风险预防式护理对肺炎患儿临床疗效及康复效果的影响

The effect of risk preventive nursing on clinical curative effect and rehabilitation in children with pneumonia

目的观察风险预防式护理在小儿肺炎中的临床应用效果及对患儿康复的影响.方法选择2016年3月至2017年3月在山西省孝义市人民医院接受治疗的肺炎患儿100例,其中2016年3月1日至8月1日就诊的45例肺炎患儿采用常规护理方式(常规护理组),2016年8月2日至2017年3月1日就诊的55例肺炎患儿采用风险预防式护理(风险预防组).采用酶联免疫吸附试验(ELISA)检测两组患儿入院和出院时肿瘤坏死因子-α(TNF-α)、白细胞介素(IL-6、IL-8)的水平;观察两组患儿临床症状消失时间、康复效果、住院时间、家属满意度及并发症发生率.结果两组患儿入院时血清TNF-α、IL-6及IL-8水平比较差异均无统计学意义(均P>0.05);出院时两组炎症因子水平均较入院时明显降低,且风险预防组的降低程度较常规护理组更显著〔TNF-α(μg/L):16.54±7.13比22.78±9.12,IL-6(ng/L):9.25±5.48比15.11±7.01,IL-8(μg/L):4.08±2.16比7.69±3.56,均P<0.05〕.风险预防组患儿临床症状消失时间、住院时间明显短于常规护理组〔止咳时间(d):6.87±2.54比10.35±3.08,啰音消失时间(d):7.01±2.13比10.87±3.25,体温恢复时间(d):6.25±2.64比8.76±3.58,憋喘缓解时间(d):7.59±3.17比10.26±3.26,住院时间(d):8.16±1.86比13.25±3.64,均P<0.05〕.风险预防组患儿家属满意度显著高于常规护理组〔96.36%(53/55)比84.44%(38/45),P<0.05〕.风险预防组患儿治疗总有效率明显高于常规护理组〔94.54%(52/55)比77.78%(35/45),P<0.05〕.风险预防组患儿并发症发生率显著低于常规护理组〔5.45%(3/55)比46.67%(21/45),P<0.05〕.结论风险预防式护理能降低小儿肺炎的炎症反应,降低风险事件的发生,提高家属对护理的满意度,加速患儿康复进程.

Objective To study the clinical application effect of risk preventive nursing on children with pneumonia and their rehabilitation. Methods One hundred children with pneumonia admitted to Xiaoyi People's Hospital from March 2016 to March 2017 for treatment were enrolled. Among them, 45 cases from March the 1st to August the 1st in 2016 were treated with conventional nursing (conventional nursing group), while 55 cases from August the 2nd, 2016 to March the 1st, 2017 were taken cared by the risk prevention nursing (risk prevention group). The levels of tumor necrosis factor-α(TNF-α), interleukins (IL-6, IL-8) were examined on admission and discharge in the two groups by enzyme-linked immunosorbent assay (ELISA);the time length for clinical symptoms to disappear, rehabilitation effect, hospitalization time, family members' satisfaction and incidence of complications were observed in the two groups. Results No statistically significant differences were detected in serum TNF-α, IL-6 and IL-8 levels between the two groups before nursing (all P > 0.05).The levels of inflammatory factors at discharge in both groups were lower than those at admission, the levels of TNF-α, IL-6 and IL-8 in the children of risk prevention group were significantly lower than those in the conventional nursing group discharge [TNF-α(μg/L): 16.54±7.13 vs. 22.78±9.12, IL-6 (ng/L): 9.25±5.48 vs. 15.11±7.01, IL-8 (μg/L): 4.08±2.16 vs. 7.69±3.56, all P < 0.05]. The duration for clinical symptoms to disappear and duration of hospital stay in the risk prevention group were significantly shorter than those in the conventional nursing group [cough stopping time (days): 6.87±2.54 vs. 10.35±3.08, duration of rale disappearance (days): 7.01±2.13 vs. 10.87±3.25, fever recovery time (days): 6.25±2.64 vs. 8.76±3.58, duration of asthma relief (days): 7.59±3.17 vs. 10.26±3.26, duration of hospital stay (days): 8.16±1.86 vs. 13.25±3.64, all P < 0.05]. The total effective rate and family members' satisfaction in the risk prevention group were significantly higher than those in the conventional nursing group [total effective rate: 94.54%(52/55) vs. 77.78%(35/45), family members' satisfaction: 96.36%(53/55) vs. 84.44%(38/45), both P < 0.05]. The incidence of complications in the risk prevention group was obviously lower than that in the conventional nursing group [5.45%(3/55) vs. 46.67%(21/45), P < 0.05]. Conclusion Risk prevention nursing can reduce the incidence of inflammatory reaction, improve the family members' satisfaction with nursing, and promote the children recovery process.