综合护理联合层级链式护理在重症肺炎并发呼吸衰竭患儿中的应用效果

Application effect of comprehensive nursing combined with hierarchical chain nursing in the children with severe pneumonia complicated with respiratory failure

目的 分析综合护理联合层级链式护理在重症肺炎并发呼吸衰竭患儿中的应用效果。方法 回顾性分析2019年1月至2020年12月南华大学附属第二医院收治的90例重症肺炎并发呼吸衰竭患儿的临床资料,将接受综合护理的45例患儿纳入对照组,接受综合护理联合层级链式护理的45例患儿纳入观察组。比较2组患儿的临床症状缓解情况、肺功能和生活质量。结果 观察组的呼吸困难缓解、发绀消失、肺部啰音消失和心率恢复时间均早于对照组(P均<0.05)。干预1周及2周后,2组的最大呼气流量、最大通气量和用力肺活量均大于干预前(P均<0.05),且观察组均大于同期对照组(P均<0.05);干预2周后,2组的上述指标均大于干预1周后(P均<0.05)。干预2周后,2组的儿童生活质量量表4.0(PedsQL4.0)各领域评分均高于干预前(P均<0.05),且观察组均高于对照组(P均<0.05)。结论 将综合护理联合层级链式护理应用于重症肺炎并发呼吸衰竭患儿,可促进其临床症状消退,改善其肺功能和生活质量。

Objective To analyze the application effect of comprehensive nursing combined with hierarchical chain nursing in the children with severe pneumonia complicated with respiratory failure.Methods The clinical data of 90 children with severe pneumonia complicated with respiratory failure treated in the Second Hospital,University of South China from January 2019 to December 2020 were retrospectively analyzed.The 45 children receiving comprehensive nursing were included in the control group,and the 45 children receiving comprehensive nursing combined with hierarchical chain nursing were included in the observation group.The clinical symptom relief,pulmonary function,and quality of life were compared between the two groups.Results The time of dyspnea relief,cyanosis disappearance,pulmonary rale disappearance,and heart rate recovery in the observation group was earlier than that in the control group(all P<0.05).After 1 and 2 weeks of intervention,the maximal expiratory flow,maximal voluntary ventilation,and forced vital capacity of the two groups were greater than those before the intervention(all P<0.05),and the above indicators of the observation group were greater than those of the control group(all P<0.05).After 2 weeks of intervention,the above indicators of the two groups were greater than those after 1 week of intervention(all P<0.05).After 2 weeks of intervention,the scores of various domains of pediatric quality of life inventory 4.0(PedsQL4.0)in the two groups were higher than those before the intervention(all P<0.05),and the scores of the observation group were higher than those of the control group(all P<0.05).Conclusion The application of comprehensive nursing combined with hierarchical chain nursing in children with severe pneumonia complicated with respiratory failure can promote the relief of clinical symptoms and improve the pulmonary function and quality of life.