曾萍芳++++++黄海波++++++周燕

[摘要]目的 探讨预见性护理在提高重症肺炎患儿治疗效果和降低并发症发生率中的作用。方法 选取2012年1月～2016年5月我院收治的66例重症肺炎患儿，随机分为研究组和对照组，各33例。对照组采用常规护理措施，研究组在对照组基础上给予预见性护理，对两组患儿治疗前后肺功能改善情况、临床症状、体征改善时间及并发症情况进行综合比较。结果 治疗后7 d和14 d，研究组患儿动脉二氧化碳分压（PaCO2）明显低于对照组（P<0.01），研究组氧分压（PaO2）及血氧饱和度（SpO2）高于对照组（P<0.01）；研究组患儿咳嗽、气促、哮鸣音等症状消失时间短于对照组（P<0.01）；研究组住院时间短于对照组（P<0.01）；对照组出现肺水肿4例（12.1%），支气管扩张1例（3.0%），感染性休克1例（3.0%），研究组患儿未出现治疗并发症，优于对照组（P<0.05）。结论 预见性护理应用于重症肺炎患儿效果确切，能有效改善肺功能、增强治疗效果，降低并发症发生率，改善患儿预后，值得临床推广。

[关键词]预见性护理；儿童；重症肺炎；并发症

[中图分类号] R248.4 [文献标识码] A [文章编号] 1674-4721（2016）10（a）-0179-03

[Abstract]Objective To explore the role of predictive nursing in enhancing the treatment effects of children with severe pneumonia and decreasing the incidence rate of complications.Methods 66 children with severe pneumonia from January 2012 to May 2016 of our hospital were selected and were randomly divided into study group and control group.33 cases in each group.Patients in control group were used routine nursing measures，and patients in study group were given predictive nursing on the basis of control group.Improvement of pulmonary function，clinical symptom and signs improvement time and complications before and after treatment of children patients in two groups were comprehensive compared.Results After treatment for 7 days and 14 days，the artery PaCO2 of study group was lower than that of control group （P<0.01），the PaO2 and SpO2 of study group was higher than that of control group （P<0.01），the symptom disappearance time of cough，shortness of breath and wheeze of study group were shorter than those of control group （P<0.01）；the hospital stay of study group was shorter than that of control group （P<0.01）；there were 4 cases （12.1%） of pulmonary edema，1 case （3.0%） bronchiectasia and 1 case （3.0%） septic shock in control group，while no complications appeared in study group and which was better than that of control group （P<0.05）.Conclusion Using predictive nursing in children with severe pneumonia with definitely effects，which can improve pulmonary function effectively，enhance treatment effects，decrease incidence rate of complications，improve prognosis of children patients and is worth to popularize in clinical.

[Key words]Predictive nursing；Children；Severe pneumonia；Complications

肺炎是儿童的常见病和多发病，是引起儿童死亡的重要原因之一。儿童重症肺炎起病急、变化快，病情重，并发症较多，严重影响患儿的生长发育[1]。临床给予积极治疗的同时，配合针对性护理措施，能明显改善病情，促进患儿早期康复[2-3]。预见性护理即超前护理，采取积极主动防范措施，及时发现和解决患儿存在和潜在的护理问题，保障临床治疗效果。为探讨预见性护理在提高重症肺炎患儿治疗效果和降低并发症发生率中的作用，本研究选取我院重症肺炎患儿，现报道如下。

1资料与方法

1.1一般资料

选取2012年1月～2016年5月我院66例重症肺炎患儿。将其随机分为研究组和对照组，各33例。研究组男19例，女14例；平均年龄（38.61±4.65）d；体重（5.21±0.84）kg。对照组男20例，女13例；平均年龄（39.16±4.42）d；体重（5.35±0.92）kg。本研究经医院医学伦理委员会审核，患儿家属签署知情同意书。两组一般资料比较，差异无统计学意义（P>0.05），具有可比性。……