张琪媚 叶东枚 赖柏聪

[摘要]目的 探讨特殊护理干预在小儿先天性心脏病（CHD）介入治疗中的应用效果。方法 分析2016年6月～2017年12月广东省中医院收治的91例CHD患儿的临床资料，依据护理措施不同进行分组，常规组40例和加强组51例。观察两组手术护理缺陷发生率、患儿家属满意度和手术医生满意度情况。结果 加强组手术护理缺陷发生率低于常规组，加强组家属满意度和手术医生满意度高于常规组，加强组在术前准备、气管插管护理、留置管管理、术中配合、术后巡视、术后并发症方面的护理工作质量评分高于常规组，差异均有统计学意义（P<0.05）。结论 在小儿CHD介入治疗中应用特殊护理干预，术前物品准备齐全，熟练掌握手术配合，术中配合到位，做好术中应急准备，提供优质护理服务，才能确保手术顺利完成。

[关键词]特殊护理干预；小儿；先天性心脏病；介入治疗

[中图分类号] R473.72 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0192-04

[Abstract] Objective To approach application result of Congenital heart disease （CHD） children in interventional therapy by special nursing intervention. Methods 91 cases clinical data of CHD children in Guangdong province traditional Chinese hospital from July 2016 to December 2017 were analyzed， which was to be divided into two group by different nursing， regular group 40 cases and strengthened group 51 cases. The nursing errors rate paediatric patients family of satisfaction and operation doctors of satisfaction for two group children were detected. Results The nursing errors rate of strengthened group were lower than regular group， the paediatric patients family of satisfaction and operation doctors of satisfaction for strengthened group were higher than regular group， The preoperative preparation， tracheal intubation nursing， indwelling tube administration， Intraoperative coordination， inspection after operation， complications after operation for nursing work quality score of strengthened group were higher than regular group， the difference were statistical significance（P<0.05）. Conclusion In pediatric interventional treatment of CHD， preoperative preparation is complete， the skilled operation coordination， intraoperativecoordination in place， intraoperative emergency prepare to provide high quality nursing service， to ensure the operation is completed.

[Key words] Special nursing intervention； Children； Congenital heart disease； Interventional therapy

先天性心臟病（CHD）是先天性畸形最常见的一种，是胎儿期心脏和大血管在母体内发育异常、部分停顿或有缺陷所造成，危害患儿的生命与健康[1]。随着导管介入治疗技术的发展，介入器材的不断改进，介入治疗已经成为多种CHD的常用治疗方式[2]，相比外科手术治疗，介入治疗具有创伤小、痛苦少、术后恢复快、疗效可靠、住院时间短等优势[3]，深受广大患儿家属的青睐。良好的护理配合是手术成功及患儿术后康复的重要前提，手术护士必须熟练掌握手术配合，术中配合到位，及时处理术中情况，同进做好术前的物品准备，充分估计手术可能发生意外，随时做好术中转小切口经胸封堵术或体外循环补片修补术的应急准备，才能保证手术顺利完成。……