摘要
目的 探讨基于需求理论的综合干预对先天性十二指肠闭锁与狭窄(CDAS)围手术期新生儿康复质量及新生儿疼痛评估量表(NIPS)评分的影响。方法 选取2016年1月至2018年1月收治的新生儿CDAS患者137例进行回顾分析,按随机数字表法分为试验组(n=69)和对照组(n=68),其中试验组在围手术期均予以基于需求理论的综合干预,对照组则单纯予以常规干预,比较2组患儿康复质量及两种干预方法对NIPS评分的影响。结果 2组干预前D-乳酸、二胺氧化酶(DAO)、内毒素比较差异无统计学意义(P>0.05);干预后试验组上述3项指标均低于对照组(P<0.05)。CDAS严重程度与D-乳酸、DAO、内毒素水平高低呈正相关(P<0.05)。2组干预前白细胞(WBC)、血小板(PLT)、C反应蛋白(CRP)及降钙素原(PCT)比较差异无统计学意义(P>0.05);干预后试验组上述4项指标均低于对照组(P<0.05)。CDAS严重程度与PLT、CRP、PCT水平呈正相关(P<0.05)。试验组留置胃管时间、首次排气时间均短于对照组(P<0.05),试验组术后并发症发生率显著低于对照组(P<0.05)。2组干预前的面部表情、哭吵、呼吸形式、上肢形态、下肢形态及觉醒状态的单项分、总分比较差异无统计学意义(P>0.05);干预后试验组上述指标的单项分、总分均低于对照组(P<0.05),且CDAS严重程度与NIPS评分高低呈正相关(P<0.05)。结论 在CDAS患儿的围手术期干预中科学、合理的实施基于需求理论的综合干预能有效提升患儿康复质量,降低NIPS评分表达,有较好的临床应用价值。
Objective To explore the effect of a comprehensive intervention based on the needs theory on the quality of rehabilitation and the Neonatal Infant Pain Scale(NIPS)score in newborns with congenital duodenal atresia or stenosis(CDAS).Methods A total of 137 neonates with CDAS admitted from January 2016 to January 2018 were retrospectively enrolled.They were randomly assigned into the experimental group(n=69)and control group(n=68)using the random number table method(RNTM).A comprehensive intervention during the perioperative period based on the needs theory was applied to patients of the experimental group,while routine interventions were given to those of control group.Quality of rehabilitation and NIPS scores were compared between groups.Results There were no significant differences in D-lactate,diamine oxidase(DAO)and endotoxin before interventions between groups(P>0.05).After interventions,their levels were significantly lower in the experimental group than those of control group(P<0.05).The severity of CDAS was positively correlated with the levels of D-lactate,DAO,and endotoxin(P<0.05).There were no significant differences in the white blood cell count(WBC),platelet count(PLT),C-reactive protein(CRP)and procalcitonin(PCT)before interventions(P>0.05),which were significantly lower in the experimental group than those of control group(P<0.05).The severity of CDAS was positively associated with PLT,CRP,and PCT levels(P<0.05).The time of indwelling gastric tube and first exhaust were significantly shorter in the experimental group than those of control group(P<0.05).The incidence of postoperative complications was significantly lower in the experimental group than that of control group(P<0.05).There were no significant differences in the scores of facial expression,crying,breathing form,upper limb morphology,lower limb morphology and awakening state and the total scores before interventions between groups(P>0.05),which,after interventions,were significantly lower in the experimental group than those of control group(P<0.05).The severity of CDAS was positively correlated with NIPS score(P<0.05).Conclusion For neonates with CDAS,perioperative comprehensive interventions based on the needs theory can effectively improve the quality of rehabilitation,reduce NIPS score,and have good clinical application value.
作者
刘娟
杨延洁
王晶
唐春
巴依尔才次克
LIU Juan;YANG Yanjie;WANG Jing(Neonatal Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830011,China)
出处
《河北医药》
CAS
2024年第13期1960-1964,共5页
Hebei Medical Journal
基金
新疆维吾尔自治区自然科学基金项目(编号:2022D01C216)。
关键词
基于需求理论的综合干预
新生儿
先天性十二指肠闭锁与狭窄
康复质量
新生儿疼痛评估量表
comprehensive intervention based on needs theory
newborn
congenital duodenal atresia or stenosis
quality of rehabilitation
Neonatal Infant Pain Scale(NIPS)
