系統(tǒng)護理干預(yù)對重癥病毒性腦炎伴吞咽功能障礙患兒生活質(zhì)量的影響

　　[摘要] 目的 探討系統(tǒng)護理干預(yù)對重癥病毒性腦炎伴吞咽功能障礙患兒生活質(zhì)量的影響。 方法 選取2016年1月～2017年5月在沈陽市兒童醫(yī)院康復(fù)科接受治療的重癥病毒性腦炎伴吞咽功能障礙患兒60例作為研究對象，按照隨機數(shù)字表法分為對照組和觀察組，每組各30例。對照組患兒給予常規(guī)護理干預(yù)，觀察組患兒給予系統(tǒng)護理干預(yù)。兩組均干預(yù)14 d。采用吞咽障礙調(diào)查問卷（DDS）和簡體中文版PedsQLTM 3.0量表對護理干預(yù)前后兩組患兒的吞咽障礙和生活質(zhì)量進行評價。 結(jié)果 干預(yù)前兩組患兒DDS評分及生活質(zhì)量評分比較，差異均無統(tǒng)計學(xué)意義（P > 0.05）。干預(yù)后兩組患兒DDS評分均低于干預(yù)前，且觀察組DDS評分明顯低于對照組，差異均有統(tǒng)計學(xué)意義（P < 0.05）。干預(yù)后兩組患兒生活質(zhì)量各項評分均高于干預(yù)前，且觀察組均高于對照組，差異均有統(tǒng)計學(xué)意義（P < 0.05）。 結(jié)論 系統(tǒng)護理干預(yù)可以改善重癥病毒性腦炎伴吞咽功能障礙患兒的臨床癥狀，提高其生活質(zhì)量，值得臨床推廣應(yīng)用。
　　[關(guān)鍵詞] 病毒性腦炎；吞咽功能障礙；護理干預(yù)；生活質(zhì)量
　　[中圖分類號] R473.2 [文獻(xiàn)標(biāo)識碼] A [文章編號] 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
　　病毒性腦炎是由腸道病毒、蟲媒病毒、常見傳染病病毒等引起的損害中樞神經(jīng)系統(tǒng)的感染性疾病，臨床癥狀的輕重與感染部位、感染范圍及感染的嚴(yán)重程度有關(guān)。在以往的臨床工作中發(fā)現(xiàn)，重癥腦炎患兒往往伴發(fā)吞咽功能障礙。吞咽功能障礙主要臨床表現(xiàn)為攝食困難、咀嚼動作不協(xié)調(diào)、構(gòu)音障礙、流涎及飲水嗆咳等，如吞咽功能障礙持續(xù)得不到緩解，則可導(dǎo)致患兒營養(yǎng)不良、反復(fù)呼吸道感染、吸入性肺炎和誤吸等，在很大程度上影響了患兒的生命安全及生活質(zhì)量[1]。因此，在臨床工作中逐漸受到醫(yī)生及護士的關(guān)注。有研究顯示，有效的護理干預(yù)有助于提高病毒性腦炎患兒的遵醫(yī)行為，有效促進其智力和運動功能的恢復(fù)，因此，對提高患兒日后的生活質(zhì)量具有重要意義[2]。本研究針對重癥病毒性腦炎伴吞咽功能障礙患兒給予具體護理需求，實施有針對性的、個體化的護理干預(yù)措施，如基礎(chǔ)功能訓(xùn)練、感覺刺激、日常攝食功能訓(xùn)練及心理護理干預(yù)等，防止患兒誤吸情況的發(fā)生，并與采用常規(guī)護理干預(yù)的患兒進行護理效果比較，旨在明確系統(tǒng)性護理干預(yù)在此類患兒康復(fù)過程中的重要作用�，F(xiàn)將結(jié)果報道如下：

相關(guān)熱詞搜索：腦炎 干預(yù) 生活質(zhì)量 患兒 重癥