阶段性结合结构式心理干预在先天性心脏病术后患儿康复中的应用  

Application of staged rehabilitation combined with structural psychological intervention in postoperative rehabilitation of children with congenital heart disease

作　　者：钱筠 殷杰[1] 陈梅 Qian Yun;Yin Jie;Chen Mei(Department of Cardiovascular Medicine,Children’s Hospital,Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属儿童医院心血管内科,江苏南京210019

出　　处：《海军医学杂志》2025年第4期357-361,共5页Journal of Navy Medicine

基　　金：国家自然科学基金资助项目(82100779)。

摘　　要：目的探究阶段性结合结构式心理干预在先天性心脏病术后患儿康复中的应用效果。方法收集114例2021年2月至2023年6月南京医科大学附属儿童医院手术治疗的先天性心脏病患儿资料进行回顾性分析,根据患儿术后护理干预方案将其分为对照组(53例,实施常规护理)和观察组(61例,实施阶段性康复结合结构式心理干预护理)。比较2组患儿术后康复指标[术后ICU住院时间、持续气道内正压通气(CPAP)时间、总住院时间]、干预前后患儿治疗依从性、负性情绪以及心功能指标[左心室射血分数(LVEF)、左心室每搏输出量(LVSV)]。结果观察组术后ICU住院、CPAP以及总住院时间均短于对照组(P<0.05);与干预前比较,干预4周后2组患儿治疗依从性评分提高,LVEF、LVSV等心功能指标均上升,且观察组上述指标变化幅度高于对照组,差异有统计学意义(P<0.05);2组儿童抑郁障碍自评量表(DSRSC)、儿童焦虑性情绪障碍筛选量表(SCARED)评分均下降,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论阶段性结合结构式心理干预应用于先天性心脏病患儿术后康复护理,可以改善患儿负性情绪,有效提升其治疗依从性,有利于促进患儿术后康复。Objective To explore the effect of staged rehabilitation combined with structural psychological intervention on postoperative rehabilitation of children with congenital heart disease.Methods The clinical data of 114 children with congenital heart disease who underwent surgical treatment in the Children’s Hospital of Nanjing Medical University from February 2021 to June 2023 were retrospectively analyzed.According to postoperative nursing,the patients were assigned to control group(53 cases,routine nursing)and observation group(61 cases,staged rehabilitation combined with structural psychological intervention).Postoperative rehabilitation indexes(postoperative ICU stay time,continuous positive airway pressure[CPAP]time,total hospital stay),treatment compliance,negative emotion,and cardiac function indexes(left ventricular ejection fraction[LVEF],and left ventricular stroke volume[LVSV])were compared between the two groups.Results Postoperative ICU stay time,CPAP and total hospital stay in the observation group were shorter than those in the control group(all P<0.05).After 4 weeks of nursing intervention,the treatment compliance score,LVEF,and LVSV were increased in both groups,and the above indexes in the observation group were significantly higher than those in the control group(all P<0.05);the depression self⁃rating scale for children(DSRSC)score and screen for child anxiety related emotional disorders(SCARED)score were decreased in the two groups,and the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion The staged rehabilitation combined with structural psychological intervention can effectively ameliorate negative emotions,improve treatment compliance,and promote postoperative rehabilitation of children with congenital heart disease.

关 键 词：先天性心脏病 术后康复 心理干预 治疗依从性 

分 类 号：R473.72[医药卫生—护理学]