风险分级护理联合闭环式管理对细菌性肺炎患儿临床症状、功能恢复及心理状态的影响

林晓敏; 蔡圆圆; 钱金吉; 林小清

doi:10.16766/j.cnki.issn.1674-4152.003858

风险分级护理联合闭环式管理对细菌性肺炎患儿临床症状、功能恢复及心理状态的影响

doi: 10.16766/j.cnki.issn.1674-4152.003858

1.
温州医科大学附属第二医院儿童急重症医学科，浙江温州 325000
2.
温州医科大学附属第二医院手术室
3.
温州医科大学附属第二医院新生儿科

基金项目:

浙江省医药卫生科技计划项目 2021KY800

温州市科技局基础性公益科研项目 S20220040

详细信息

通讯作者:
林晓敏，E-mail：linxm801@163.com

中图分类号: R473.72 R725.6
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-17
- 网络出版日期: 2025-02-13

The impact of risk grading nursing combined with closed-loop management on clinical symptoms, functional recovery, and psychological status of children with bacterial pneumonia

1.
Pediatric Emergency and Critical Care Medicine, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的分析将风险分级护理与闭环式管理联合应用于细菌性肺炎患儿的临床效果，观察其对患儿临床症状、功能恢复及心理状态的影响，为临床护理提供参考。方法选取2023年1—12月温州医科大学附属第二医院收治的100例细菌性肺炎患儿，采用随机数表法分为对照组(50例)及观察组(50例)。对照组患儿应用常规护理干预，观察组在对照组基础上应用风险分级护理联合闭环式管理。比较2组患儿临床症状改善时间、肺功能、舒适度及负性情绪水平，统计2组患儿家长满意度情况。结果观察组退热时间、咳嗽、喘憋及肺部啰音消失时间均短于对照组(P < 0.05)；干预后，观察组患儿第一秒用力呼气容积(FEV₁)、呼气峰流速(PEF)和用力肺活量(FVC)均高于对照组(P < 0.05)；干预后，观察组患儿儿童舒适度问卷、儿童焦虑障碍自评量表(SCARED)及抑郁障碍自评量表(DSRSC)评分均低于对照组(P < 0.05)；观察组患儿家长满意度为96%(48/50)，高于对照组[82%(41/50)，χ²=5.005, P=0.025]。结论风险分级护理联合闭环式管理可有效缓解细菌性肺炎患儿临床症状，促进患儿肺功能恢复，缓解患儿不良情绪，提高患儿舒适度及家长满意度。
- 细菌性肺炎 /
- 风险分级护理 /
- 闭环式管理 /
- 临床症状 /
- 肺功能 /
- 心理状态
Abstract: Objective The present study will discuss the effect of combining risk grading nursing with closed-loop management in children with bacterial pneumonia. The impact on the clinical symptoms, functional recovery, and psychological state of the children will be observed. The study will provide a new theoretical basis for clinical nursing. Methods A total of 100 children diagnosed with pneumonia at the Second Affiliated Hospital of Wenzhou Medical University from January 2023 to December 2023 were divided into two groups: a control group and an observation group. The randomization of cases within each group was achieved using a random number list method, with 50 cases allocated to each group. The control group was responsible for the routine nursing management, while the observation group employs risk grading nursing in combination with closed-loop management, based on the control group ' s approach. The study will compare the improvement time of clinical symptoms, lung function levels, comfort levels, and negative emotional levels between the two groups of children. Additionally, it will calculate the satisfaction levels of parents for both groups. Results The time required for fever relief, cough relief, wheezing relief and the disappearance of lung rales was found to be shorter in the observation group when compared to the control group (P < 0.05). Following the intervention, the forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF) and forced vital capacity (FVC) of the observation group were all higher than those of the control group (P < 0.05). Following the implementation of the intervention, the results of the comfort questionnaire, the children ' s anxiety self-rating scale (SCARED), and the depression self-rating scale (DSRSC) of the observation group were found to be lower than those in the control group, with a statistical significance of P < 0.05. Furthermore, the satisfaction rate of parents in the observation group was 96% (48/50), which was higher than the 82% (41/50) recorded for the control group, again with a statistical significance of χ²=5.005, P=0.025. Conclusion The integration of risk grading nursing with closed-loop management has been demonstrated to effectively alleviate clinical symptoms in children diagnosed with bacterial pneumonia. This approach has also been shown to promote the recovery of lung function in children, alleviate their negative emotions, and improve both their comfort and that of their parents.
- Bacterial pneumonia /
- Risk grading nursing /
- Closed-loop management /
- Clinical symptoms /
- Pulmonary function /
- Mentality

