Abstract:

This article summarized nursing experience of procedural feeding for five pediatric patients with complicated congenital heart disease underwent post-operative delayed chest closure. Key nursing points included: a procedural feeding program was developed together with pediatric cardiologists,cardiac surgeons,cardiac specialist nurse,nutritionists,gastroenterologists and rehabilitation specialists; minimal feeding was performed to maintain intestinal function; enteral nutrition was initiated as early as possible after full assessment of intestinal function,and initial feeding volume was set at 1 to 2 ml/（kg·h）; feeding intolerance was assessed by abdominal circumference measurement（once/12 h）,bowel sounds and gastrointestinal symptoms; implementation of enteral nutrition was advanced in an orderly and regular manner,and nutritional status of pediatric patients was continuously monitored,weight was assessed twice a week,and length of body was assessed once a week. All pediatric patients in this group successfully received chest closure,and all reached the full amount of oral feeding,who were discharged after the disease was relieved.

Key words: Congenital Heart Disease, Delayed Sternal Closure, Minimal Enteral Nutrition, Pediatric Nursing

摘要：

总结5例复杂性先天性心脏病术后延迟关胸患儿程序式喂养的护理经验。护理要点包括：由儿童心脏病专家、心胸外科医生、心脏专科护士、营养师、胃肠病专家、康复治疗专家联合制订程序式喂养方案;微量喂养以维持其肠道功能;肠道功能评估后尽早启动肠内营养,初始喂养量设定为1~2 ml/（kg·h）;联合使用腹围测量（1次/12 h）、肠鸣音及胃肠道症状评估喂养不耐受;有序规律地推进肠内营养的实施,持续监测患儿的营养状况,每周监测2次体重、1次身长。本组均顺利关胸,达到全量经口喂养,病情缓解后出院。

关键词: 先天性心脏病, 延迟关胸, 微量喂养, 儿科护理学