28

摘要/Abstract

摘要： 目的探讨围术期精细化液体管理联合细节护理在小儿室间隔修补术中的综合效果。方法选取郑州大学附属儿童医院2021年6月至2023年12月收治的98例先天性心脏病(congenital heart disease,CHD)患儿,所有患儿均行室间隔修补术。围术期精细化液体管理联合细节护理模式49例患儿为研究组,同时选取49例同期行常规护理患儿为对照组。比较两组患儿手术相关指标、术后疼痛、炎症因子水平、术后并发症及护理满意度。结果研究组术中出血量、手术时间、住院时间低于对照组(P<0.05);研究组术后24 h及48 h的婴幼儿行为观察法评分低于对照组(P<0.05);研究组术后3 d血清IL-6、IL-17及hs-CRP水平低于对照组(P<0.05);研究组术后并发症发生率与对照组间差异无统计学意义(P>0.05);研究组护理满意度评分高于对照组(P<0.05)。结论围术期精细化液体管理联合细节护理可减少室间隔修补术患儿术中出血量、手术时间及术后康复时间,减轻术后疼痛,调节炎症因子水平,提高家属及患儿满意度。

关键词: 围术期, 精细化液体管理, 细节护理, 先天性心脏病, 室间隔修补术

Abstract: Objective To explore the comprehensive effect of perioperative refined fluid management combined with detailed nursing in prediatric ventricular septal defect repair surgery. Methods A total of 98 CHD children treated at Zhengzhou University Affiliated Children's Hospital from June 2021 to December 2023 were selected. All children underwent ventricular septal defect repair surgery to treat congenital heart disease. The study group consisted of 49 children who received perioperative refined fluid management combined with detailed nursing, and the control group consisted of 49 children who received conventional nursing during the same period. The two groups were compared in terms of surgical indicators, postoperative pain, inflammation factors, postoperative complications, and nursing satisfaction. Results The study group had lower intraoperative blood loss, shorter surgery time, and shorter hospital stay compared with the control group(P<0.05). Infants and children pain scale scoes at 24 and 48 hours postoperative were lower in the study group than that in the control group(P<0.05). The levels of serum IL-6, IL-17, and hs-CRP at 3 days postoperative were lower in the study group than that in the control group(P<0.05). The incidence of postoperative complications between the study and control groups showed that there was no significant difference(P>0.05). The nursing satisfaction score in the study group was higher than in the control group(P<0.05). Conclusion Perioperative refined fluid management combined with detailed nursing can reduce intraoperative blood loss, surgery time, and postoperative recovery time in children undergoing ventricular septal defect repair surgery, alleviate postoperative pain, regulate inflammation factor levels, and improve family and patient satisfaction.

Key words: perioperative period, refined fluid management, detailed nursing, congenital heart disease, ventricular septal defect repair surgery

中图分类号:

连亚帅,邱永升,高瑞玲,王文华. 围术期精细化液体管理联合细节护理在小儿室间隔修补术中的综合效果评价[J]. 医学研究与教育, 2025, 42(5): 40-46.

