Abstract:

Objective　To explore the effect of quantitative evaluation model of airway nursing for postoperative respiratory management in children with congenital heart disease. Methods　In this randomized controlled trial, 96 children with congenital heart disease admitted to Fuwai Central China Cardiovascular Hospital from September 2022 to October 2023 were divided into two groups by random drawing with 48 cases in each group. The control group included 27 boys and 21 girls, with an age of (3.57±0.53) years old. The observation group included 29 boys and 19 girls, with an age of (3.64±0.54) years old. The control group was given routine airway management after surgery, and the observation group was given quantitative evaluation model of airway nursing, until the children were discharged from the hospital. The perioperative indexes, oxygenation indicators [partial pressure of arterial oxygen (PaO₂), fraction of inspired oxygen (FiO₂), and oxygenation index (PaO₂/FiO₂)] before and 14 d after intervention, and incidence of postoperative complications were compared between the two groups. χ² test and t test were performed. Results　Compared with those in the control group [(86.26±12.93) h, (7.35±1.10) d, and (8.49±1.27) d], the duration of ventilator use, monitoring, and hospitalization [(45.32±6.79) h, (4.04±0.60) d, and (5.58±0.83) d] in the observation group were shorter, with statistically significant differences (t=19.421, 18.302, and 13.288, all P<0.001). After intervention, the levels of PaO₂, FiO₂, and PaO₂/FiO₂ in the observation group were (121.63±18.24) mmHg (1 mmHg = 0.133 kPa), (48.67±7.30)%, and (439.62±65.94) mmHg, respectively, which were higher than (110.58±16.58) mmHg, (39.82±5.97)%, and (378.40±56.76) mmHg in the control group, with statistically significant differences (t=3.105, 6.501, and 4.874, all P<0.05). Compared with that in the control group [16.66% (8/48)], the incidence of postoperative complications in the observation group [4.16% (2/48)] was lower, with a statistically significant difference (χ²=4.018, P=0.045). Conclusion　The application of quantitative evaluation model of airway nursing to respiratory management in postoperative nursing for children with congenital heart disease can effectively promote the children's recovery, improve the oxygenation indicators, and has positive significance in reducing the incidence of postoperative complications.

Key words:

Congenital heart disease, Children, Quantitative evaluation model of airway nursing, Respiratory tract management, Application value

摘要：

目的　探讨气道护理量化评估模式用于先天性心脏病（先心病）患儿术后呼吸道管理的效果。方法　本文为随机对照试验，通过随机抽签法将2022年9月至2023年10月阜外华中心血管病医院收治的先心病患儿96例分为两组各48例。对照组男27例，女21例，年龄（3.57±0.53）岁；观察组男29例，女19例，年龄（3.64±0.54）岁。对照组和观察组术后分别施以常规呼吸道管理和气道护理量化评估模式的呼吸道管理，均干预至患儿出院。比较两组围手术期指标，干预前、干预后14 d氧合指标［动脉血氧分压（PaO₂）、吸入气中的氧浓度分数（FiO₂）、氧合指数（PaO₂/FiO₂）］，术后并发症发生率。行χ²检验、t检验。结果　与对照组［（86.26±12.93）h、（7.35±1.10）d、（8.49±1.27）d］相比较，观察组呼吸机使用、监护、住院时间［（45.32±6.79）h、（4.04±0.60）d、（5.58±0.83）d］均较短，差异均有统计学意义（t=19.421、18.302、13.288，均P<0.001）。干预后，观察组PaO₂、FiO₂、PaO₂/FiO₂水平分别为（121.63±18.24）mmHg（1 mmHg=0.133 kPa）、（48.67±7.30）%、（439.62±65.94）mmHg，均高于对照组的（110.58±16.58）mmHg、（39.82±5.97）%、（378.40±56.76）mmHg，差异均有统计学意义（t=3.105、6.501、4.874，均P<0.05）。与对照组［16.66%（8/48）］相比较，观察组术后并发症发生率［4.16%（2/48）］较低，差异有统计学意义（χ²=4.018，P=0.045）。结论　将气道护理量化评估模式的呼吸道管理应用于先心病患儿术后的护理工作中，能有效促进患儿恢复，提高患儿氧合指标，在降低术后并发症发生率方面亦具有积极意义。

关键词:

先天性心脏病, 小儿, 气道护理量化评估模式, 呼吸道管理, 应用价值