改良早期预警评分系统联合层级链式护理对重症肺炎患儿的影响  

Effect of hierarchical chain care based on an modifi ed early warning scoring system on children with severe pneumonia

作　　者：李筱 贾彩萍 乔静 李文刚 王莉 谷琳 LI Xiao;JIA Caiping;QIAO Jing;LI Wengang;WANG Li;GU Ling(Jiaozuo Maternal and Child Health Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市妇幼保健院儿科二区,河南省焦作市454000

出　　处：《护理实践与研究》2024年第6期905-910,共6页Nursing Practice and Research

基　　金：焦作市科技计划项目(编号:202223066)。

摘　　要：目的 探讨基于改良早期预警评分(MEWS)系统的层级链式护理对重症肺炎患儿临床症状改善、肺功能、并发症的影响。方法 选择医院2021年1月—2022年12月收治的重症肺炎患儿128例为研究对象,按照组间基本特征具有可比性的原则分为对照组和观察组,各64例。对照组采用常规护理干预模式,观察组在常规护理基础上采用基于MEWS系统的层级链式护理干预。比较两组患儿的临床症状改善情况、肺功能指标[呼吸频率(RR)、用力肺活量(FVC)、达峰容积比(vPTEF/vE)]、并发症发生率、依从率、家属焦虑情绪[汉密尔顿焦虑量表(HAMA)、Zung焦虑自评量表(SAS)]评分。结果 护理干预后,观察组患儿发热、咳嗽、气促、肺啰音消失时间均短于对照组,差异有统计学意义(P<0.05)。护理干预1周后,观察组患儿RR低于对照组,FVC、vPTEF/vE高于对照组,差异均有统计学意义(P<0.05);观察组患儿并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组患儿依从性高于对照组,差异有统计学意义(P<0.05);观察组患儿家属HAMA、SAS评分低于对照组,差异有统计学意义(P<0.05)。结论 基于MEWS系统的层级链式护理可有效改善重症肺炎患儿的临床症状和肺功能,降低并发症的发生率,提高患儿的依从率,减轻患儿家属的焦虑情绪,有助于促进患儿康复。Objective To explore the effect of hierarchical chain care based on the modified early warning score(MEWS)system on the improvement of clinical symptoms,lung function,and complications in children with severe pneumonia.Methods 128 children with severe pneumonia admitted to the hospital from January 2021 to December 2022 were selected as the study subjects,and were divided into a control group and an observation group according to the principle of comparability of basic characteristics between groups,with 64 cases in each group.The control group received the routine care intervention model,and the observation group received the hierarchical chain care intervention based on the MEWS system on the basis of routine care.Clinical symptom improvement,pulmonary function indicators[respiratory rate(RR),forced vital capacity(FVC),peak volume ratio(vPTEF/vE)],complication rate,compliance rate,and family anxiety[Hamilton Anxiety Scale(HAMA),Zung Self-Rating Anxiety Scale(SAS)]scores were compared between the two groups.Results After nursing intervention,the time of disappearance of fever,cough,shortness of breath,and pulmonary rales in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).After 1 week of nursing intervention,the RR of the children in the observation group was lower than that of the control group,and the FVC and vPTEF/vE were higher than that of the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);the compliance of the children in the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05);the HAMA and SAS scores of the families of the children in the observation group were lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Hierarchical chain care based on

关 键 词：层级链式护理 改良早期预警评分系统 重症肺炎 肺功能 并发症 

分 类 号：R473.72[医药卫生—护理学]