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综合护理干预对改善先天性心脏病患儿预后的影响:一项回顾性临床评估

Association of bundled care interventions in improving outcomes for pediatric patients with congenital heart disease: a retrospective clinical evaluation.

作者信息

Zhang Li, Song Yu-Ting

机构信息

Department of Cardiovascular Pediatric CICU Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China.

出版信息

Front Pediatr. 2025 Mar 4;13:1525020. doi: 10.3389/fped.2025.1525020. eCollection 2025.

Abstract

BACKGROUND

Congenital heart disease (CHD) in pediatric patients requires comprehensive care to address complex medical and psychological needs. Traditional approaches may lack the structure and coordination to optimize recovery fully. This study evaluates the association of Bundled Care Interventions, a structured multidisciplinary approach, in improving clinical outcomes and quality of life in pediatric CHD patients.

MATERIALS AND METHODS

A retrospective evaluation was conducted at our hospital from January 2021 to December 2023. Pediatric patients ( = 136) under 14 years of age diagnosed with CHD were included, with 70 receiving Bundled Care Interventions (observation group) and 66 receiving conventional care (control group). The bundled care model included preoperative education, optimized intraoperative management, personalized postoperative rehabilitation, home-based care, and medication management. Primary outcome measures included oxygenation status, quality of life, adverse events, and complications. Statistical analyses were performed using independent -tests and chi-square tests.

RESULTS

Patients in the Bundled Care Interventions group showed significant improvements in oxygenation (PaO and FiO;  < 0.001) and quality of life across all dimensions ( < 0.001) compared to the control group. Additionally, adverse event incidence was lower in the observation group (4.29% vs. 15.2%;  = 0.031), as was the incidence of postoperative complications (5.71% vs. 18.2%;  = 0.024).

CONCLUSIONS

Bundled Care Interventions might improve oxygenation levels, enhance quality of life, and reduce adverse events and complications in pediatric CHD patients. This structured, multidisciplinary approach could offer a promising model for optimizing clinical outcomes and supporting comprehensive rehabilitation in this vulnerable population.

摘要

背景

儿科患者的先天性心脏病(CHD)需要全面护理,以满足复杂的医疗和心理需求。传统方法可能缺乏充分优化康复的结构和协调性。本研究评估了捆绑式护理干预(一种结构化的多学科方法)与改善儿科CHD患者的临床结局和生活质量之间的关联。

材料与方法

2021年1月至2023年12月在我院进行了一项回顾性评估。纳入14岁以下诊断为CHD的儿科患者(n = 136),其中70例接受捆绑式护理干预(观察组),66例接受常规护理(对照组)。捆绑式护理模式包括术前教育、优化术中管理、个性化术后康复、居家护理和药物管理。主要结局指标包括氧合状态、生活质量、不良事件和并发症。采用独立样本t检验和卡方检验进行统计分析。

结果

与对照组相比,捆绑式护理干预组患者的氧合(PaO₂和FiO₂;P < 0.001)及各维度生活质量均有显著改善(P < 0.001)。此外,观察组的不良事件发生率较低(4.29% 对15.2%;P = 0.031),术后并发症发生率也较低(5.71% 对18.2%;P = 0.024)。

结论

捆绑式护理干预可能改善儿科CHD患者的氧合水平,提高生活质量,并减少不良事件和并发症。这种结构化的多学科方法可为优化这一脆弱人群的临床结局和支持全面康复提供一个有前景的模式。

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