Abstract:

Objective To study the feasibility and safety of shortening preoperative fasting time and early postoperative food intaking time under the guidance of Enhanced Recovery After Surgery（ERAS） concept in perioperative pediatric patients.Methods Pediatric patients undergoing elective surgery in urology department of a tertiary hospital in Zhejiang Province from November 15,2018,to March 15,2019,were selected and divided into the experimental group and the control group according to the time,in the experimental group,200 patients were treated with an individual diet plan according to the operation time;in the control group,200 patients were treated with traditional preoperative fasting methods. The actual preoperative fasting time and postoperative feeding time were compared between two groups,the clinical manifestation of thirst,hunger,crying,aspiration,postoperative nausea and vomiting,abdominal distension,and parents satisfaction were observed.Results Compared with the control group,the actual preoperative fasting time was significantly reduced in the experimental group（P<0.001）. There was no significant difference in the incidence of aspiration,postoperative nausea and vomiting and abdominal distension（P>0.05）. Perioperative thirst and hunger score,and crying rate in the experimental group were lower than those in the control group,parents satisfaction was higher,and the differences were statistically significant（P<0.01）.Conclusion Applying the concept of ERAS,it is safe and feasible to shorten preoperative fasting time and earlier postoperative food intaking time,which can reduce the discomfort and promote the early recovery of pediatric patients.

Key words: Enhanced Recovery After Surgery（ERAS）, Pediatric Urology, Fasting, Water Deprivation, Perioperative Nursing, Pediatric Nursing

摘要：

目的 在加速康复外科理念下,探讨围手术期患儿术前缩短禁食禁饮时间与术后早期进食进饮的可行性与安全性,优化临床护理质量。方法 选取杭州市某三级甲等儿童医院泌尿外科2018年11月15日—2019年3月15日收治的择期手术患儿为研究对象,按时间顺序分为试验组和对照组。试验组200例采用所制订的术前禁食禁饮方法,对照组200例采用传统的术前禁食禁饮方法,比较两组实际术前禁食禁饮时间及术后进食时间,观察两组围手术期口渴评分、饥饿评分、哭闹情况,术中误吸发生率,术后恶心呕吐和腹胀的发生率及家长的满意度。结果 与对照组相比,试验组围手术期禁食禁饮时间明显缩短（P<0.001）,术中误吸发生率、术后恶心呕吐及腹胀发生率差异均无统计学意义（均P>0.05）;围手术期口渴、饥饿评分及哭闹率较对照组低,家长满意度较对照组高,差异有统计学意义（均P<0.01）。结论 应用加速康复外科的理念,围手术期患儿术前缩短禁食禁饮时间与术后早期进食进饮的饮食方案安全可行,可以减少患儿不适感,促进患儿早日康复。

关键词: 加速康复外科, 小儿泌尿外科, 禁食, 禁水, 围手术期护理, 儿科护理学