系统护理干预对重症病毒性脑炎伴吞咽功能障碍患儿生活质量的影响

　　[摘要] 目的 探讨系统护理干预对重症病毒性脑炎伴吞咽功能障碍患儿生活质量的影响。 方法 选取2016年1月～2017年5月在沈阳市儿童医院康复科接受治疗的重症病毒性脑炎伴吞咽功能障碍患儿60例作为研究对象，按照随机数字表法分为对照组和观察组，每组各30例。对照组患儿给予常规护理干预，观察组患儿给予系统护理干预。两组均干预14 d。采用吞咽障碍调查问卷（DDS）和简体中文版PedsQLTM 3.0量表对护理干预前后两组患儿的吞咽障碍和生活质量进行评价。 结果 干预前两组患儿DDS评分及生活质量评分比较，差异均无统计学意义（P > 0.05）。干预后两组患儿DDS评分均低于干预前，且观察组DDS评分明显低于对照组，差异均有统计学意义（P < 0.05）。干预后两组患儿生活质量各项评分均高于干预前，且观察组均高于对照组，差异均有统计学意义（P < 0.05）。 结论 系统护理干预可以改善重症病毒性脑炎伴吞咽功能障碍患儿的临床症状，提高其生活质量，值得临床推广应用。
　　[关键词] 病毒性脑炎；吞咽功能障碍；护理干预；生活质量
　　[中图分类号] R473.2 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0167-04
　　[Abstract] Objective To explore the effect of systematic nursing intervention on the quality of life in children with severe viral encephalitis combined with dysphagia. Methods From January 2016 to May 2017， 60 patients with severe viral encephalitis combined with dysphagia treated in Shenyang Children′s Hospital were selected as the research subjects and divided into the control group and observation group by random number table， with 30 cases in each group. The control group was given routine nursing intervention and the observation group was given systematic nursing intervention. Both groups were all intervened for 14 d. The dysphagia disorders survey （DDS） and the Chinese version of the pediatria quality of life inventory 3.0 healthcare satisfaction hematology/oncology module were applied to evaluate the dysphagia and the quality of life before and after nursing intervention. Results Before intervention， there were no statistically significant differences in the scores of DDS and quality of life between the two groups （P > 0.05）. After intervention， the scores of DDS in the two groups were all lower than those of before intervention， and that in the observation group was significantly lower than that of control group， with statistically significant differences （P < 0.05）. After intervention， the scores of life quality in each item in the two groups were all higher than those of before intervention， and the scores above in the observation group were all significantly higher than those of control group， with statistically significant differences （P < 0.05）. Conclusion Systematic nursing intervention can improve the clinical symptoms and enhance the quality of life in children with severe viral encephalitis combined with dysphagia. It is worthy of promotion and application.
　　[Key words] Viral encephalitis； Dysphagia； Nursing intervention； Quality of life
　　病毒性腦炎是由肠道病毒、虫媒病毒、常见传染病病毒等引起的损害中枢神经系统的感染性疾病，临床症状的轻重与感染部位、感染范围及感染的严重程度有关。在以往的临床工作中发现，重症脑炎患儿往往伴发吞咽功能障碍。吞咽功能障碍主要临床表现为摄食困难、咀嚼动作不协调、构音障碍、流涎及饮水呛咳等，如吞咽功能障碍持续得不到缓解，则可导致患儿营养不良、反复呼吸道感染、吸入性肺炎和误吸等，在很大程度上影响了患儿的生命安全及生活质量[1]。因此，在临床工作中逐渐受到医生及护士的关注。有研究显示，有效的护理干预有助于提高病毒性脑炎患儿的遵医行为，有效促进其智力和运动功能的恢复，因此，对提高患儿日后的生活质量具有重要意义[2]。本研究针对重症病毒性脑炎伴吞咽功能障碍患儿给予具体护理需求，实施有针对性的、个体化的护理干预措施，如基础功能训练、感觉刺激、日常摄食功能训练及心理护理干预等，防止患儿误吸情况的发生，并与采用常规护理干预的患儿进行护理效果比较，旨在明确系统性护理干预在此类患儿康复过程中的重要作用。现将结果报道如下：

相关热词搜索：脑炎 干预 生活质量 患儿 重症