兴趣游戏在学龄前儿童术后急性疼痛和术后早期下床活动中的效果研究

耿荷红; 朱莹莹; 燕林; 闫丽丽; 张现伟; 石彩晓

doi:10.16766/j.cnki.issn.1674-4152.001752

兴趣游戏在学龄前儿童术后急性疼痛和术后早期下床活动中的效果研究

doi: 10.16766/j.cnki.issn.1674-4152.001752

1.
郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院普通外科二病区，河南郑州 450018
2.
郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院护理部，河南郑州 450018

基金项目:

河南省卫生科技攻关项目 172102310006

详细信息

通讯作者:
石彩晓，E-mail：shicaixiao69@163.com

中图分类号: R441.1 R619 R473.6
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- 文章访问数: 237
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- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2019-10-08
- 网络出版日期: 2022-02-19

Effects of interested games on acute pain and early ambulation of postoperative in preschool children

1.
The Second Wards of General Surgery, Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital, Zhengzhou, Henan 450018, China

摘要

摘要: 目的探究兴趣游戏对学龄前儿童术后急性疼痛和术后早期下床活动的影响。方法选择2018年5月—2019年5月在河南省儿童医院普通外科二病区就诊的胃肠道手术患儿114例作为研究对象。为避免干预措施交叉影响，将先入院的57例患儿作为对照组，后入院的57例患儿作为干预组。对照组实施加速康复外科常规术后护理；干预组在实施加速康复外科常规术后护理的基础上，对患儿实施兴趣游戏干预。比较2组患儿术后急性疼痛评分、术后首次下床活动时间、术后首次下床活动量、术后前3天下床活动量、术后相关并发症发生率以及患儿家长满意度。结果 2组患儿的术后疼痛评分存在显著差别(P < 0.01)，干预组和对照组相比，在术后不同时间段疼痛评分显著降低；干预组患儿术后首次下床活动时间、术后相关并发症的发生率(恶心/呕吐、上呼吸道感染、切口感染和粘连性肠梗阻均低于对照组(均P < 0.05)；干预组患儿术后首次下床活动量、术后第一天活动量、术后第二天活动量、术后第三天活动量明显高于对照组(均P < 0.01)；另外，干预组患儿家长满意度评分(96.5%)高于对照组(87.7%)。结论兴趣游戏能够有效减轻学龄前儿童术后急性疼痛，促进患儿术后早期下床活动，降低术后相关并发症发生率，提高患儿家长的满意度。
- 兴趣游戏 /
- 学龄前 /
- 急性疼痛 /
- 早期下床活动
Abstract: Objective To explored the application effect of interested games on acute pain and early ambulation of postoperative in preschool children. Methods Total 114 children with gastrointestinal surgery were selected from May 2018 to May 2019 in our Department. In order to avoid the cross-influence of interventions, 57 children who were admitted to the hospital were used as the control group, and 57 children who were admitted to the hospital as the intervention group. The control group performed routine postoperative nursing of enhanced recovery after surgery, and the intervention group was based on the control group and implemented interested games intervention on the children. The postoperative acute pain scores, the time of first postoperative activities, the number of first postoperative activities, the amount of getting out of the first three days after surgery, the incidence of postoperative complications, and the satisfaction of the parents of the children were compared between the two groups. Results There was significant difference in postoperative pain score between the two groups (P < 0.01). Compared with the control group, the pain score in the intervention group was significantly lower than that in the control group; the time of first ambulation and the incidence of postoperative complications (nausea / vomiting, upper respiratory tract infection, incision infection and adhesive intestinal obstruction) in the intervention group were lower than those in the control group (all P < 0.05). The activities of the first time out of bed, the first day, the second day and the third day were significantly higher than those in the control group (all P < 0.01). In addition, the parental satisfaction score (96.5%) of the intervention group was higher than that of the control group (87.7%). Conclusion Interested games can effectively alleviate postoperative acute pain in preschool children, promote early ambulation, reduce the incidence of postoperative complications, and improve the satisfaction of parents.
- Interested games /
- Preschool children /
- Acute pain /
- Early ambulation

HTML全文

表 1 2组胃肠道手术患儿术后不同时间段的疼痛评分(x ±s，分)

组别	例数	返回病房时	术后6 h	术后12 h	术后24 h	术后48 h	F值	P值
干预组	57	3.83±1.82	1.93±0.78^a	1.67±1.07^a	0.88±0.85^a	0.44±0.66^a	78.067	< 0.001
对照组	57	3.75±1.64	2.79±0.77^a	2.25±1.44^a	1.35±1.11^a	1.07±0.94^a	45.242	< 0.001
t值		0.216	5.925	2.430	2.562	4.155
P值		0.829	< 0.001	0.017	0.012	< 0.001
注：与同组返回病房时比较，^aP < 0.05。

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表 2 2组胃肠道手术患儿术后下床活动时间和活动量的比较(x ±s)

组别	例数	术后首次下床活动时间(h)	术后下床活动量(m)
组别	例数	术后首次下床活动时间(h)	首次	第一天	第二天	第三天	F值	P值
干预组	57	15.15±4.38	99.65±9.63^a	1 087.72±84.66^a	2 324.56±151.52^ab	3 020.18±281.55^abc	3 506.004	< 0.001
对照组	57	19.89±4.82	52.35±8.16^a	272.28±69.90^a	677.02±108.58^ab	2 229.83±486.96^abc	1 053.149	< 0.001
t值		5.492	28.297	56.075	66.730	10.608
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
注：与同组首次下床活动量比较，^aP < 0.05；与同组第1天下床活动量比较，^bP < 0.001；与同组第2天下床活动量比较，^cP < 0.001。

