陆映霞 陈婉敏 伍微 周彩柳

[摘要] 目的 探討儿童互助（CTC）模式对肱骨髁上骨折患儿的应用效果。 方法 选择2017年1～8月在佛山市中医院接受治疗的肱骨髁上骨折患儿93例作为研究对象，按照入院时间顺序分为对照组（46例）和CTC组（47例），对照组采用常规护理教育模式，CTC组采用CTC干预模式进行健康宣教，比较两组患儿治疗依从性、Mayo评分及肘关节活动度。 结果 CTC组患儿治疗依从性明显优于对照组，差异有统计学意义（P < 0.05）。干预前两组疼痛、肿胀、关节活动范围及生活自理能力评分比较，差异无统计学意义（P > 0.05）。干预后两组上述评分均降低，且CTC组明显低于对照组，差异均有统计学意义（P < 0.05）。干预后CTC组屈曲、背屈、旋前和旋后的肘关节活动度均明显高于对照组，差异有统计学意义（P < 0.05）。 结论 基于CTC模式的健康宣教可有效提升肱骨髁上骨折患儿的治疗依从性，改善肘关节功能，对于促进患儿的疾病康复具有积极作用。

[关键词] 肱骨髁上骨折；CTC模式；护理教育；依从性；肘关节功能

[中图分类号] R473.72 [文献标识码] A [文章编号] 1673-7210（2018）07（a）-0163-05

The application effect of CTC mode-based nursing health education on children with supracondylar fracture of humerus

LU Yingxia CHEN Wanmin WU Wei ZHOU Cailiu

The Tenth Department of Orthopedics， Foshan Hospital of Traditional Chinese Medicine， Guangdong Province， Foshan 528000， China

[Abstract] Objective To explore the application effect of child to child （CTC） mode-based nursing health education on children with supracondylar fracture of humerus. Methods A total of 93 children with supracondylar fracture of humerus treated in Foshan Hospital of Traditional Chinese Medicine from January to August 2017 were selected and divided into the control group （46 cases） and the CTC group （47 cases） according to the admission time. The control group was given routine nursing education， while the CTC group was given CTC nursing health education. The treatment compliance， Mayo scores and range of mobility （ROM） in elbow joint in the two groups were compared. Results The treatment compliance in the CTC group was better than that of control group， with statistically significant difference （P < 0.05）. Before intervention， there were no statistically significant differences in the scores of pain， swelling， joint ROM and self-care ability between the two groups （P > 0.05）. After intervention， the scores above in the two groups were significant lower than those of control group and the scores above in the CTC group were lower than those of control group， with statistically significant differences （P < 0.05）. After intervention， flexion， dorsiflexion， pronation and supination of the elbow joint ROM in the CTC group were significantly higher than those of control group， with statistically significant differences （P < 0.05）. Conclusion CTC mode-based nursing health education can effectively improve the treatment compliance and elbow joint function in children with supracondylar fracture of humerus， and positively accelerate the rehabilitation.

[Key words] Supracondylar fracture of humerus； Child to child mode； Nursing education； Compliance； Elbow joint function

肱骨髁上骨折是最常见的儿童骨折类型，占所有儿童骨折的30%～40%[1]。由于解剖结构相对特殊，在创伤发生后可发生关节僵硬、肘内翻畸形或Volkmann缺血性肌挛缩等并发症，严重影响手术治疗效果[2]。早期的功能锻炼是促进关节功能恢复和预防各类并发症的有效措施，但由于肱骨髁上骨折多发生于学龄期儿童，患儿的自律性较差，且缺乏对疾病的必要认知，大多数患儿康复锻炼的依从性均相对较低，从而容易诱发不同程度的肘关节运动功能障碍[3-4]。儿童互助（child to child，CTC）模式是在20世纪70年代由伦敦大学儿童健康与教育研究所提出的儿童健康教育模式，该模式认为儿童在合作的状态下具备对健康问题的发现、分析及解决能力，通过儿童相互之间的知识传授、技能示范等活动可提升患儿参与健康管理的积极性[4]，目前该模式已经应用于疾病预防及健康教育等多个领域，并取得了一定的临床效果[4]。……