儿童医疗辅导照护干预模式在植入式输液港首次穿刺中的作用  

The role of Child life intervention model in the fi rst puncture of implantable infusion ports

作　　者：喻萍萍 孙华中 杨萌 高群 赵金都 Yu Pingping;Sun Huazhong;Yang Meng;Gao Qun;Zhao Jindu(Department of Oncology,Anhui Children’s Hospital,Hefei Anhui 230022,China)

机构地区：[1]安徽省儿童医院肿瘤外科,安徽合肥230022

出　　处：《中国医刊》2024年第9期986-990,共5页Chinese Journal of Medicine

基　　金：安徽省卫生健康委科研项目立项项目(AHWJ2021a025)。

摘　　要：目的探讨儿童医疗辅导照护干预模式在恶性肿瘤患儿植入式输液港首次穿刺中的应用效果。方法选择安徽省儿童医院2021年1月至2023年12月收治的恶性肿瘤患儿80例作为研究对象,按随机分层法分为研究组和对照组两组,每组40例,研究组接受儿童医疗辅导照护(Child life)干预模式,对照组接受常规干预模式。比较分析两组患儿的临床资料、穿刺并发症发生率、穿刺疼痛程度、穿刺时间、意外拔针率、一次性穿刺成功率、患儿治疗依从性、家属配合度及家属满意度,其中患儿穿刺疼痛程度采用疼痛相关行为学评分法(FLACC)评估。结果两组患儿的性别、年龄、肿瘤类型等临床资料比较差异无统计学意义(P>0.05)。对照组的并发症发生率高于研究组,差异有统计学意义(P<0.05)。两组患儿干预前FLACC评分比较差异无统计学意义(P>0.05);干预3 d后两组FLACC中腿部活动、可抚慰性、哭闹程度、体位、面部表情及总分均较干预前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组患儿一次性穿刺成功率高于对照组,而穿刺时间、意外拔针率短于或少于对照组,差异有统计学意义(P<0.05)。研究组患儿治疗依从性、家属配合度及家属满意度均高于对照组,差异有统计学意义(P<0.05)。结论Child life干预模式在植入式输液港首次穿刺中效果显著,一次性穿刺成功率较高,并降低意外拔针率和并发症发生率,安全性高,同时有利于患儿积极配合治疗,且家属配合度及家属满意度也明显提高。Objective To study the role of Child life intervention model used in the first puncture of implantable infusion ports in children with malignant tumors.Method 80 cases of children with malignant tumors were selected for observation in our hospital from January 2021 to December 2023,and were grouped according to the randomized stratifi cation method,with 40 cases in each group,and the study group received the Child life intervention model,while the control group adopted the conventional intervention.Comparison of clinical data,complications,pain-related behavioral scoring method(FLACC),puncture time,one-time puncture success rate,accidental needle removal rate,children’s adherence to treatment,family cooperation and satisfaction between the two groups.Result There was no statistically significant difference in clinical data such as gender,age,and tumor type between the two groups of patients(P>0.05).The incidence of complications in the control group was higher than that in the study group(P<0.05).There was no statistically significant difference in FLACC scores between the two groups of children before intervention(P>0.05);after 3 days of intervention,leg activity,appealability,crying level,posture,facial expression,and total score in both FLACC groups decreased compared to before intervention,and the study group was lower than the control group(P<0.05).The success rate of one-time puncture in the study group was higher than that in the control group,while the puncture time and accidental needle extraction rate were shorter or less than those in the control group(P<0.05).The proportion of treatment compliance,family cooperation,and family satisfaction in the study group was higher than that in the control group(P<0.05).Conclusion Child life intervention model in implantable infusion port first puncture effect is remarkable,one-time puncture success rate is higher,and reduce the accidental withdrawal rate and the incidence of complications,high safety,and at the same time to promote the active cooperation of chi

关 键 词：儿童医疗辅导照护 植入式输液港 儿童 恶性肿瘤 循证医学 

分 类 号：R720.5[医药卫生—儿科]