Application of nurse led collaborative integrated nursing model in children undergoing hypospadias surgery / 中国实用护理杂志

Objective:To explore the effect of nurse led cooperative integrated nursing model in children with hypospadias, provide reference for the integration of collaborative medical care and patient care, improve the nursing level of nurses and the quality of child care.Methods:By adopting a quasi experimental study method, from January 2020 to December 2021, the clinical data of 84 male children undergoing hypospadias surgery in the Department of Urology, Children ′s Hospital of Nanjing Medical University were retrospectively analyzed, and 84 accompanying staff were included in the study. Among them, 42 children admitted from January to December 2020 and 42 accompanying staff served as the control group, and 42 children admitted from January to December 2021 and 42 accompanying staff served as the intervention group. The control group adopted the routine perioperative nursing mode, and the intervention group adopted the nurse-led collaborative integrated nursing mode. The anxiety and satisfaction of the caregivers in the two groups, the medical fear, medical compliance and postoperative pain of the children in the two groups, and the incidence of postoperative complications of the children in the two groups were compared. Results:After intervention, the satisfaction score of the intervention group ′s accompanying staff and the score of the patient ′s medical compliance were (96.46 ± 3.27) and (2.93 ± 0.89) points. The control group ′s scores were (85.24 ± 5.71) and (1.75 ± 0.63) points. The differences between the two groups were statistically significant ( t=9.52, -8.40, both P<0.05). The anxiety score of the accompanying staff in the intervention group was (44.33 ± 2.43) points, and the medical fear score and postoperative pain score of the patients were (20.76 ± 2.92) and (3.06 ± 0.57) points, respectively. The control group′s scores were (67.11 ± 3.36), (33.58 ± 3.84) and (6.24 ± 0.71) points, respectively. The differences between the two groups were statistically significant ( t=23.47, 12.51, 22.66, all P<0.05). The total incidence of postoperative complications in the intervention group was 4.76% (2/42), while in the control group was 52.38% (22/42). The difference was statistically significant ( χ2=23.33, P<0.05). Conclusions:The nurse led collaborative integrated nursing mode has a positive effect on relieving the negative emotions of caregivers and children, improving the satisfaction of hospitalization, improving the quality of care for children, and reducing the incidence of postoperative complications of children.

Clinical application of a Kirschner wire assisted double-hook water-injection hernia needle in complicated pediatric oblique inguinal hernia / 中华实用儿科临床杂志

Objective:To explore the clinical value of single-hole laparoscopic percutaneous extraperitoneal closure operation using a Kirschner wire assisted double-hook water-injection hernia needle in treating complicated pediatric oblique inguinal hernia.Methods:The clinical data of 366 children with oblique inguinal hernia treated in the Department of Urology Surgery, Children′s Hospital of Nanjing Medical University from December 2020 to October 2021 were retrospectively analyzed.According to the surgical methods, the children were divided into the ordinary crochet needle group and the Kirschner wire assisted group.Children treated by a single-port laparoscopic double hook water-injection hernia crochet needle (309 cases) were classified into the ordinary crochet needle group.Children treated by a single-port laparoscopic Kirschner wire assisted double hook water-injection hernia crochet needle (57 cases) were included in the Kirschner wire assisted group.The independent sample t-test and rank sum test was used to compare the relevant clinical indicators between the two groups. Results:Compared with the ordinary crochet needle group, children in the Kirschner wire assisted group were younger at surgery[(2.87±1.88) years vs.(4.91±2.39) years] and had larger hernia sacs [17 303.89(8 622.49, 37 295.42) mm 3vs.9 650.97(3 849.24, 17 539.51) mm 3]. The differences in the age at surgery and hernia sac volume were statistically significant ( t=-5.407, Z=-4.218; all P<0.001). There was no significant difference in body mass index between the 2 groups ( P>0.05). Taking hernias with sac volume >10 000 mm 3 as huge hernias, there were 70.18%(40/57 cases) and 47.25%(146/309 cases) of huge hernias in the Kirschner wire assisted group and the ordinary crochet needle group, respectively.The overall operation time of the Kirschner wire assisted group was significantly longer than that of the ordinary crochet needle group[(20(15, 20) min vs.15(15, 20) min] ( Z=-2.842, P<0.05). However, the operation time for huge oblique hernias with sac volume >10 000 mm 3 was not statistically significant between the 2 groups ( P>0.05). No recurrence in both groups was found during 6-16 months of follow-up. Conclusions:For complicated oblique inguinal hernia in children with a huge hernia or obvious retroperitoneal folds at the internal ring and heavy scar adhesion between the hernia sac and abdominal wall, the insertion of a Kirschner wire can help the hernia crochet needle to traverse the vas de-ferens and spermatic cord vessels smoothly.As a single port laparoscopic operation, the Kirschner wire assisted hernia crochet needle requires no addition of trocar holes and leaves only a small surgical scar.With good feasibility and safety, it is applicable for clinical popularization.

