白噪声联合改良式护理干预在新生儿经原切口行肠造瘘术后的应用效果

Application Effect of White Noise Combined with Modified Nursing Intervention in Neonatals after Enterostomy through Primary Incision

目的:探究白噪声联合改良式护理干预在新生儿经原切口行肠造瘘术后的应用效果。方法:采用前瞻性非同期对照设计,选取2021年5月—2022年5月广西壮族自治区妇幼保健院50例患儿作为对照组,2022年6月—2023年6月50例患儿作为干预组。对照组采用常规护理方法、更换造口袋方法、伤口护理及非营养性吸吮,干预组在对照组基础上伤口造口专科护理小组指导下采用白噪声联合改良式护理干预,比较两组伤口愈合时间、伤口愈合不良发生情况、伤口换药次数、造口袋更换次数、疼痛程度[汉化版新生儿疼痛、躁动、镇静量表(neonatal pain,agitation and sedation scale,N-PASS)]。结果:干预组伤口愈合时间短于对照组,伤口愈合不良少于对照组,换药次数、造口袋更换次数少于对照组,差异有统计学意义(P<0.05)。两组术后1 d换药时N-PASS评分比较,差异无统计学意义(P>0.05);干预组术后3 d、7 d换药时N-PASS评分低于对照组,差异有统计学意义(P<0.05)。结论:白噪声联合改良式护理干预能缓解患儿操作性疼痛,促进伤口愈合,减少伤口换药次数、造口更换次数及并发症发生。

Objective:To explore the application effect of white noise combined with modified nursing intervention in neonatus after enterostomy through primary incision.Method:A prospective non-concurrent control design was used,fifty children from May 2021 to May 2022 in Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital were selected as the control group,and 50 children from June 2022 to June 2023 were selected as the intervention group.The control group was given routine nursing method,replacement of ostomy bag method,wound nursing and non-nutritive sucking,the intervention group was given white noise combined with modified nursing intervention under the guidance of Wound Ostomy Specialist Nursing Group on the basis of the control group.The wound healing time,incidence of poor wound healing,number of wound dressing changes,number of ostomy bag replacements,and degree of pain[Chinese version of neonatal pain,agitation and sedation scale(N-PASS)]were compared between two groups.Result:The wound healing time of the intervention group was shorter than that of the control group,the poor wound healing was less than that of the control group,the number of wound dressing changes and the number of ostomy bag replacements were less than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the N-PASS score between two groups at 1 d after operation(P>0.05);the N-PASS scores of the intervention group at 3 d and 7 d after operation were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:White noise combined with modified nursing intervention can relieve children's operative pain,promote wound healing,reduce the number of wound dressing changes,the number of stoma replacements and complications.