治疗性沟通模式用于发育性髋关节脱位术后患儿Ⅲ~Ⅳ级会阴部肿胀的护理研究

Clinical study of a therapeutic communication model onⅢ~Ⅳgrade perineal swelling in children with developmental dislocation of hip

目的观察治疗性沟通模式用于发育性髋关节脱位术后患儿Ⅲ~Ⅳ级会阴部肿胀的护理研究。方法选取2016年1月至2020年10月经解放军总医院小儿外科诊断为发育性髋关节脱位并接受手术治疗的患儿428例,术后发生Ⅲ~Ⅳ级会阴部肿胀患儿138例。根据随机数字法进行分组,对照组给予常规护理干预,观察组给予以治疗性沟通模式为主的护理干预。比较2组总有效率、水肿消退时间、疼痛消失时间及患儿家长满意度,记录2组干预前、干预24 h、48 h、72 h后面部疼痛评分的变化。结果观察组会阴水肿消退有效率高达92.8%(64/69),高于对照组的81.2%(56/64),水肿消退时间(3.8±1.1)d、疼痛消失时间(2.8±0.9)d短于对照组的(5.1±1.7)d、(3.8±1.2)d,差异有统计学意义(P<0.05)。干预前,2组面部疼痛评分比较,差异无统计学意义(P>0.05)。干预24 h、48 h、72 h后,2组面部疼痛评分均较干预前下降(P<0.05),且观察组干预后各时间点面部疼痛评分低于对照组(P<0.05)。观察组干预后患儿家长满意度高达95.6%,高于对照组的84.1%,差异有统计学意义(P<0.05)。结论治疗性沟通模式为主的护理干预用于发育性髋关节脱位术后患儿Ⅲ~Ⅳ级会阴部肿胀可有效缩短水肿消退和疼痛消失时间,提高患儿家长满意度,减轻术后患儿痛苦。

Objective A therapeutic communication model was observed for the nursing study of gradeⅢ~Ⅳperineal swelling in children with developmental dislocation of hip.Methods A total of 138 cases ofⅢ~Ⅳgrade perineum swelling occurred after operation were selected from 428 cases of children with developmental hip dislocation diagnosed by pediatric surgery in PLA General Hospital from January 2016 to October 2020.According to the random number method,these 138 cases were divided into control group and observation group.The control group was given routine nursing intervention,and the observation group was given therapeutic communication mode.The total effective rate,edema regression time,pain disappearance time and the patients′satisfaction were compared,and the changes of pain score before and after intervention 24 h,48 h,72 h were recorded.Results The effective rate of perineal edema regression in the observation group was 92.8%(64/69),which was higher than 81.2%(56/64)in the control group,the time of edema regression(3.8±1.1)d,the time of pain disappearance(2.81±0.93)d shorter than that in the control group(5.1±1.7)d,(3.8±1.2)d.Before intervention,there was no significant difference in facial pain score between the two groups(P>0.05).The scores of facial pain in the two groups decreased after 24 h,48 h,72 h of intervention(P<0.05),and the scores of facial pain in the observation group were lower than those in the control group(P<0.05).Conclusion Nursing intervention based on therapeutic communication mode can effectively shorten the time of edema regression and pain disappearance,improve the satisfaction of parents and alleviate the pain of children after developmental dislocation of hip.