Efficacy of the dust mites drops sublingual immunotherapy in pediatric allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the role of the dust mites drops sublingual immunotherapy(SLIT) in pediatric allergic rhiriitis caused by dust mites and compare its efficacy between monosensitized and polysensitized children.@*METHOD@#A total of 77 pediatric allergic rhinitis patients received Dermatophagoides farina extracts sublingual immunotherapy for 2 years were enrolled as desensitization group and were allocated into monosensitized group (41 cases) and polysensitized group (36 cases) according to the number of coexisting allergens. Meanwhile another 33 allergic rhinitis children treated by pharmacotherapy during the period were collected as control group. The total symptom scores (TNSS), total medication scores (TMS) and visual analogue scale(VAS) were assessed at the beginning, six months, 1 year and 2 years of the treatment. SPSS 13. 0 software was used to analyze the data.@*RESULT@#the score of TNSS and VAS in desensitization was slightly higher than the control after six months treatment, but without difference at l year and 2 years; the score of TMS had significantly improved in desensitization compared with the corresponding points in control. All the parameters in monosensitized group were equivalent with polysensitizend group, except the score of TMS was slightly lower than the polysensitizend group at six months.@*CONCLUSION@#Dust mite drops sublingual immunotherapy is effective for the allergic rhinitis children caused by mites. And it has similar immunotherapy efficacy between monosensitized and polysensitized children.

Efficacy of sublingual immunotherapy in children with perennial allergic rhinitis / 重庆医学

Objective To observe the efficacy of the sublingual immunotherapy in children with perennial allergic rhinitis caused by mites .Methods A total of 61 pediatric patients with perennial allergic rhinitis caused by mite in otorhinolaryngology clinic were collected .The children were randomized into two groups :27 cases were divided into sublingual dust mite drops group(group A) , and 34 cases were divided into conventional treatment group (group B) .The symptom scores and sign scores of allergic rhinitis were observed after 6 months ,1 year and 2 years of treatment .Both the efficacy at the end of treatment and the rate of recurrence following 2 years were compared between the two groups .Results After six month of treatment ,the symptom scores in group A was reduced to (3 .70 ± 1 .54)scores ,higher than group B(2 .82 ± 1 .40)scores ,while sign scores in group A was reduced to (1 .19 ± 0 .68)scores ,having no statistically significance compared with group B ,Both symptom scores and sign scores were not changed sig-nificantly after 1 and 2 years of treatment .The efficacy evaluation was 74 .07% in group A ,and 82 .35% in group B .The difference had no statistical difference .The recurrence rate in group A was 29 .63% following 2 years after terminal treatment ,and was superi-or to those in group B (94 .12% ) ,with significant difference(P<0 .01) .Conclusion Dust mite drops sublingual immunotherapy is effective measures for the treatment of children with allergic rhinitis caused by mites .