纤维支气管镜肺泡灌洗治疗重症肺炎患儿的镇静干预研究

Effects of fiberoptic bronchoscopic alveolar lavage technique combined with targeted sedation intervention on treatment compliance and vital signs in children with severe pneumonia

目的探究纤维支气管镜肺泡灌洗技术联合目标性镇静干预对重症肺炎患儿治疗依从性及生命体征的影响。方法以2018年1月~2019年12月我院儿科收治的200例重症肺炎患儿为研究对象,通过随机数字表法分为观察组(n=100)、对照组(n=100)。两组均行纤维支气管镜肺泡灌洗技术治疗,对照组进行常规镇静护理,观察组在对照组基础上接受目标性镇静干预。比较两组术中患儿依从性、不良反应,手术开始前(T1)、支气管镜进入声门时(T2)、吸出痰液时(T3)以及手术结束时(T4)Ramsay镇静评分及生命体征,术后家属满意度。结果观察组术中患儿依从率以及术后家长满意率分别为92.00%和94.00%,均显著高于对照组(69.00%,73.00%,P<0.05)。与T1时比较,T2时观察组Ramsay镇静评分显著升高,而对照组则显著下降,观察组高于对照组;T3时,两组Ramsay镇静评分较T1时均显著升高,且观察组高于对照组;T4时两组Ramsay镇静评分较T1时均显著降低,且观察组高于对照组(P<0.05);与T1时比较,T2、T3以及T4时,两组心率和呼吸频率均显著升高,而观察组低于对照组;SpO2水平均显著下降,观察组高于对照组(P<0.05)。术中,观察组喉痉挛、烦躁、呼吸抑制、发绀发生率,显著低于对照组(P<0.05)。结论纤维支气管镜肺泡灌洗技术联合目标性镇静干预可提高重症肺炎患儿术中依从性,提高镇静效果及生命体征稳定性,同时不良反应发生率较低,提高家属满意度。

Objective To explore the effect of fiberoptic bronchoscopic alveolar lavage technique combined with targeted sedation intervention on treatment compliance and vital signs in children with severe pneumonia.Methods 200 children with severe pneumonia admitted to our hospital from January 2018 to December 2019 were divided into the observation group(n=100)and the control group(n=100)by random number table method.Both groups were treated with fiberoptic bronchoscopic alveolar lavage technique.The control group received routine sedation care.The observation group received targeted sedation intervention based on the control group.The compliance and adverse reactions during the operation,the Ramsay sedation score and vital signs at the start of the operation(T1),the bronchoscope entered the glottis(T2),the sputum was aspirated(T3),and at the end of the operation(T4),family satisfaction after surgery between the two groups were compared.Results The compliance rate of children in the observation group during the operation and the satisfaction rate of the parents after the operation were 92.00%and 94.00%,which were significantly higher than those in the control group(69.00%,73.00%,P<0.05).Compared with T1,the observation group Ramsay sedation score was significantly increased at T2,while the control group was significantly decreased,the observation group was higher than the control group;at T3,both groups Ramsay sedation score was significantly higher than T1,and the observation group was higher in the control group;the Ramsay sedation scores of the two groups at T4 were significantly lower than those at T1,and the observation group was higher than the control group(P<0.05).At T2,T3,and T4,the heart rate and respiratory rate of the two groups Compared with T1,the observation group was significantly increased,and the observation group was lower than the control group;SpO2 level was significantly decreased,the observation group was higher than the control group(P<0.05).During the operation,the incidence of laryngospasm,irritability,respiratory depression and cyanosis in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Fiberoptic bronchoscopic alveolar lavage technique combined with targeted sedation intervention can improve the compliance of intervention in children with severe pneumonia,improve the sedation effect and stability of vital signs,reduce the incidence of adverse reactions,and improved family satisfaction。