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表 1 PEWS评分标准

Table 1. PEWS scoring criteria

参数	0分	1分	2分	3分
意识	正常	嗜睡	易激惹	昏迷或疼痛反应下降
心血管系统	肤色粉红，毛细血管充盈试验(CRT)1~2 s。	肤色苍白，CRT 3 s。	肤色灰白，CRT 4 s，心率较常升高20次/min。	肤色青紫伴有花斑，CRT≥5 s，心率较常升高30次/min或心动过缓。
呼吸系统	正常范围无吸气性凹陷。	呼吸频率较正常升高10~19次/min，吸氧流量4 L/min。	呼吸频率较正常升高≥20次/min，吸氧流量6 L/min，有吸气性凹陷。	呼吸频率较正常减少5次/min，吸氧流量8 L/min，伴胸骨吸气性凹陷。

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表 2 2组细菌性肺炎患儿及家长一般资料比较

Table 2. Comparison of general information between two groups of children with bacterial pneumonia and their parents

组别	例数	性别(例)		患儿年龄 (x±s，岁)	病程时间 (x±s，d)	家长年龄 (x±s，岁)	家长文化程度(例)
组别	例数	男	女	患儿年龄 (x±s，岁)	病程时间 (x±s，d)	家长年龄 (x±s，岁)	高中及以下	大专及以上
对照组	50	26	24	5.38±1.16	5.96±1.83	37.28±3.55	30	20
观察组	50	27	23	5.67±1.24	6.13±2.05	36.90±4.21	28	22
统计量		0.040^a		0.042^b	0.437^b	0.488^b	0.164^a
P值		0.841		0.967	0.663	0.627	0.685
注：^a为χ²值，^b为t值。

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表 3 2组细菌性肺炎患儿临床症状改善时间对比(x±s，d)

Table 3. Comparison of clinical symptom improvement time between two groups of children with bacterial pneumonia (x±s, d)

组别	例数	退热时间	咳嗽消失时间	喘憋消失时间	肺部啰音消失时间
对照组	50	2.66±0.42	6.54±1.36	6.20±1.15	7.82±2.10
观察组	50	3.25±0.58	5.88±0.92	5.46±0.84	6.55±1.38
t值		5.826	2.842	3.674	3.574
P值		< 0.001	0.005	< 0.001	< 0.001

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表 4 2组细菌性肺炎患儿干预前后肺功能比较(x±s)

Table 4. Comparison of lung function before and after intervention in two groups of children with bacterial pneumonia (x±s)

组别	例数	FEV₁(L)		PEF(L/s)		FVC(L)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	50	75.42±4.96	86.43±6.63^b	76.42±5.10	83.05±5.33^b	88.95±5.42	95.62±6.35^b
观察组	50	76.11±5.23	91.22±6.01^b	75.98±4.69	89.11±5.26^b	89.12±4.89	98.85±5.77^b
统计量		0.677^a	3.767^c	0.959^a	6.382^c	0.165^a	5.275^c
P值		0.500	< 0.001	0.340	< 0.001	0.870	< 0.001
注：^a为t值，^c为F值；与同组内干预前比较，^bP＜0.05。

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表 5 2组细菌性肺炎患儿干预前后舒适度及心理状态比较(x±s，分)

Table 5. Comparison of comfort and psychological status before and after intervention in two groups of children with bacterial pneumonia(x±s, points)

组别	例数	舒适度		SCARED		DSRSC
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	50	16.44±2.18	12.13±3.08^b	60.78±4.83	41.37±5.44^b	28.92±4.76	24.72±3.55^b
观察组	50	16.15±2.46	8.96±1.54^b	59.43±5.24	32.68±3.78^b	29.33±4.28	20.19±3.17^b
统计量		0.624^a	10.287^c	1.340^a	12.336^c	0.453^a	6.792^c
P值		0.534	< 0.001	0.184	< 0.001	0.652	< 0.001
注：^a为t值，^c为F值；与同组内干预前比较，^bP＜0.05。

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