基于King达标理论的集中护理管理模式对无创持续气道正压通气患儿的影响

霍培卿; 魏文雅; 杜艳娜; 赵慧玲; 曹丽洁; 黄坤玲; 崔玉会

doi:10.16766/j.cnki.issn.1674-4152.004230

基于King达标理论的集中护理管理模式对无创持续气道正压通气患儿的影响

doi: 10.16766/j.cnki.issn.1674-4152.004230

河北省儿童医院呼吸二科(河北省儿童健康与疾病临床医学研究中心，河北省医学重点学科)，河北石家庄 050031

基金项目:

河北省医学科学研究课题计划 20210650

详细信息

通讯作者:
崔玉会，E-mail：383466439@qq.com

中图分类号: R473.72
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出版历程
- 收稿日期: 2025-02-11

The effect of centralized nursing management model based on King standard theory on children with non-invasive ventilation continuous positive airway pressure

Children's Hospital of Hebei Province (Hebei Provincial Clinical Research Center for Child Health and Disease; Hebei Provincial Medical Key Discipline), Shijiazhuang, Hebei 050031, China

摘要

摘要: 目的通过科学、严谨的研究方法，探讨基于King达标理论的集中护理管理模式在无创持续气道正压通气(NIVCPAP)患儿中的应用效果，为提升临床护理质量和患儿治疗效果提供有力支持。方法选择2021年3月—2022年12月在河北省儿童医院儿科住院使用NIVCPAP的105例患儿为研究对象，采用随机数字表法将患儿分为对照组(53例)及观察组(52例)，对照组进行常规干预，观察组进行基于King达标理论的集中护理管理模式干预，记录2种干预方式对患儿血气指标、肺功能、并发症的影响，记录家属满意度。结果观察组体温恢复时间、给氧时间、用机时间、住院天数均显著短于对照组(P＜0.05)；干预后与对照组比较，观察组血氧饱和度(SaO₂)、动脉血氧饱和度(PaO₂)、pH值、用力肺活量、一秒用力呼气容积更高，二氧化碳分压(PaCO₂)更低(P＜0.05)；观察组患儿误吸、鼻腔发红、导管处压伤发生率均显著低于对照组(1.89%、3.77%、0 vs. 23.08%、23.08%、11.54%，P＜0.05)；观察组家属对护理态度、护理技术、护理方式、护理环境、沟通/交流、护理服务满意度均显著高于对照组(P＜0.05)。结论基于King达标理论的集中护理管理模式能够更有效地促进患儿的康复，改善肺功能，减少并发症的发生，并提高家属的满意度，为NIVCPAP患儿的护理管理提供了新的有效策略。
- King达标理论 /
- 集中护理管理模式 /
- 无创持续气道正压通气
Abstract: Objective To explore the application effect of the centralized nursing management model based on King standard theory on children with non-invasive ventilation continuous positive airway pressure (NIVCPAP) through scientific and rigorous research methods, so as to provide strong support for improving the quality of clinical nursing and the treatment effect of children. Methods A total of 105 pediatric patients who received NIVCPAP at the Children's Hospital of Hebei Province from March 2021 to December 2022 were studied and separated into the control group (n=53, routine intervention) and the observation group (n=52, centralized nursing management intervention based on the King standard theory) by random number table method. The effects of the two intervention methods on blood gas index, lung function, and complications of the children were recorded, and family satisfaction was also recorded. Results The temperature recovery time, oxygen administration time, machine use time and hospitalization days in the observation group were significantly shorter than those in the control group (P < 0.05); After intervention, the blood oxygen saturation (SaO₂), arterial oxygen saturation (PaO₂), pH value forced vital capacity and forced expiratory volume in one second of both groups significantly were higher compared with the control group, while the carbon dioxide partial pressure (PaCO₂) was lower (P < 0.05). The incidence of aspiration, nasal redness, and catheter crush in the observation group was significantly lower than that in the control group (1.89%, 3.77%, 0 vs. 23.08%, 23.08%, 11.54%, P < 0.05). The satisfaction of nursing attitude, nursing technique, nursing style, nursing environment, communication, and nursing service in the observation group was significantly higher than that in the other group (P < 0.05). Conclusion The centralized nursing management model based on the King standard theory can more effectively promote the rehabilitation of children, improve their lung function, reduce the occurrence of complications, and increase the satisfaction of family members, providing a new and effective strategy for the nursing management of NIVCPAP children.
- King standard theory /
- Centralized nursing management model /
- Noninvasive ventilation continuous positive airway pressure
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表 1 2组使用NIVCPAP的患儿一般资料比较

Table 1. Comparison of baseline characteristics between the two groups of children using NIVCPAP