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表 3 2组胃肠道手术患儿术后相关并发症发生情况比较[例(%)]

组别	例数	恶心/呕吐	上呼吸道感染	切口感染	粘连性肠梗阻
干预组	57	1(1.8)	3(5.3)	1(1.8)	0(0.0)
对照组	57	8(14.0)	11(19.3)	7(12.3)	3(5.3)
χ²值		5.911	5.211	4.840	5.229
P值		0.015	0.022	0.028	0.022

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参考文献(20)

[1]	江志伟, 黎介寿. 规范化开展加速康复外科几个关键问题[J]. 中国实用外科杂志, 2016, 36(1): 44-46. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201601017.htm
[2]	张现伟, 贾英萍, 张飞, 等. 加速康复外科在小儿结肠病变围手术治疗中的应用[J]. 中华全科医学, 2020, 18(3): 358-361, 475. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202003006.htm
[3]	VAN ZELM R, COECKELBERGHS E, SERMEUS W, et al. Variation in care for surgical patients with colorectal cancer: protocol adherence in 12 European hospitals[J]. Int J Colorectal Dis, 2017, 32(10): 1471-1478. doi: 10.1007/s00384-017-2863-z
[4]	WOLK S, DISTLER M, MÜSSLE B, et al. Adherence to ERAS elements in major visceral surgery-an observational pilot study[J]. Langenbeck Arch Surg, 2016, 401(3): 349-356. doi: 10.1007/s00423-016-1407-2
[5]	李智, 龚姝. 加速康复外科理念下促进腹部手术患者术后早期下床活动的研究进展[J]. 中国护理管理, 2019, 19(1): 142-145. doi: 10.3969/j.issn.1672-1756.2019.01.032
[6]	张智慧, 王文华. 兴趣诱导改善患儿术前心理状态和麻醉诱导配合度的研究[J]. 中华护理杂志, 2017, 52(4): 405-408. doi: 10.3761/j.issn.0254-1769.2017.04.004
[7]	LIOUPI C, SYRMOS N C, LIOUPIS M, et al. Preoperative anxiety in children undergoing neurosurgical operations and proposed effective interventions[J]. Childs Nerv Syst, 2018, 34(2): 197-198. doi: 10.1007/s00381-017-3703-8
[8]	汪文娟, 周亚琴, 何双八, 等. 专科化游戏干预在眼科学龄前患儿围手术期护理中的应用研究[J]. 中华护理杂志, 2018, 53(12): 1429-1433. doi: 10.3761/j.issn.0254-1769.2018.12.004
[9]	EIJLERS R, DIERCKX B, STAALS L M, et al. Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: A randomised controlled trial[J]. Eur J Anaesthesiol, 2019, 36(10): 728-737. doi: 10.1097/EJA.0000000000001059
[10]	MATTHYSSENS L E, VANHULLE A, SELDENSLACH L, et al. A pilot study of the effectiveness of a serious game CliniPup^® on perioperative anxiety and pain in children[J]. J Pediatr Surg, 2020, 55(2): 304-311. doi: 10.1016/j.jpedsurg.2019.10.031
[11]	王翠莲. 游戏护理模式在内窥镜下小儿腺样体切除手术中的应用效果[J]. 护理实践与研究, 2018, 15(21): 119-121. doi: 10.3969/j.issn.1672-9676.2018.21.049
[12]	GAN T J. Poorly controlled postoperative pain: prevalence, consequences, and prevention[J]. J Pain Res, 2017, 10: 2287-2298. doi: 10.2147/JPR.S144066
[13]	徐皓芝. 综合性护理干预对腺样体切除患儿术后疼痛及生活质量的影响[J]. 中西医结合护理(中英文), 2019, 5(2): 142-145. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXHL201902038.htm
[14]	BORIC K, DOSENOVIC S, JELICIC KADIC A, et al. Interventions for postoperative pain in children: An overview of systematic reviews[J]. Paediatr Anaesth, 2017, 27(9): 893-904. doi: 10.1111/pan.13203
[15]	陶小红, 张冰, 孙敏. 游戏护理模式在小儿腹部手术中的应用[J]. 现代中西医结合杂志, 2017, 26(2): 218-220. doi: 10.3969/j.issn.1008-8849.2017.02.039
[16]	黄春柳, 高少艳, 覃兴龙. 互动游戏对OSAHS患儿术前焦虑及术后疼痛的影响[J]. 中华现代护理杂志, 2014, 20(5): 565-566. doi: 10.3760/cma.j.issn.1674-2907.2014.05.022
[17]	董秀丽, 覃倩, 李燕华, 等. 术后疼痛患儿镇痛药物使用研究现状[J]. 护理学杂志, 2014, 29(10): 20-22. doi: 10.3870/hlxzz.2014.10.020
[18]	邓克霞. 童趣化护理干预对学龄前患儿麻醉诱导配合的影响[J]. 护理学杂志, 2016, 31(10): 56-58. doi: 10.3870/j.issn.1001-4152.2016.10.056
[19]	张标新, 李伦兰, 朱子秀, 等. 儿童扁桃体切除术后疼痛的非药物性护理干预[J]. 护理学杂志, 2016, 31(14): 21-23. doi: 10.3870/j.issn.1001-4152.2016.14.021
[20]	张伟芬, 潘巧琴. 住院肺炎患儿家属心理反应及需求的调查[J]. 中华现代护理杂志, 2018, 24(14): 1711-1714. doi: 10.3760/cma.j.issn.1674-2907.2018.14.027