基于4E模式的早期呼吸训练方案在闭塞性细支气管炎患儿中的应用  

Application of early respiratory training program based on 4E model in children with bronchiolitis obliterans

作　　者：刘花艳[1] 易敏 谢鑑辉[3] 陈艳萍[1] 谭小艳 钟丽娜[1] 谷利凤[1] Liu Huayan;Yi Min;Xie Jianhui;Chen Yanping;Tan Xiaoyan;Zhong Lina;Gu Lifeng(Department of Respiratory Medicine,Hunan Children's Hospital,Changsha 410007,China;School of Nursing,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Nursing,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院呼吸内科,长沙410007 [2]湖南中医药大学护理学院,长沙410208 [3]湖南省儿童医院护理部,长沙410007

出　　处：《中国实用护理杂志》2023年第19期1448-1455,共8页Chinese Journal of Practical Nursing

基　　金：湖南省自然科学基金(2023JJ60008)。

摘　　要：目的:探讨基于4E模式的早期呼吸训练方案在闭塞性细支气管炎(BO)患儿中的应用效果,以期为BO患儿早期呼吸康复的临床实施提供依据。方法:本研究为类实验性研究。选取2021年1月1日至12月31日湖南省儿童医院呼吸内科2个病区收治的BO患儿为研究对象,按随机数字表法分为对照组和试验组各23例;对照组接受常规治疗、护理和康复指导,试验组在对照组的基础上组建多学科团队,采用基于4E模式的早期呼吸训练方案实施干预;分别在入院诊断为BO的24 h内、出院当日及出院后1、3个月回院复查时采用临床症状严重程度评分表评估患儿临床症状改善情况,采用调取病历和问卷调查的方式统计患儿住院时间和呼吸训练相关不良事件发生次数等。结果:入院诊断24 h内、出院当日试验组临床症状严重程度评分分别为(20.00±2.51)、(11.30±2.46)分,对照组分别为(20.57±2.21)、(11.70±2.42)分,2组比较差异均无统计学意义(t=0.81、0.54,均P>0.05)。出院1、3个月回院复查时试验组临床症状严重程度评分分别为(10.52±2.31)、(8.55±1.06)分,低于对照组的(12.32±1.39)、(12.45±2.19)分,差异均有统计学意义(t=3.14、7.25,均P<0.05)。试验组住院时间为(11.78±1.17)d,低于对照组的(13.74±1.63)d,差异有统计学意义(t=4.68,P<0.05);住院期间2组患儿均未发生呼吸训练相关不良事件,出院后居家呼吸训练过程中,出院1、3个月试验组分别发生1、2例次呼吸训练相关不良事件,对照组分别为6、9例次,2组比较差异均有统计学意义(χ2=4.64、5.94,均P<0.05)。结论:基于4E模式的早期呼吸训练方案可有效改善BO患儿的临床症状、缩短住院时间、减少呼吸训练相关不良事件发生次数,从而促进患儿疾病康复。Objective To explore application effect of early respiratory training schemes based on 4E mode(Engage,Educate,Execute,Evaluate)in children with bronchiolitis obliterans(BO)and provide evidence for the clinical implementation of early respiratory rehabilitation in children with BO.MethodsThis was a quasi-experimental study.The children with BO who were admitted to 2 wards of the Department of Respiratory Medicine of Hunan Children's Hospital from January 1 to December 31,2021 were selected as the research objects.They were randomly divided into the control group and the experimental group,with 23 cases in each group.The control group received routine treatment,nursing and rehabilitation guidance.The experimental group established a multidisciplinary team based on the control group,and used the early respiratory training program based on the 4E model to implement intervention.The clinical symptom severity scale was used to evaluate the improvement of the clinical symptoms of the children within 24 hours of being diagnosed as BO,the day of discharge,and 1 and 3 months after discharge for re-examination,and the hospitalization time of the children and the incidence of adverse events related to respiratory training were counted by using medical records and questionnaires.ResultsThe clinical symptom severity scores of the experimental group within 24 hours of admission diagnosis and the day of discharge were(20.00±2.51)and(11.30±2.46)points respectively,while those of the control group were(20.57±2.21)and(11.70±2.42)points respectively,with no statistically significant difference(t=0.81,0.54,both P>0.05).The clinical symptom severity scores of the experimental group were(10.52±2.31)and(8.55±1.06)points,lower than(12.32±1.39)and(12.45±2.19)points of the control group when they returned to the hospital for re-examination 1 and 3 months after discharge,with a statistically significant difference(t=3.14,7.25,both P<0.05).The experimental group was hospitalized for(11.78±1.17)days,which was showter than(13.74±1.63

关 键 词：呼吸锻炼 护理 闭塞性细支气管炎 患儿 4E模式 

分 类 号：R473.72[医药卫生—护理学]