Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiologica...Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiological problems in newborns. Excessive protein expenditure when exposed to pain for a long time, electrolyte inhalation, weakening of the immune system. Even repetitive painful procedures increase mortality and morbidity. Children experience pain due to acute onset diseases such as otitis media or pharyngitis and also in different medical interventions such vaccination, blood transfusion, vascular access, dressing change, lumber punching, or sickle cell anemia. Appropriate assessment scales should be used to treat pain effectively and adequately. Pharmacological treatment as well as non-pharmacological treatment methods has been found to be effective in the treatment of pain. Non-pharmacological methods allow your body to release natural endorphins and help to lift the pain to a minimum level or completely. In this study, current approaches and studies about pain in children will be presented. Non-pharmacological methods will be examined in more detail. Every child has right to live a painless life. It is one of the main purposes of nursing care to relieve children’s pain and improve their life quality.展开更多
Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in th...Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .展开更多
BACKGROUND Acute lung injury(ALI)after liver transplantation(LT)may lead to acute respiratory distress syndrome,which is associated with adverse postoperative outcomes,such as prolonged hospital stay,high morbidity,an...BACKGROUND Acute lung injury(ALI)after liver transplantation(LT)may lead to acute respiratory distress syndrome,which is associated with adverse postoperative outcomes,such as prolonged hospital stay,high morbidity,and mortality.Therefore,it is vital to maintain hemodynamic stability and optimize fluid management.However,few studies have reported cardiac output-guided(CO-G)management in pediatric LT.AIM To investigate the effect of CO-G hemodynamic management on early postoperative ALI and hemodynamic stability during pediatric living donor LT.METHODS A total of 130 pediatric patients scheduled for elective living donor LT were enrolled as study participants and were assigned to the control group(65 cases)and CO-G group(65 cases).In the CO-G group,CO was considered the target for hemodynamic management.In the control group,hemodynamic management was based on usual perioperative care guided by central venous pressure,continuous invasive arterial pressure,urinary volume,etc.The primary outcome was early postoperative ALI.Secondary outcomes included other early postoperative pulmonary complications,readmission to the intense care unit(ICU)for pulmonary complications,ICU stay,hospital stay,and in-hospital mortality.RESULTS The incidence of early postoperative ALI was 27.7%in the CO-G group,which was significantly lower than that in the control group(44.6%)(P<0.05).During the surgery,the incidence of postreperfusion syndrome was lower in the CO-G group(P<0.05).The level of intraoperative positive fluid transfusions was lower and the rate of dobutamine use before portal vein opening was higher,while the usage and dosage of epinephrine during portal vein opening and vasoactive inotropic score after portal vein opening were lower in the CO-G group(P<0.05).Compared to the control group,serum inflammatory factors(interleukin-6 and tumor necrosis factor-α),cardiac troponin I,and N-terminal pro-brain natriuretic peptide were lower in the CO-G group after the operation(P<0.05).CONCLUSION CO-G hemodynamic management in pediatric living-donor LT decreases the incidence of early postoperative ALI due to hemodynamic stability through optimized fluid management and appropriate administration of vasopressors and inotropes.展开更多
Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-yea...Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.展开更多
目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)...目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)进行问卷调查,分析其影响路径。结果患儿AAMR适应行为量表得分(84.87±9.16)分,FaMM量表得分(188.77±19.01)分,C-ACT得分(15.20±4.66)分。Pearson相关分析结果显示,适应性行为分别与家庭管理、哮喘控制呈正相关关系(r=0.580、0.219,P<0.05),家庭管理与哮喘控制呈正相关关系(r=0.401,P<0.05)。结构方程模型结果表明,家庭管理在哮喘患儿适应性行为和哮喘控制有部分中介调节作用,效应占比为45.95%。结论儿童行为特点能够通过家庭管理方式对患儿哮喘控制水平产生影响,临床护理人员应重视对患儿家属的健康教育管理,提升家属对疾病的认知度及家庭管理能力,以改善患儿的行为方式,达到有效控制患儿疾病的目的。展开更多
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在儿童复杂阑尾炎围手术期的应用效果。方法选取2020年1月至2023年1月于泉州市儿童医院行腹腔镜手术的复杂阑尾炎患儿248例,根据随机数字表法将其分为对照组和ERAS组,每组各...目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在儿童复杂阑尾炎围手术期的应用效果。方法选取2020年1月至2023年1月于泉州市儿童医院行腹腔镜手术的复杂阑尾炎患儿248例,根据随机数字表法将其分为对照组和ERAS组,每组各124例。两组患儿均行腹腔镜阑尾切除术,对照组患儿围手术期施行传统治疗方案,ERAS组患儿采用基于ERAS理念的治疗方案。比较两组患儿的术后首次排气/排便时间、住院时间、视觉模拟评分法(visual analogue scale,VAS)评分、术后并发症发生情况及住院满意度。结果ERAS组患儿的术后首次排气/排便时间、住院时间均明显短于对照组,术后并发症总发生率、术后VAS评分均显著低于对照组,住院满意度显著优于对照组(P<0.05)。结论儿童复杂阑尾炎围手术期实施ERAS措施,可促进患儿术后早期康复,同时减轻术后疼痛,降低并发症发生率,提高住院满意度,值得临床推广应用。展开更多
目的探讨妇幼健康信息化在高危孕产妇管理工作中的应用效果。方法选取2019年1—12月深圳市南山区妇幼保健院实施常规管理的100例高危孕产妇作为对照组,选取2020年1—12月深圳市南山区妇幼保健院实施妇幼健康信息化管理的100例高危孕产...目的探讨妇幼健康信息化在高危孕产妇管理工作中的应用效果。方法选取2019年1—12月深圳市南山区妇幼保健院实施常规管理的100例高危孕产妇作为对照组,选取2020年1—12月深圳市南山区妇幼保健院实施妇幼健康信息化管理的100例高危孕产妇中作为研究组。对比2组管理效果。结果研究组登记建档率、产检次数高于对照组,胎儿宫内窘迫、新生儿窒息发生率低于对照组(P<0.05)。研究组产妇急性事件总发生率为4.00%,低于对照组的15.00%(P<0.05)。管理后,研究组遵医嘱依从性(遵医嘱服药、科学运动、合理饮食、规律作息、自我管理)评分高于对照组,焦虑自评量表评分(self-rating anxiety scale,SAS)低于对照组(P<0.05)。出院时,研究组满意度(主动服务、健康宣教、交流能力、操作水平、环境评估)评分高于对照组(P<0.05)。管理后,研究组健康调查简表(the MOS item short fromhealth survey,SF-36)评分高于对照组(P<0.05)。结论高危孕产妇管理中使用妇幼健康信息化技术有利于提高管理效果,预防产妇急性事件的发生,改善产妇不良情绪,提高其遵医嘱依从性和生活质量,提高产妇对护理服务的满意度。展开更多
目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上...目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上海交通大学医学院附属儿童医院呼吸科收治的67例0~6岁喘息性疾病患儿,按照随机数字表分为观察组33例和对照组34例,其中失访3例,最终每组32例。观察组采用基于EMS管理模式的延续性护理,对照组给予常规护理和出院电话随访。2组患儿出院后1、3、6个月随访评估儿童呼吸和哮喘测试(Test for Respiratory and Asthma Control in Kids,TRACK)结果、喘息复发情况;出院后6个月随访采用支气管哮喘用药依从性评分表(Medication Adherence Report Scale for Asthma,MARS-A)和护理工作满意度调查表评估用药依从性及护理工作满意度。结果·2组患儿人口学特征及临床基线特征差异无统计学意义。重复测量方差分析结果显示,时间、组别、组别×时间的交互作用对TRACK总分的影响均有统计学意义;出院后1、3、6个月,观察组TRACK总分均显著高于对照组(均P=0.000);2组患儿TRACK总分均随时间推移逐渐上升(P=0.000)。观察组1、3、6个月随访发现喘息复发率分别为25.0%、18.7%、9.4%,均显著低于对照组(分别为50.0%、43.7%、31.3%,均P<0.05);广义估计方程分析显示组间比较差异有统计学意义(P=0.013),观察组干预效果优于对照组(OR=0.292)。出院后6个月观察组MARS-A得分为(4.519±0.395)分,显著高于对照组[(3.994±0.739)分,P=0.001]。护理工作满意度调查结果显示,观察组显著高于对照组(P=0.000)。患儿MARS-A得分与护理工作满意度呈中度正相关(r=0.389,P=0.001)。结论·基于EMS管理模式的延续性护理可显著提高学龄前喘息性疾病儿童的用药依从性和喘息控制水平,明显降低喘息复发率,以及提高护理工作满意度。展开更多
