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目的探讨婴幼儿先天性心脏病实施快通道手术后喂养时机及其安全性。方法纳入124例先天性心脏病快通道手术后的患儿,随机分为两组。实验组采用按需喂养方法,患儿拔除气管插管后,每30 min采用Steward苏醒评分对其进行评估,当评分≥4分时,开始喂养。对照组采用常规喂养方法,拔除气管插管后4 h,由责任护士采用Steward苏醒评分对其进行评估,当评分≥4分时开始喂养。两组患儿的喂养内容及喂养量均一致。记录两组喂养后不良事件的发生情况,并评估两组患儿拔管后1 h、3 h、6 h、12 h的舒适度。结果实验组喂养时间为拔除气管插管后(2.41±1.04)h,显著早于对照组的4 h(P<0.05),两组均未发生恶心、呕吐等胃肠道不良反应。两组舒适度比较,差异无统计学意义(P>0.05)。结论先天性心脏病快通道手术后,可以根据患儿的清醒程度尽早开始喂养,不会增加患儿术后与麻醉相关的胃肠道不适的发生。
Objective To investigate the timing of feeding and safety of infants with congenital heart disease after fast-track surgery. Methods A total of 124 children with congenital heart disease undergoing fast-track surgery were randomly divided into two groups. In the experimental group, on-demand feeding was used. After removal of the tracheal intubation, the patients were evaluated with Steward awakening score every 30 minutes. When the score ≥4 points, they started to feed. In the control group, routine feeding was used. After 4 h of tracheal intubation, the responsible nurses used Steward’s wake-up score to evaluate them. When the score was> 4, they began to feed. The two groups of children’s feeding content and feeding amount are the same. The incidence of adverse events after feeding was recorded and the comfort of the two groups was evaluated at 1 h, 3 h, 6 h and 12 h after extubation. Results The feeding time of experimental group was (2.41 ± 1.04) h after tracheal intubation, significantly earlier than that of control group (P <0.05). No adverse reactions such as nausea and vomiting were found in gastrointestinal tract in both groups. Comfort between the two groups, the difference was not statistically significant (P> 0.05). Conclusion After the operation of quick access to congenital heart disease, we can start feeding as soon as possible according to the degree of soberness in children without increasing the postoperative anesthesia-related gastrointestinal discomfort.