基于多元化康复理念的预见性干预在小儿鼾症伴腺样体面容围术期护理中的应用

Application of Predictive Intervention Based on Diversified Rehabilitation Concept in Perioperative Nursing of Snoring in Children with Adenoid Facies

目的:探究基于多元化康复理念的预见性干预在小儿鼾症伴腺样体面容围术期护理中的应用效果。方法:选取笔者医院2019年8月-2022年12月收治的80例小儿鼾症伴腺样体面容患儿,按照随机对照法分为对照组和实验组,各40例。对照组采用常规护理,实验组采用常规护理+基于多元化康复理念的预见性干预护理。比较两组术后疼痛程度[视觉模拟评分法(Visual analogue scale,VAS)]、负性情绪[综合性医院焦虑抑郁量表(Hospital anxiety and depression scale,HADS)]、自护能力[自我护理能力测定量表(Exercise of self-care agency scale,ESCA)]、睡眠监测[呼吸暂停低通气指数(Apnea hypopnea index,AHI)、最低血氧饱和度(Lowest oxygen saturation,LSaO_(2))]、生活质量[儿童阻塞性睡眠呼吸暂停疾病特异性生活质量调查表(OSA-18量表)]、不良事件发生情况及护理满意度。结果:术后2、3、7、28 d,实验组VAS评分均低于对照组(P<0.05);术后28 d,实验组HAD(a)、HAD(d)、OSA-18评分及AHI低于对照组(P<0.05);实验组ESCA评分、LSaO_(2)及护理满意度高于对照组(P<0.05);干预期间,实验组不良事件发生率为10.00%,低于对照组的27.50%(P<0.05)。结论:基于多元化康复理念的预见性干预能显著改善小儿鼾症患儿围术期心理负性情绪,缓解术后疼痛,增强预后自护能力,提高预后睡眠质量及生活质量。

Objective To explore the application effect of predictive intervention based on diversified rehabilitation concept in perioperative nursing of snoring in children with adenoid facies.Methods 80 snoring in children with adenoid facies in the author's hospital from August 2019 to December 2022 were selected and divided into control group and experimental group according to randomized control method,with 40 cases in each group.The control group received routine nursing,and the experimental group was given routine nursing+predictive intervention nursing based on diversified rehabilitation concept.Pain degree[visual analogue scale(VAS)]at 1 day,2 days,3 days and 7 days after surgery and after intervention,negative emotions[hospital anxiety and depression scale(HADS)],self-care ability[exercise of self-care agency scale(ESCA)]and sleep monitoring[apnea hypopnea index(AHI),lowest oxygen saturation(LSaO_(2))]before and after intervention and quality of life[disease specific quality of for children with obstructive sleep apnea 18-item survey(OSA-18)]after intervention were compared.The adverse events during intervention were analyzed and the nursing satisfaction was compared between the two groups after intervention.Results The VAS scores of the experimental group were lower than those of the control group at 2,3,7,and 28 days after operation(P<0.05).At 28 days after operation,the HAD(a),HAD(d),OSA-18 scores and AHI of the experimental group were lower than those of the control group(P<0.05).The ESCA score,LSaO_(2) and nursing satisfaction of the experimental group were higher than those of the control group(P<0.05).During the intervention period,the incidence of adverse events in the experimental group was 10.00%,which was lower than 27.50%in the control group(P<0.05).Conclusion Predictive intervention based on diversified rehabilitation concept can significantly improve the perioperative psychological negative emotions,relieve the postoperative pain,enhance the self-care ability and improve the sleep quality and quality of life in children with snoring.