文摘Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiological problems in newborns. Excessive protein expenditure when exposed to pain for a long time, electrolyte inhalation, weakening of the immune system. Even repetitive painful procedures increase mortality and morbidity. Children experience pain due to acute onset diseases such as otitis media or pharyngitis and also in different medical interventions such vaccination, blood transfusion, vascular access, dressing change, lumber punching, or sickle cell anemia. Appropriate assessment scales should be used to treat pain effectively and adequately. Pharmacological treatment as well as non-pharmacological treatment methods has been found to be effective in the treatment of pain. Non-pharmacological methods allow your body to release natural endorphins and help to lift the pain to a minimum level or completely. In this study, current approaches and studies about pain in children will be presented. Non-pharmacological methods will be examined in more detail. Every child has right to live a painless life. It is one of the main purposes of nursing care to relieve children’s pain and improve their life quality.
文摘Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .
文摘BACKGROUND Acute lung injury(ALI)after liver transplantation(LT)may lead to acute respiratory distress syndrome,which is associated with adverse postoperative outcomes,such as prolonged hospital stay,high morbidity,and mortality.Therefore,it is vital to maintain hemodynamic stability and optimize fluid management.However,few studies have reported cardiac output-guided(CO-G)management in pediatric LT.AIM To investigate the effect of CO-G hemodynamic management on early postoperative ALI and hemodynamic stability during pediatric living donor LT.METHODS A total of 130 pediatric patients scheduled for elective living donor LT were enrolled as study participants and were assigned to the control group(65 cases)and CO-G group(65 cases).In the CO-G group,CO was considered the target for hemodynamic management.In the control group,hemodynamic management was based on usual perioperative care guided by central venous pressure,continuous invasive arterial pressure,urinary volume,etc.The primary outcome was early postoperative ALI.Secondary outcomes included other early postoperative pulmonary complications,readmission to the intense care unit(ICU)for pulmonary complications,ICU stay,hospital stay,and in-hospital mortality.RESULTS The incidence of early postoperative ALI was 27.7%in the CO-G group,which was significantly lower than that in the control group(44.6%)(P<0.05).During the surgery,the incidence of postreperfusion syndrome was lower in the CO-G group(P<0.05).The level of intraoperative positive fluid transfusions was lower and the rate of dobutamine use before portal vein opening was higher,while the usage and dosage of epinephrine during portal vein opening and vasoactive inotropic score after portal vein opening were lower in the CO-G group(P<0.05).Compared to the control group,serum inflammatory factors(interleukin-6 and tumor necrosis factor-α),cardiac troponin I,and N-terminal pro-brain natriuretic peptide were lower in the CO-G group after the operation(P<0.05).CONCLUSION CO-G hemodynamic management in pediatric living-donor LT decreases the incidence of early postoperative ALI due to hemodynamic stability through optimized fluid management and appropriate administration of vasopressors and inotropes.
文摘Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.
