循证护理在普萘洛尔治疗婴幼儿难治性血管瘤中的应用效果

The effectiveness of evidence-based nursing for propranolol treatment of the Intractable infantile hemangiomas

目的 探讨循证护理在普萘洛尔治疗婴幼儿难治性血管瘤中的作用。 方法 84例采用口服普萘洛尔治疗难治性血管瘤的婴幼儿,按随机数字表法分为试验组和对照组,每组42例。试验组采用循证护理,根据PICO工具描述问题结合责任护士定期随访的评估结果,提出循证问题,寻求高级别证据,结合现有护理条件,制定相应的护理规范、不良反应的应急预案、健康宣教卡、操作视频等措施并实施。对照组采用常规护理程序。在治疗12个月后按照Achauer 4级分级标准判定2组疗效;在治疗过程中评估2组患儿出现的血压下降、心率减慢、腹泻、睡眠障碍、低血糖等不良反应的发生情况。 结果 按Achauer 4级分级,试验组和对照组的Ⅰ、Ⅱ、Ⅲ、Ⅳ级例数分别是3、7、20、12例和11、15、11、5例,2组比较差异有统计学意义(t1=1 372,t2=2 132,P<0.05);试验组和对照组的血压下降、心率减慢、腹泻、睡眠障碍、低血糖不良反应的人数分别是12、2、3、6、1例和26、15、12、21、8例,2组比较差异有统计学意义(χ^2=6.098~12.464,P<0.01或0.05)。 结论 循证护理有效提高普萘洛尔治疗婴幼儿难治性血管瘤的治疗效果,并有效预防了治疗过程中不良反应的发生。

Objective To investigate the effecs of evidence-based nursing of the treatment with propranolol forthe intractable infantile hemangiomahemangioma. Methods Dividing the children who were treated with propranolol into experimental groups and matched groups randomly according to the random number table each 42. The experimental group adopted evidence-based care, according to PICO tool description of the problem and combining the results of theresponsibility nurse′s regular follow-up and assessment to come up with evidence-based problems, seeking for high-level evidences, combining the existing conditions of careand having formulated corresponding care norms,contingency plans for adverse reactions,healthy education card,the operation videos and other measures and they are implemented.The control group adopted the routine care procedure.two groups of effects were determined by the Achauer level 4 classification after 12 months of treatment, and evaluating the condition of occur of blood pressure drop,slow heart beat,diarrhea, sleepdisorders, hypoglycemia and other adverse reactions in both groups during the process of treatment. Results there was statistical significance in the difference of two groups′Achauer 4 levels. The numbers of Ⅰ, Ⅱ, Ⅲ, and Ⅳ in the two groups were 3, 7, 20, 12, and 11, 15, 11, 5, respectively (t1=1 372, t2=2 132, P<0.05). The two groups had a statistically significant difference in blood pressure, heart rate, diarrhea, sleep disorder, and low blood sugar response. The numbers of two groups were 12, 2, 3, 6, 1 and 26, 15, 12, 21, 8 respectively (χ^2=6.098-12.464, all P<0.05). Conclusions Evidence-based nursing enhances the treatment effectiveness of theintractable infantile hemangioma with propranolol effectively and has preventing the occur of adverse reactions during the process of treatment.