儿童危重病例评分在肺炎支原体肺炎患儿病情管理中的应用

Application of Critical Case Score in the Management of Children with Mycoplasma Pneumoniae Pneumonia

目的探讨分析儿童危重病例评分在肺炎支原体肺炎患儿病情管理中的应用,从而为提高肺炎支原体肺炎患儿的临床管理质量提供依据。方法选择2020年4月1月-2022年4月30日某院收治的重症MPP患儿139例,根据患儿的入院时间,将2020年4月1日-2021年3月31日入院患儿63例作为对照组,将2021年4月1日-2022年4月30日入院患儿76例作为观察组。对照组采取常规病情管理对策,观察组在对照组基础上给予PICS评分分级下的病情管理对策,比较两组患儿症状、体征消失时间、治疗前后肺功能指标变化及出院时家长对病情治疗管理的满意度。结果观察组患儿咳嗽、啰音、喘憋以及退热时间均显著短于对照组[(7.95±1.63)dvs.(9.82±1.84)d;(4.18±0.83)dvs.(5.47±1.10)d;(2.64±0.72)d vs.(3.81±0.80)d;(4.37±1.15)d vs.(5.21±1.73)d](P<0.05)。治疗前两组患儿肺功能指标FEV1、PEF、FVE比较差异无统计学意义(P>0.05),治疗2周后两组患儿肺功能指标FEV1、PEF、FVE均较治疗前显著升高(P<0.05),且治疗后观察组患儿肺功能指标FEV1、PEF、FVE显著高于对照组[(1.74±0.41)L vs.(1.52±0.33)L;(2.87±0.85)L/mimvs.(2.43±0.76)L/mim;(1.89±0.37)Lvs.(1.64±0.45)L](P<0.05)。观察组患儿家长满意度显著高于对照组(97.37%vs.85.71%)(P<0.05)。结论基于PICS评分系统下的分级管理对策有助于重症肺炎支原体肺炎患儿疾病的管理,缩短疾病病程、改善患儿肺功能,同时可显著提高家长对治疗的满意度,值得临床推广。

Objectives To explore the application of critical case score in the management of children with mycoplasma pneumoniae pneumonia,so as to provide evidence for improving the quality of clinical management of children with mycoplasma pneumoniae pneumonia.Methods A total of 139 children with severe MPP admitted to our hospital from April 1st,2020 to April 30th,2022 were selected.According to the admission time of the children,63 children admitted from April 1st,2020 to March 31st,2021 were selected as the control group,and 76 children admitted from April 1st,2021 to April 30th,2022 were selected as the observation group.The control group took routine disease management measures,and the observation group gave disease management measures under PICS grading on the basis of the control group.The disappearance time of symptoms and signs,changes of pulmonary function indicators before and after treatment,and the satisfaction of parents on the treatment management of the disease were compared between the two groups.Results The cough,rale,dyspnea and antipyretic time of children in the observation group were significantly shorter than those in the control group[(7.95±1.63)d vs.(9.82±1.84)d;(4.18±0.83)d vs.(5.47±1.10)d;(2.64±0.72)d vs.(3.81±0.80)d;(4.37±1.15)d vs.(5.21±1.73)d](P<0.05).Before treatment,there was no significant difference between the two groups in the pulmonary function indicators FEV1,PEF and FVE(P>0.05).After 2 weeks of treatment,the pulmonary function indicators FEV1,PEF and FVE in the two groups were significantly higher than those before treatment(P<0.05),and after treatment,the pulmonary function indicators FEV1,PEF and FVE in the observation group were significantly higher than those in the control group[(1.74±0.41)L vs.(1.52±0.33)L;(2.87±0.85)L/mim vs.(2.43±0.76)L/mim;(1.89±0.37)L vs.(1.64±0.45)L](P<0.05).The satisfaction of parents in the observation group was significantly higher than that in the control group(97.37%vs.85.71%)(P<0.05).Conclusions Hierarchical management strategy based on PICS scoring system was helpful to the management of severe mycoplasma pneumoniae pneumonia in children,shorten the course of disease,improve the pulmonary function of children,and significantly improve the satisfaction of parents with treatment,which was worthy of clinical promotion.