呼吸困难护理综合评分和儿童呼吸困难评分在中重度支气管哮喘患儿护理干预中的应用对比

Application Value of Dyspnea Nursing Comprehensive Score and PRAM in Nursing Intervention of Moderate and Severe Bronchial Asthma Children

目的比较呼吸困难护理综合评分(BRNCS)和儿童呼吸困难评分(PRAM)在中重度支气管哮喘儿护理干预中的应用效果。方法将126例中重度支气管哮喘患儿随机分为观察组和对照组,每组63例。观察组根据PRAM评价结果分为重度支气管哮喘患儿(8分≤PRAM≤12分,n=31)和中度支气管哮喘患儿(4分≤PRAM≤7分,n=32);对照组根据BRNCS评价结果分为重度支气管哮喘患儿(BRNCS>50分,n=33)和中度支气管哮喘患儿(26分≤BRNCS≤50分,n=30)。对中度哮喘患儿调配1名护师和1名护士进行护理,对重度哮喘患儿调配1名主管护师、1名护师和1名护士进行护理。比较两组护理前后日间和夜间哮喘症状评分、肺功能、1个月内哮喘发作情况及健康调查简表(SF-36)评分。结果护理干预前观察组和对照组日间和夜间哮喘症状评分、肺功能、1个月内哮喘发作率和SF-36评分比较差异均无统计学意义(P>0.05)。与护理前比较,观察组和对照组护理2周和4周的日间和夜间哮喘症状评分及1个月内哮喘发作率均降低,且观察组低于对照组;PEF%Pred、FEV1%Pred等肺功能指标和SF-36评分均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 PRAM指导中重度支气管哮喘患儿护理干预,可更有效缓解患儿的哮喘症状,提高其肺功能和生活质量,减少其哮喘的发作率,值得临床推广应用。

Objective To compare the application value of dyspnea nursing comprehensive score（ BRNCS） and PRAM in nursing intervention of moderate and severe bronchial asthma children. Methods 126 moderate and severe bronchial asthma children in our hospital from January 2012 to February 2014,were randomly divided into observation group and control group,63 cases in each group. Observation group were divided into severe bronchial asthma children（ 8≤PRAM≤12,n = 31） and moderate bronchial asthma children（ 4≤PRAM≤7,n = 32） according to the results of the PRAM,while control group were divided into severe bronchial asthma children（ BRNCS 50,n =33） and moderate bronchial asthma children（ 26≤BRNCS≤50,n = 30） according to BRNCS evaluation results. Children with moderate asthma adopted 1 nurse practitioner and a nurse,and children with severe asthma adopted 1 nurse- in- charge,1 practitioner and a nurse.Daytime and nighttime asthma symptom scores,lung function,1 months asthma occurrence rate and health survey profiles（ SF- 36） score of 2 groups before and after nursing were compared. Results Daytime and nighttime asthma symptom scores,lung function,1 months asthma occurrence rate and SF- 36 score of 2 groups before nursing had no statistical significant differences（ P〉0. 05）. Compared with before treatment,daytime and nighttime asthma symptom scores and 1 month＇s asthma occurrence rates of observation group and control group after nursed with 2 weeks and 4 weeks were lowered,and PEF% Prad,FEV% Pred and other pulmonary function of observation group and control group were increased. Daytime and nighttime asthma symptom scores and 1 month ＇s asthma occurrence rates of observation group after nursed with 2 weeks and 4 weeks were lower than that of the control group while lung function and SF- 36 points were higher than that of the control group,and the difference was statistically significant（ P〈0. 05）. Conclusion PRAM guidance in nurse of children with bronchial asthma could effectively relieve asthma symptoms,improve the pulmonary function and life quality,and reduce the outbreak of the asthma.