PICU小儿重症肺炎应用层级链式护理的效果研究

The nursing effects of hierarchical chain nursing mode for the children with severe pneumonia in PICU

目的探讨儿科重症监护病房(pediatric intensive care unit,PICU)小儿重症肺炎应用层级链式护理的效果。方法选择PICU收治的60例小儿重症肺炎患儿(2017年8月至2018年8月),随机划分患儿为2组各30例,对照组施行常规护理,观察组施行层级链式护理,比较两组患儿症状及体征改善情况、患儿血气分析指标、家属疾病不确定感评分、家属不良情绪评分、家属满意度。结果观察组患儿的发热消退时间、咳嗽缓解时间、肺啰音消失时间均较对照组缩短(P均<0.05)。护理后,2组患儿的,PaO2、PaCO2均较护理前改善,而观察组的PaO2较对照组更高,其PaCO2较对照组更低(P均<0.05)。护理后,2组家属的疾病不确定感、SAS、SDS评分均较护理前降低,而观察组家属各项评分均较对照组更低(P均<0.05)。家属总满意率观察组为96.67%,高于对照组80.00%(P<0.05)。结论层级链式护理可确保PICU重症肺炎患儿的治疗效果,加快患儿症状及体征缓解速度,改善其动脉血气状况,还可减轻其家属疾病不确定感和不良情绪,提高家属对PICU护理服务的满意度。

Objective To investigate the nursing effects of hierarchical chain nursing mode for the children with severe pneumonia in pediatric intensive care unit(PICU).Methods A total of 60 patients with infantile severe pneumonia who were admitted and treated in PICU from August 2017 to August 2018 were enrolled,who were randomly divided in to two groups with 30cases in each group.The patients in control group were treated by routine nursing,however,the patients in observation group were treated by hierarchical chain nursing.The improvement of status symptoms and signs,blood gas analysis indexes,uncertainty scores of family members,bad emotion score of family members and satisfaction degree of family members were observed and compared between the two groups.Results The fever regression time,cough relief time and lung rale disappearance time in observation group were significantly shorter than those in control group(P<0.05).After nursing,and PaO2 and PaCO2 in both groups were improved,as compared with those before nursing,moreover,the PaO2 levels in observation group were significantly higher than those in control group,however,the PaCO2 levels in observation group were significantly lower than those in control group(P<0.05).After nursing,the uncertainty scores of family members,SAS and SDS scores in both groups were significantly lower than those before nursing,moreover,which in observation group were significantly lower than those in control group(P<0.05).In addition the total satisfaction rate of family members in the observation group was 96.67%,which was significantly higher than that(80.00%)in control group(P<0.05).Conclusion Hierarchical chain nursing can ensure the therapeutic effects for the patients with infantile severe pneumonia in PICU,which can speed up the alleviation of symptoms and signs,improve the arterial blood gas status of patients,reduce the uncertainty and bad emotion of patients’family members,and improve the satisfaction degree of family members with PICU nursing service.