游戏护理模式在内窥镜下扁桃体切除术患儿中的应用效果

The Effect of Playing Nursing Mode in the Perioperative Period of Children Undergoing Endoscopic Tonsillectomy

目的探讨游戏护理模式在内窥镜下扁桃体切除术患儿围手术期中的应用效果。方法选取2020年6月—2021年6月厦门大学附属第一医院年龄7~14岁的内窥镜下扁桃体切除术患儿120例为研究对象,根据随机数字表分为游戏组(n=60)与对照组(n=60)。对照组围手术期行常规护理干预,游戏组在对照组基础上采用游戏护理模式对患儿进行护理干预。比较两组患儿的不良情绪、治疗依从性、围手术期应激反应及预后情况。结果游戏组遵医行为评分高于对照组(P<0.05);而游戏组干预后儿童焦虑性情绪障碍筛查表(screen for child anxiety related emotional disorders,SCARED)评分、儿童抑郁障碍自评量表(self-rating scale for depressive disorder in childhood,DSRSC)评分较对照组明显下降(P<0.05)。游戏组气管插管时(T1)、插管后5 min(T2)、拔管时(T3)收缩压(systolic blood pressure,SBP)、舒张压(Diastolic blood pressure,DBP)、心率、血肾上腺素(blood Adrenaline,AD)、皮质醇(cortisol,CORT)与麻醉诱导前(T0)比较,差异无统计学意义(P>0.05),而对照组T1~T3时段SBP、DBP、心率、AD、CORT水平较T0显著升高(P<0.05),且对照组T1~T3时段SBP、DBP、心率、AD、CORT水平高于游戏组(P<0.05)。游戏组麻醉苏醒时间、住院时间短于对照组(P<0.05),而游戏组术后脸谱疼痛评分(faces pain scalerevised,FACES)、临床症状总评分低于对照组(P<0.05),而患儿家属治疗满意度评分高于对照组(P<0.05)。结论采用游戏护理模式不仅有助于内窥镜下扁桃体切除术患儿围手术期不良情绪的管理,还能够减轻患儿的应激反应,提高其治疗依从性,进而改善预后,促进康复。

Objective To explore the effect of playing nursing mode in the perioperative period of children undergoing endoscopic tonsillectomy.Methods A total of 120 cases of children aged 7 to 14 years of endoscopic adenoidectomy were selected as the research objects from June 2020 to June 2021.The patients were divided into game care groups according to a random number table(n=60)and control group(n=60).The control group was received with routine nursing intervention during the perioperative period.The game care group was received with game nursing model on the basis of the control group.The levels of perform nursing intervention,stress response and prognosis during operation of two groups was compared.Results The compliance behavior score of game care group were higher than control group(P<0.05),while the scores of anxiety mood disorder screening form(SCARED)and self-rating scale for depressive disorder in childhood(DSRSC)scores of game care group were lower than control group after intervention(P<0.05).The levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate,blood adrenaline(AD),cortisol(CORT)of game care group,during tracheal intubation(T1),5 minutes after intubation(T2),and extubation(T3)of game care group compared than before induction of anesthesia(T0)were not significant difference(P>0.05),while the levels of SBP,DBP,heart rate,AD,and CORT of control group during T1-T3 were significantly higher than T0(P<0.05),and the levels of SBP,DBP,heart rate,AD,and CORT of control groups after T1-T3 were higher than game care group(P<0.05).The levels of recovery time from anesthesia,postoperative tracheal removal time,and hospital stay of game care group were shorter than control group(P<0.05),while the faces pain scale-revised(FACES)and total clinical symptoms score of game care group were lower than control group(P<0.05).The treatment satisfaction scores of family members of game care group were higher than control group(P<0.05).Conclusion The play nursing mode can reduce the stress response and bad mood of children undergoing endoscopic adenoidectomy,improve their compliance with treatment,improve the prognosis of children,promote postoperative recovery of children,and improve the treatment of children’s families Satisfaction.