集束化干预在婴幼儿水合氯醛灌肠镇静中的应用研究

The application of cluster intervention in sedation of chloral hydrate enema in infants

目的探究集束化干预在婴幼儿水合氯醛灌肠镇静中应用效果。方法选取2018年12月至2019年6月于大连市儿童医院就诊并采用水合氯醛灌肠镇静的368例0~3岁患儿为研究对象,按序列顺序隔号分组,分为对照组和观察组各184例。对照组在水合氯醛灌肠镇静的同时进行常规护理干预,观察组在水合氯醛灌肠镇静的同时加集束化干预。入院后记录每个患者的基线资料,同时做2组镇静之后的Ramsay镇静评分。根据镇静评分比较2组水合氯醛灌肠镇静失败率。结果观察组灌肠后Ramsay镇静评分为(5.42±1.34)分,对照组为(3.14±1.21)分,2组比较差异有统计学意义(t值为2.08,P<0.05)。观察组水合氯醛灌肠镇静失败25例占13.59%,明显低于对照组的71例占38.59%,差异有统计学意义(χ^2值为29.82,P<0.05)。结论集束化干预有效降低婴幼儿水合氯醛灌肠镇静失败率,并且能够减轻患儿反复灌肠的痛苦,有临床探讨的价值。

Objective To investigate the effect of bundles of care on pediatric hypnosis by rectal chloral hydrate.Method A total of 368 children aged 0 to 3 years old who were treated in Dalian Children′s Hospital from December 2018 to June 2019 and were treated with chloralhydrate enemas were randomly divided into the control group(routine nursing intervention)and observation groups(bundled Intervention)184 cases each.The chloralhydrate enemas were inserted for sedation,and the observation group added sedation while chloralhydrate enemas for sedation.After admission,record the data of each patient,and do the Ramsay sedation score after sedation.According to the sedation score,the sedation failure rate of chloralhydrate enema was increased,and the proportion of each score in the group was compared.Results Ramsay sedation scores of the observation group and the control group after enema were 5.42±1.34 and 3.14±1.21,respectively.There was significant difference between the two groups(t value was 2.08,P<0.05).The failure rates in experimental group and control group were 13.59%(25/184)and 38.59%(71/184),respectively.There was a significant difference between two groups(χ^2 value was 29.82,P<0.05).Conclusion Bundles of care could decrease the failure rate of rectal chloral hydrate hypnosis significantly,then reduce the suffering of children.It is worth being widely used in clinic.