在儿科食道按电池病例中评估过程措施和实践变化:一个多机构队列研究
Anoosha Moturu1, Vanessa Thompson2, Catherine Grant2
1American College of Surgeons, Division of Research and Optimal Patient Care, Chicago, IL, USA; Stanford Healthcare, Stanford, CA, USA.
Journal of pediatric surgery
|August 15, 2025
概括
儿童摄入食道按电池是一个非常重要的紧急情况. 这项研究发现,转诊患者的重复成像和推迟的术后食道图可以延长治疗时间,突出改善护理的领域.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 紧急医疗 紧急医疗
- 改善外科手术的质量
背景情况:
- 食道按电池 (BB) 摄入是一种罕见但严重的儿科紧急情况.
- 及时干预对于预防严重发病率和死亡率至关重要.
- 国家外科质量改善计划-儿科 (NSQIP-Ped) 提供数据来评估护理过程.
研究的目的:
- 为了分析食道BB过程,测量NSQIP-Ped.数据.
- 为了识别儿科食道BB摄入的护理交付的变化.
- 确定改善患者护理和结果的机会.
主要方法:
- 使用NSQIP-Ped数据对患有食道BB摄入的儿科患者 (0-17岁) 的回顾性分析 (2021年1月至2023年12月).
- 评估护理的及时性,术前成像和术后无菌酸灌.
- 重复成像对干预时间的影响的子组分析.
主要成果:
- 分析了来自28个机构的86名患者.
- 介绍到手术的平均时间为98分钟.
- 在转诊患者中,重复成像显著增加了呈现至手术的时间 (104分62分,p=0.013).
- 在70%的案例中使用了无菌的酸灌,在87%的案例中使用了足够的体积.
结论:
- 减少转诊患者的重复成像可以加快护理.
- 需要优化术后食道图的时间.
- 改善无菌酸灌文档和使用可以标准化护理,并减少按电池摄入的病率.
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