参考文献

[1] 苏翠敏,刘芳意,蔡红珠,等.新生儿先天性心脏病患病调查分析[J].中国妇幼健康研究, 2020, 31(4): 533-536. DOI: 10.3969/j.issn.1673-5293.2020.04.026.
[2] 樊云,刘娜.宽体探测器CT低剂量扫描联合迭代重建技术在先天性心脏病患儿诊断中的应用价值[J].河北医学, 2020, 26(2): 264-267. DOI: 10.3969/j.issn.1006-6233.2020.02.022.
[3] SALAM A, BAUTISTA-RODRIGUEZ C, KARSENTY C, et al. Transcatheter closure of tubular patent ductus arteriosus using muscular ventricular septal defect devices in infants and small children with congestive heart failure[J]. Arch Cardiovasc Dis, 2022, 115(3): 134-141. DOI: 10.1016/j.acvd.2022.01.003.
[4] 龚丁旭,张本青,林野,等.室间隔缺损介入封堵术后并发症的外科治疗[J].中国循环杂志, 2020, 35(8): 777-780. DOI: 10.3969/j.issn.1000-3614.2020.08.009.
[5] 向龙,向道康,胡馗,等.主动脉弓缩窄球囊扩张联合体外循环下室间隔缺损修补术治疗小儿主动脉缩窄合并室间隔缺损的临床效果分析[J].四川解剖学杂志, 2020, 28(1): 45-46. DOI: 10.3969/j.issn.1006-1457.2020.01.021.
[6] ZHANG D N, OUYANG C, ZHAO X, et al. Renal tissue desaturation and acute kidney injury in infant cardiac surgery: a prospective propensity score-matched cohort study[J]. Br J Anaesth, 2021, 127(4): 620-628. DOI: 10.1016/j.bja.2021.06.045.
[7] 范春玲,刘永哲.白介素-6联合中性粒细胞明胶酶相关载脂蛋白对紫绀型先天性心脏病患儿体外循环术后急性肾损伤的预测价值[J].中国心血管病研究, 2023, 21(8): 697-703. DOI: 10.3969/j.issn.1672-5301.2023.08.005.
[8] 张欣蕾,杨丽平,尉进芳,等. 加速康复外科理念下肝癌肝切除患者围手术期液体管理最佳证据总结[J]. 中华现代护理杂志, 2025, 31(18): 2480-2487. DOI:10.3760/cma.j.cn115682-20241010-05537.
[9] 邓茂丹, 郑亚妮. 细节及舒适护理对小儿支气管肺炎疗效及治疗依从性影响[J]. 贵州医药, 2023, 47(2): 327-328.
[10] 洪婉,章玲霞,李东燕,等.儿童难治性肾病综合征应用他克莫司并发急性肾损伤的护理[J].护理与康复, 2022, 21(7): 59-60. DOI: 10.3969/j.issn.1671-9875.2022.07.016.
[11] 杨晋仙.心内科护理管理中细节思维管理理论的应用及对护理质量与满意度的影响[J].中国药物与临床, 2021, 21(18): 3197-3199. DOI: 10.11655/zgywylc2021.18.056.
[12] 王卫平,孙锟,常立文.儿科学[M].9版.北京:人民卫生出版社, 2018: 268-279.
[13] 吴怡雪,陈易,邱文波,等.婴儿疼痛行为指征量表的汉化及信效度检验[J].中国疼痛医学杂志, 2021, 27(11): 835-840. DOI: 10.3969/j.issn.1006-9852.2021.11.008.
[14] KHWAJA A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract, 2012, 120(4): c179-c184. DOI: 10.1159/000339789.
[15] 谷波,张骏,成翼娟.住院患者护理满意度量表信度效度测量[J].护理学杂志, 2008, 23(5): 45-47.
[16] 李东林,邱国玲.心脏彩色多普勒超声诊断小儿先天性心脏病的临床价值研究[J].实用临床医药杂志, 2020, 24(3): 13-15. DOI: 10.7619/jcmp.202003004.
[17] 柳立平,张明杰,陈曦,等.肠和肾血氧饱和度能较好预测小儿先天性心脏病术后急性肾损伤[J].浙江大学学报(医学版),2022,51(3):334-340.DOI: 10.3724/zdxbyxb-2022-0069.
[18] 陈闻婕,钟鸣,陈影,等.重症急性胰腺炎合并急性肾损伤的临床预防[J].中国中西医结合急救杂志, 2022, 29(5):513-517.DOI: 10.3969/j.issn.1008-9691.2022.05.001.
[19] 谢馥懋,刘凤鸣,易文枫.重症超声与脉搏指示连续心排出量监测在重症监护室急性肾损伤患者液体管理中的对比研究[J].现代医学与健康研究电子杂志, 2023, 7(17): 39-42. DOI: 10.3969/j.issn.2096-3718.2023.17.013.
[20] 孙佳晗,徐毅,罗艳.不同液体治疗方案对腹部大手术患者急性肾损伤发生率影响的研究进展[J].国际麻醉学与复苏杂志, 2022, 43(2):177-181. DOI:10.3760/cma.j.cn321761-20200907-00482.

围术期精细化液体管理联合细节护理在小儿室间隔修补术中的综合效果评价

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