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Objective To investigate the application of nurse-led chain management in extended care of children undergoing surgical treatment for Hirschsprung’s disease. Methods Totally 60 children with Hirschsprung’s disease were divided into control group and observation group according to the sequence of hospital admission, with 30 cases in each group. The control group received routine perioperative nursing management, and a nurse-led chain management model was adopted in perioperative nursing management and extended care of children in the observation group. Intervention efficacy was evaluated via incidence of postoperative complications and satisfaction of children’s parents. Results The incidence of postoperative complications in the observation group was lower than that in the control group(P＜0. 05). Parents of children in the observation group were more satisfied with nursing service compared with those in the control group(P＜0. 01). Conclusion The nurse-led chain management in extended care is potentially effective to reduce the risk of postoperative complications and improve the quality of life of children with Hirschsprung’s disease. (目的 探讨以护士为主导的链式管理模式在先天性巨结肠患儿术后延续性护理中的应用效果。方法 将60例先天性巨结肠患儿按照入院时间分为对照组与观察组, 各30例。对照组接受常规先天性巨结肠围手术期管理模式, 观察组采用链式管理协同延续护理模式。干预6个月后评价效果。结果 观察组术后并发症发生率低于对照组, 差异有统计学意义(P＜0. 05)。观察组患儿家属对护理工作的满意度高于对照组, 差异有统计学意义(P＜0. 01)。结论 以护士为主导的链式管理模式有利于减少术后并发症的发生, 对提升先天性巨结肠患儿术后生活质量具有积极意义。)

Objective Methods Totally 96 children with appendicitis requiring surgical treatment were divided into the two group according to the sequence of hospital admissions: 48 cases with admission date between Jan and Dec, 2020 were included as the control group, receiving routine management after surgery; 48 cases with admission date between Jan and Dec, 2021 were included as the observation group, receiving nursing management using specialist care quality indicators based on doctor-nurse-patient integration model. The primary outcomes included: ambulation distance within 24 hrs after surgery and rate of qualified early ambulation; Time of first exhaust and defecation, postoperative first out-of-bed activity time, first time to food-taking and incidence of symptoms of postoperative discomfort; satisfaction of children’s parents with communication and information support, respect, emotional support and high-quality nursing care. Results ambulation distance within 24 hrs after surgery in the observation group was longer than that in the control group (P＜0. 01). The rate of qualified early ambulation in the observation group (27. 08%) was higher than that in the control group (97. 92% vs. 27. 08%, P＜0. 01). The time of first exhaust and defecation, postoperative first out-of-bed activity time, first time to food-taking in the observation group was shorter than that in the control group(P＜0. 01, respectively). Parents of children in the observation group were more satisfied with communication and information support, respect, emotional support and high-quality nursing care compared with those in the control group(P＜0. 01). Conclusion Application of specialist care quality indicators based on doctor-nurse-patient integration model is potentially effective to improve the children’s compliance with early ambulation, promote the development of standard nursing procedure, improve the parents’ satisfaction and quality of specialist care. The To investigate the effect of specialist care quality indicators based on doctor-nurse-patient integration model in improving compliance with early ambulation in children with appendicitis. (目的 在加速康复外科理念下, 探讨医护患一体化专科护理质量指标管理提高阑尾炎患儿术后早期下床活动中的效果。方法 选取医院小儿外科2020年1月—2021年12月收治的96例阑尾炎的患儿为研究对象。将2020年1月—12月收治的48例患儿作为对照组, 运用常规护理管理落实术后早期下床活动; 将2021年1月—12月收治的48例患儿作为观察组, 运用医护患一体化专科护理质量指标管理落实术后早期下床活动。比较两组患儿术后24 h下床活动距离及达标情况; 术后首次排气排便时间、首次下床活动时间、首次进食时间、术后不适症状(恶心呕吐及腹胀)发生率; 患儿家属在沟通和信息支持、尊重支持、情感支持以及优质护理照护支持四个维度方面的满意度。结果 观察组患儿术后24 h下床活动距离较对照组增加, 差异有统计学意义(P＜0. 01)。观察组术后24 h下床活动达标率(97. 92%)高于对照组(27. 08%), 差异有统计学意义(P＜0. 01)。观察组术后首次下床活动时间、首次排气时间、首次排便时间、首次进食时间均早于对照组, 差异有统计学意义(P＜0. 01), 观察组术后恶心呕吐腹胀发生率低于对照组, 差异有统计学意义(P＜0. 05)。观察组患儿家属在沟通和信息支持、尊重支持、情感支持以及优质护理照护支持四个维度满意度评分高于对照组, 差异有统计学意义(P＜0. 01)。结论 医护患一体化的专科质量指标的实施, 提高了阑尾炎患儿术后早期下床活动的依从性, 促进了标准护理工作的开展, 提高了患儿家属的满意度, 提升了专科护理服务质量水平。)

This paper reviewed the clinical data of 5 newborn infants with acute peripheral vascular lesion, and summarized individualized surgical treatment and nursing management. The types of peripheral vascular lesion included mural thrombus at initiation site of left external iliac vein in 2 cases, false aortic aneurysm of posterior tibial of left leg in 1 case, thrombophlebitis of left leg in 1 case, false aortic aneurysm of at left elbow in 1 case. Based on the analysis of cause analysis, implementation of individualized surgical treatment and nursing strategy may achieve good clinical outcomes in the treatment of acute peripheral vascular lesion in neonates. (回顾性分析医院2015年10月—2022年10月收治的5例外周血管病损的新生儿临床护理资料, 分析发病原因, 总结护理经验。5例新生儿外周血管病损类别: 左髂外静脉起始部完全性附壁血栓2例, 左小腿胫后动脉假性动脉瘤1例, 右小腿血栓性静脉炎1例, 左肘部肱动脉假性动脉瘤1例。对于新生儿外周血管病损, 在治疗及护理过程中, 针对不同的病因造成的病损, 应采取个性化治疗护理进行干预, 取得较好的结局。)