抚触加音乐疗法对2～5岁急性肠梗阻非手术患儿腹痛及心理状态的影响

Impact of message combined with music therapy on abdominal pain and psychological state for non operative children （2 to 5 years old） with acute ileus

目的：探讨抚触加音乐疗法对儿科重症监护病房（ PICU）急性肠梗阻非手术患儿腹痛及心理状态的影响。方法选取2012年1月—2013年12月在PICU住院的急性肠梗阻的患儿140例,采用电脑随机数随机分为干预组及对照组各70例,在入住PICU当日应用东安大略儿童医院疼痛评分标准及自制心理状态量表对患儿进行评估,入住PICU当日起连续6 d干预组每日晨及晚间睡前放儿歌,同时进行身体抚触,每次持续15 min；对照组只进行常规护理。在入住PICU第1,6天分别观察患儿腹部疼痛情况及心理状况。结果入住PICU后当日干预组及对照组均为Ⅱ级疼痛居多,其中干预组33例,对照组34例,差异无统计学意义（χ^2=0.092,P=0.951）；入住PICU后6天,两组患儿全部为Ⅰ级疼痛居多,其中干预组39例,对照组37例,差异无统计学意义（χ^2=0.372,P=0.857）。入住PICU当日,两组患儿心理状态无明显差异,但是干预组在入住PICU第6天时心理状态显著优于对照组,干预组恐惧、不稳定、不愉快心理状态患儿例数分别为32,31,52例,对照组45,55,40例,差异均有统计学意义（χ^2=4.88,P=0.033；χ^2=17.36,P=0.002；χ^2=4.57,P=0.033）。结论身体抚触加音乐疗法可帮助PICU急性肠梗阻患儿有效地缓解不稳定、不愉快及恐惧心理状态,但是对于缓解急性肠梗阻非手术患儿腹部疼痛无明显作用。

Objective To explore the effect of maternal message combined with music therapy on pain and psychological state for non operative children with acute ileus in Pediatric Intensive Care Unit （ PICU ） . Methods A total of 140 children at the PICU of Maternal and Child Care Service Center of Tangshan from January 2012 to December 2013 were enrolled in the study. All the children were used computer random number grouping into test group and control group, with 70 children in each group. The pain scales of the two groups were compared by the children′s hospital of easter on-tario pain scale （ CHEOPS） before the study, and the stress scales were compared by the self-made scale. Maternal message （15 min） and music therapy began at the 1st day and end at the 6th day of admission in PICU for test group. The children in the control group received the routine unit procedures every day. The pain and psychological states were tested in 1st and 6th day of intervention in both groups. Results Most of children suffered Ⅱ degree pain at the first day of admission in two groups;however, the pain degree became to Ⅰ degree at 6^th day of admission, in which 33 cases in the test group, 34 cases in the control group with no statistical significance （χ^2 =0. 092,P =0. 951）. At the day of PICU admitted, the psychological state had no statistical difference between the two groups, but the psychological state in the test group was better than that of the control group at 6th day of PICU. The fear, unstable, unpleasant psychological states in children were 32, 31 and 52 cases in the test group, 45, 55 and 40 cases in the control group （χ^2 =4. 88,P=0. 033;χ^2 =17. 36,P=0. 002;χ^2 =4. 57,P=0. 033）. Conclusions Maternal message with music therapy have a positive effect on psychological state of acute ilues children in PICU, but have no obvious effect on the abdominal pain treatment.