品管圈气道管理联合临床护理路径干预在重症肺炎患儿中的应用观察

Application observation of quality control circle airway management combined with clinical nursing pathway intervention in children with severe pneumonia

目的探讨品管圈(QCC)气道管理联合临床护理路径(CNP)干预在重症肺炎患儿中的应用效果。方法回顾性分析2019年6月至2021年6月郑州大学附属儿童医院收治的88例重症肺炎患儿的临床资料,依照护理方式不同将其分为对照组[女21例,男23例;病程(3.59±0.21)d;年龄(5.31±1.05)岁]和观察组[女20例,男24例;病程(3.56±0.24)d;年龄(5.34±1.03)岁],每组均为44例。对照组采取常规干预,观察组在此基础上实施QCC气道管理联合CNP干预,干预至患儿出院。比较两组临床症状缓解时间、血清炎症因子水平和家属满意度。计量资料用独立样本t检验,计数资料用χ^(2)检验。结果观察组咳嗽缓解时间(5.68±1.02)d、喘憋缓解时间(3.38±0.52)d、肺啰音缓解时间(4.39±0.49)d,均短于对照组的(7.16±1.23)d、(4.67±0.79)d、(6.45±1.12)d,干预后血清C反应蛋白(CRP)(3.62±0.51)mg/L、白细胞介素-6(IL-6)(6.05±1.04)μg/ml、肿瘤坏死因子α(TNF-α)水平(9.35±2.10)μg/L,均低于对照组的(5.49±1.02)mg/L、(11.05±2.29)μg/ml、(12.97±2.17)μg/L,护理满意度为95.45%(42/44),高于对照组的81.82%(36/44),差异均有统计学意义(均P<0.05)。结论QCC气道管理联合CNP干预能够缩短重症肺炎患儿临床症状改善时间,降低炎性反应,从而提高护理满意度。

Objective To explore the application effect of quality control circle(QCC)airway management combined with clinical nursing pathway(CNP)intervention in children with severe pneumonia.Methods The clinical data of 88 children with severe pneumonia treated in Children's Hospital Affiliated to Zhengzhou University from June 2019 to June 2021 were analyzed retrospectively.According to different nursing methods,they were divided into a control group and an observation group,with 44 cases in each group.In the control group,there were 21 females and 23 males,the course of disease was(3.59±0.21)d,and the age was(5.31±1.05)years old;in the observation group,there were 20 females and 24 males,the course of disease was(3.56±0.24)d,and the age was(5.34±1.03)years old.The control group took routine intervention,and the observation group took QCC airway management combined with CNP intervention on this basis until the children were discharged from hospital.The clinical symptom relief time,serum inflammatory factors levels,and family satisfaction degree were compared between the two groups.The measurement data were tested by independent sample t test and the count data were tested byχ^(2)test.Results The cough relief time[(5.68±1.02)d],asthma relief time[(3.38±0.52)d],lung rales relief time[(4.39±0.49)d]in the observation group were shorter than those in the control group[(7.16±1.23)d,(4.67±0.79)d,and(6.45±1.12)d],the serum levels of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor(TNF)-αafter intervention were(3.62±0.51)mg/L,(6.05±1.04)μg/ml,and(9.35±2.10)μg/L,which were lower than those in the control group[(5.49±1.02)mg/L,(11.05±2.29)μg/ml,and(12.97±2.17)μg/L],and the nursing satisfaction was 95.45%(42/44),which was higher than that in the control group[81.82%(36/44)],with statistically significant differences(all P<0.05).Conclusion QCC airway management combined with CNP intervention can shorten the improvement time of clinical symptoms in children with severe pneumonia,and reduce the inflammatory reaction,so as to improve the nursing satisfaction.