Perioperative nursing care of neonatal congenital diaphragmatic hernia treated by thoracoscopic diaphragmatic hernia repair

Abstract

Objective To explore the effect of perioperative monitoring and nursing in the treatment of neonatal congenital diaphragmatic hernia (CDH) by thoracoscopic repair of diaphragmatic hernia. Methods 64 children with CDH who were treated in Beijing Luhe hospital from January 2010 to October 2018 were randomly divided into the comprehensive nursing group (32 cases) and the routine nursing group (32 cases). The routine nursing group was given routine perioperative nursing, while the comprehensive nursing group was given comprehensive nursing on the basis of routine perioperative nursing. The perioperative indicators, blood gas analysis indicators, the scores of comfort, compliance, nursing quality and complications were observed and compared between the two groups. Results There was no significant difference in operation time and bleeding volume between the comprehensive nursing group and the routine nursing group (114.29±11.54 min vs 116.83±12.73 min; 2.58±1.01 ml vs 2.81±1.03 ml, P>0.05), while the hospitalization time and mechanical ventilation time after operation in the comprehensive nursing group were lower than those in the routine nursing group (12.18±4.11 d vs 17.52±5.25 d; 2.04±1.17 d vs 2.89±2.03 d; P 0.05). Compared with pre-operation, 10 minutes after pneumoperitoneum, the levels of PaCO2, peak airway pressure and end-expiratory CO2 pressure increased in both groups (P 0.05). The scores of comfort (91.05±10.22), compliance (91.48±7.64) and nursing quality of children (93.11±10.08) in comprehensive nursing group were higher than those in routine nursing group (81.69±9.81, 80.27±7.05, and 80.97±8.19, P<0.05). The incidence of postoperative complications in the comprehensive nursing group (3.125%) was lower than that in the conventional nursing group (21.875%) (P<0.05). Conclusion Comprehensive nursing intervention plays an important role in the treatment of neonatal CDH by thoracoscopic diaphragmatic herniorrhaphy. It can significantly shorten the recovery time after operation, keep the blood gas index normal and stable, effectively reduce the incidence of complications after operation, and significantly improve the comfort, compliance and nursing satisfaction of children. It is worthy of clinical promotion. Key words: Thoracoscopic diaphragmatic hernia repair; Neonatal CDH; Blood gas analysis; Complications