游戏疗法在住院儿童腰椎穿刺术中的应用

The application of play therapy in hospitalized children during the course of lumbar puncture operation

目的探讨游戏疗法对住院儿童腰椎穿刺（腰穿术）疼痛及操作依从性等的影响。方法将准备行腰穿术的患儿60例，按照随机数字表法分为干预组和对照组各30例，对照组采用常规方式，干预组在常规方式的基础上，在腰穿术前和腰穿术中增加游戏互动环节。结果干预组患儿术后呼吸、脉搏增快的例数分别为10例和8例，与对照组的24例和21例比较，差异有统计学意义，P〈0．01。干预组术中FLACC量表和Wong—Baker笑脸量表评分分别为（2．52±1．37）分和（3．59±1．15）分，均显著低于对照组的（4．22±1．97）分和（4．93±1．71）分，差异有统计学意义，P〈0．01。干预组患儿的依从性评分及腰穿术操作时间亦显著优于对照组，差异有统计学意义，P〈0．05。结论游戏疗法可缓解患儿腰穿术操作性疼痛，降低生命体征波动，提高穿刺的依从性，缩短整个操作完成的时间。

Objective To evaluate the impact of play therapy to the pain and the compliance of hospitalized children during tht course of lumbar puncture operation. Methods Divided 60 children with lumbar puncture operation into the intervention group （30 cases） and the control group（3Ocases）randomly. Routine cares were used in the control group, while the play therapy was used in the intervention group in addition during the course of lumbar puncture operation. Results There were statistical significance in the comparisons of the changes of respiratory rate and pulse rate during the preoperative and intraoperative of lumbar puncture between the two groups, P〈0.01. There were also significant differences in the comparisons of subjective and objective pain score as well as the puncture compliance in the lumbar puncture operation. The score of FLAFF scale and the Wong- Baker scale in the intervention group was （2.52 ± 1.37） and （3.59 ± 1.15） respectively, which was significant lower than that of in the eontrol group, （4.22 ±1.97） and （4.93 ± 1.71）, the difference was significant, P〈0.01. Conclusion Play therapy can relieve the pain of chil- dren with lumbar puncture operation, reduce the changes of the vital signs, promote the puncture compli- ance and shorten the time of the who]e operation completeness.