文摘目的探讨儿童行为特点及其家庭管理方式对儿童哮喘控制水平影响路径。方法采用便利抽样法选取82例哮喘患儿,应用一般资料问卷、适应行为量表(AAMR)、家庭管理测量量表(FaMM)及儿童哮喘控制测试表(Childhood asthma control test,C-ACT)进行问卷调查,分析其影响路径。结果患儿AAMR适应行为量表得分(84.87±9.16)分,FaMM量表得分(188.77±19.01)分,C-ACT得分(15.20±4.66)分。Pearson相关分析结果显示,适应性行为分别与家庭管理、哮喘控制呈正相关关系(r=0.580、0.219,P<0.05),家庭管理与哮喘控制呈正相关关系(r=0.401,P<0.05)。结构方程模型结果表明,家庭管理在哮喘患儿适应性行为和哮喘控制有部分中介调节作用,效应占比为45.95%。结论儿童行为特点能够通过家庭管理方式对患儿哮喘控制水平产生影响,临床护理人员应重视对患儿家属的健康教育管理,提升家属对疾病的认知度及家庭管理能力,以改善患儿的行为方式,达到有效控制患儿疾病的目的。
文摘目的探讨妇幼健康信息化在高危孕产妇管理工作中的应用效果。方法选取2019年1—12月深圳市南山区妇幼保健院实施常规管理的100例高危孕产妇作为对照组,选取2020年1—12月深圳市南山区妇幼保健院实施妇幼健康信息化管理的100例高危孕产妇中作为研究组。对比2组管理效果。结果研究组登记建档率、产检次数高于对照组,胎儿宫内窘迫、新生儿窒息发生率低于对照组(P<0.05)。研究组产妇急性事件总发生率为4.00%,低于对照组的15.00%(P<0.05)。管理后,研究组遵医嘱依从性(遵医嘱服药、科学运动、合理饮食、规律作息、自我管理)评分高于对照组,焦虑自评量表评分(self-rating anxiety scale,SAS)低于对照组(P<0.05)。出院时,研究组满意度(主动服务、健康宣教、交流能力、操作水平、环境评估)评分高于对照组(P<0.05)。管理后,研究组健康调查简表(the MOS item short fromhealth survey,SF-36)评分高于对照组(P<0.05)。结论高危孕产妇管理中使用妇幼健康信息化技术有利于提高管理效果,预防产妇急性事件的发生,改善产妇不良情绪,提高其遵医嘱依从性和生活质量,提高产妇对护理服务的满意度。
文摘目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上海交通大学医学院附属儿童医院呼吸科收治的67例0~6岁喘息性疾病患儿,按照随机数字表分为观察组33例和对照组34例,其中失访3例,最终每组32例。观察组采用基于EMS管理模式的延续性护理,对照组给予常规护理和出院电话随访。2组患儿出院后1、3、6个月随访评估儿童呼吸和哮喘测试(Test for Respiratory and Asthma Control in Kids,TRACK)结果、喘息复发情况;出院后6个月随访采用支气管哮喘用药依从性评分表(Medication Adherence Report Scale for Asthma,MARS-A)和护理工作满意度调查表评估用药依从性及护理工作满意度。结果·2组患儿人口学特征及临床基线特征差异无统计学意义。重复测量方差分析结果显示,时间、组别、组别×时间的交互作用对TRACK总分的影响均有统计学意义;出院后1、3、6个月,观察组TRACK总分均显著高于对照组(均P=0.000);2组患儿TRACK总分均随时间推移逐渐上升(P=0.000)。观察组1、3、6个月随访发现喘息复发率分别为25.0%、18.7%、9.4%,均显著低于对照组(分别为50.0%、43.7%、31.3%,均P<0.05);广义估计方程分析显示组间比较差异有统计学意义(P=0.013),观察组干预效果优于对照组(OR=0.292)。出院后6个月观察组MARS-A得分为(4.519±0.395)分,显著高于对照组[(3.994±0.739)分,P=0.001]。护理工作满意度调查结果显示,观察组显著高于对照组(P=0.000)。患儿MARS-A得分与护理工作满意度呈中度正相关(r=0.389,P=0.001)。结论·基于EMS管理模式的延续性护理可显著提高学龄前喘息性疾病儿童的用药依从性和喘息控制水平,明显降低喘息复发率,以及提高护理工作满意度。
