目的

基于加速康复外科理念评价泌尿外科患儿家长参与式全麻术后早期进水进食的安全性和可行性。

方法

选取上海交通大学医学院附属上海儿童医学中心泌尿外科的382例全麻手术患儿作为研究对象，将2022年1月全麻手术后患儿设为对照组（185例），2022年2月全麻手术后患儿设为干预组（197例），干预组患儿给予基于快速康复理念的家长参与式术后早期进水进食方案，对照组患儿给予常规进水进食方案。比较两组患儿术后首次进水进食时间，术后24 h内恶心、呕吐和腹胀的发生率，术后6 h内口渴、饥饿评分，疼痛评分，家长满意度等。

结果

干预组术后首次进水和进食时间均明显短于对照组（P＜0.001），术后6 h内口渴、饥饿评分及疼痛评分均明显低于对照组（P＜0.001），术后24 h恶心呕吐及腹胀发生率差异均无统计学意义（P＞0.05），家长满意度高于对照组（P＜0.001）。

结论

基于加速康复外科理念制定的家长参与式患儿术后早期进水进食方案安全可行，可以缓解患儿术后口渴、饥饿感，减少患儿不适感，促进患儿早日康复。促进家长与护士之间的沟通与合作，减轻家长的焦虑情绪，提高患儿家长的满意度。

Objective

To evaluate the safety and feasibility of early feeding after operation under general anesthesia for children with urology based on the guidance of enhanced recovery after surgery （ERAS） concept.

Methods

382 children undergoing general anesthesia surgery in the urological department of Shanghai Children's Medical Center Affiliated to Medical College of Shanghai Jiaotong University from January 2022 to February 2022 were selected and divided into the intervention group and the control group.The children after general anesthesia surgery in January 2022 were set as the control group （185 cases）， which were given a routine food feeding program； and the children after general anesthesia surgery in February 2022 were set as the intervention group （197 cases）， which were given a parental participatory early postoperative food feeding program based on the concept of ERAS. The average initial postoperative feeding and taking food time， the incidence of nausea， vomiting and abdominal distension within 24 h， the thirst， hunger and pain score within 6 h after operation and parental satisfaction were compared between the two groups.

Results

In the intervention group， the initial postoperative feeding and taking food time was significantly shorter than that in the control group （P＜0.001）； the scores of thirst， hunger and pain within 6 h after operation were significantly lower than those in the control group（P＜0.001）； the satisfaction of parents was higher than that in the control group （P＜0.001）. There was no significant difference in the incidence of nausea， vomiting and abdominal distension 24 h after operation between two groups （P＞0.05）.

Conclusion

Parental participatory early postoperative food feeding program based on the concept of ERAS is safe and feasible， which can relieve the children's thirst and hunger， reduce their discomfort， and promote their early recovery， promote communication and cooperation between parents and nurses， reduce parents' anxiety， and improve parents' satisfaction.