循证护理在预防介入治疗动脉导管未闭伴肺动脉高压患儿并发症中的应用

Application of evidence-based nursing in the prevention of the complications of the interventional therapy for patent ductus arteriosus with pulmonary hypertension in children

【目的】探讨动脉导管未闭伴肺动脉高压介入治疗患儿的循证护理效果。【方法】将2015年11月至2017年6月收治的76例动脉导管未闭伴肺动脉高压介入治疗患儿作为研究对象,以2015年11月为时间节点,实施循证护理,通过中国知网、万方数据库寻找护理支持,确定循证护理措施并实施,设为观察组;实施循证护理前患儿给予常规护理,设为对照组,比较两组患儿收缩压、舒张压、肺动脉平均压、并发症发生、患儿及其家属满意度情况。【结果】介入治疗前对照组患儿肺动脉平均压为(21.98±5.81)mm Hg(1 mm Hg=0.1333 k Pa),观察组为(22.01±6.32)mm Hg,两组比较差异无统计学意义,介入治疗后对照组患儿肺动脉平均压为(18.88±3.02)mm Hg,观察组为(16.05±4.98)mm Hg,两组患儿肺动脉平均压均降低,但观察组下降更为理想,差异具有统计学意义(P<0.05)。两组患儿并发症中,对照组封堵器脱落1例,心律失常3例,出血或溶血4例,迷走神经反射6例,合计14例;观察组心律失常2例,出血或溶血1例,迷走神经反射2例,合计5例,两组并发症发生例数比较差异有统计学意义(P<0.05)。两组患儿及其家属满意情况中,观察组满意情况优于对照组,两组比较差异有统计学意义(P<0.05)。【结论】循证护理可有效提高动脉导管未闭伴肺动脉高压介入治疗效果,值得临床推广应用。

[Objective]To investigate the effect of evidence-based nursing on the interventional therapy for patent ductus arteriosus （PDA） with pulmonary hypertension in children. [Methods] A total of 76 children with PDA undergoing interventional therapy for pulmonary hypertension were selected as research subjects from November 2015 to June 2017. The evidence-based nursing started in November 2015 based on CNKI and Wanfang database. Evidence-based nursing measures were determined and implemented. The sick children who received evidence-based nursing were divided into the observation group. Those treated with conventional nursing before the evidence-based nursing were divided into the control group. The systolic pressure, diastolic pressure, mean pulmonary arterial pressure, complications, satisfaction of children and their families between the two groups were compared. [Results] Before the interventional therapy, the mean pulmonary arterial pressure in the control group was （21.98 ± 5.81） mmHg, and that in the observation group was （22.01 ± 6.32） mmHg. The difference between the two groups was not statistically significant （P〉0.05）. After the interventional therapy, the mean pulmonary arterial pressure in the control group was （18.88 ± 3.02） mmHg, and that in the observation group was （16.05± 4.98） mmHg. Both of them decreased, but the decrease in the observation group was more satisfactory. The differencewas statistically significant （P〈0.05）. The values of the results were added at this point. According to the complications in the control group, a total of 14 cases were included： 1 case of occluder removal, 3 cases of arrhythmia, 4 cases of hemorrhage or hemolysis and 6 casesof vagal reflex. There were a total of 5 cases in the observation group, including 2 cases of arrhythmia, 1 case of hemorrhage or hemolysis, and 2 cases of vagal reflex. The difference of the case number between the two groups was statistically significant. The satisfaction status in the children and their families of the observation group was better than thai of the control group, and the difference was statistically significant （P〈O.05）. [Conclusion] Evidence-based nursing can effectively improve the efficacy of interventional therapy for PDA with pulmonary hypertension, and is worthy of clinical application.