组别	例数	年龄 (x±s，岁)	性别 (男/女, 例)	出生体质量 (x±s，kg)
观察组	53	2.75±0.47	34/19	1.69±0.19
对照组	52	2.58±0.49	36/16	1.75±0.18
统计量		1.814^a	0.305^b	0.360^a
P值		0.073	0.581	0.720
注：^a为t值，^b为χ²值。

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表 2 2组使用NIVCPAP的患儿家长一般资料比较

Table 2. Comparison of baseline characteristics between parents of children using NIVCPAP in the two groups

组别	例数	年龄(x±s，岁)	性别(男/女, 例)	受教育年限(x±s，年)
观察组	53	28.55±2.41	25/28	13.26±2.55
对照组	52	29.17±3.03	27/25	13.19±2.47
统计量		1.162^a	0.237^b	0.143^a
P值		0.248	0.626	0.887
注：^a为t值，^b为χ²值。

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表 3 2组使用NIVCPAP的患儿临床指标比较(x±s)

Table 3. Comparison of clinical indicators between two groups of children using NIVCPAP(x±s)

组别	例数	体温恢复时间(d)	给氧时间(d)	用机时间(h)	住院天数(d)
观察组	53	3.06±0.37	5.23±0.59	80.27±7.56	10.17±1.03
对照组	52	5.11±0.57	6.44±0.85	83.24±6.17	11.10±2.55
t值		32.379	8.487	2.203	2.459
P值		＜0.001	＜0.001	0.030	0.016

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表 4 2组使用NIVCPAP的患儿干预前后血气指标比较(x±s)

Table 4. Comparison of blood gas indicators before and after intervention between two groups of children using NIVCPAP(x±s)

组别	例数	SaO₂(%)		PaCO₂(mmHg)		PaO₂(mmHg)		pH值		BE值
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	53	75.33±8.12	96.15±3.17^b	76.62±8.33	38.75±4.16^b	76.44±8.12	97.41±3.41^b	7.40±0.78	8.62±0.77^b	-2.03±0.31	-1.32±0.17^b
对照组	52	76.14±8.25	89.11±3.46^b	76.15±9.18	54.92±8.17^b	77.21±8.64	85.82±4.15^b	7.39±0.79	7.41±0.78^b	-2.11±0.28	-0.90±0.13^b
统计量		0.507^a	11.023^c	0.275^a	13.041^c	0.471^a	15.872^c	0.065^a	8.174^c	1.387^a	15.023^c
P值		0.613	＜0.001	0.784	＜0.001	0.639	＜0.001	0.948	＜0.001	0.169	＜0.001
注：^a为t值，^c为F值。与同组干预前比较，^bP＜0.05。1 mmHg=0.133 kPa。

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表 5 2组使用NIVCPAP的患儿肺功能情况(x±s，L)

Table 5. Pulmonary function in the two groups of children using NIVCPAP(x±s, L)

组别	例数	用力肺活量		一秒用力呼气容积
组别	例数	干预前	干预后	干预前	干预后
观察组	53	3.18±0.37	3.87±0.49^b	2.55±0.31	3.71±0.48^b
对照组	52	3.11±0.39	3.51±0.42^b	2.49±0.38	3.19±0.43^b
统计量		0.944^a	4.719^c	0.887^a	6.034^c
P值		0.348	＜0.001	0.377	＜0.001
注：^a为t值，^c为F值。与同组干预前比较，^bP＜0.05。

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表 6 2组使用NIVCPAP的患儿并发症发生率比较[例(%)]

Table 6. Comparison of complication rates between the two groups of children receiving NIVCPAP therapy[cases (%)]

组别	例数	误吸	鼻腔发红	导管处压伤	胃肠胀气
观察组	53	1(1.89)	2(3.77)	0	1(1.89)
对照组	52	12(23.08)	12(23.08)	6(11.54)	3(5.77)
χ²值		10.864	8.464
P值		0.001	0.004	0.027^a	0.363^a
注：^a为使用Fisher精确检验。

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表 7 2组使用NIVCPAP的患儿家长满意度比较[例(%)]

Table 7. Comparison of parental satisfaction between the two groups of children using NIVCPAP[cases (%)]

组别		护理态度	护理技术	护理方式	护理环境	沟通、交流	护理服务
观察组	53	51(96.23)	50(94.34)	50(94.34)	51(96.23)	51(96.23)	51(96.23)
对照组	52	44(53.68)	42(80.77)	41(78.85)	42(80.77)	41(78.85)	43(82.69)
χ²值		4.107	4.456	5.453	6.195	7.309	5.126
P值		0.043	0.035	0.020	0.013	0.007	0.024

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