赵莹 郑岩

[摘要]目的：探究围术期个案护理联合新型硅胶耳罩在先天性小耳畸形全耳再造术中的应用效果。方法：选取2016年1月-2019年1月于笔者医院耳鼻咽喉头颈外科进行治疗的先天性小耳畸形患儿62例，按照随机数字表法分为对照组（31例）和观察组（31例）。两组患儿均行全耳再造术，对照组予以常规护理，观察组予以围术期个案护理联合新型硅胶耳罩。均护理至出院，一般为2～6周。比较两组患儿睡眠质量评分、不良反应发生情况及家属不良情绪评分、满意度。结果：观察组不良反应发生率为3.23%显著低于对照组25.81%，观察组家属满意率为93.55%高于对照组70.97%，差异均有统计学意义（P<0.05）。护理干预后，两组患儿匹茨堡睡眠质量指数量表（Pittsburgh sleep quality index，PSQI）評分均降低，且观察组低于对照组，差异均有统计学意义（P<0.05）。两组患儿家属焦虑自评分（Self-rating anxiety scale，SAS）、抑郁自评分（Self-rating depression scale，SDS）均降低，观察组低于对照组，差异均有统计学意义（P<0.05）。结论：围术期个案护理联合新型硅胶耳罩对先天性小耳畸形患儿的护理效果更好，有利于患儿术后恢复，值得临床推广使用。

[关键词]围术期个案护理; 新型硅胶耳罩;先天性小耳畸形;全耳再造术;负性情绪

Abstract： Objective  To explore the application effects on total ear reconstruction with congenital microtia by using perioperative case nursing combined with new silicone earmuff. Methods  62 children with congenital microtia treated in otolaryngology head and neck surgery of our hospital between January 2016 and January 2019 were selected and divided into the control group （31 cases） and the observation group （31 cases） according to the random number table method. Both groups of children received total ear reconstruction， the control group received routine nursing， and the observation group received perioperative case nursing combined with new silicone earmuffs. All patients were nursed to discharge from hospital， usually for 2-6 weeks. The scores of sleep quality， and complications， family satisfaction ， adverse emotion were compared between the two groups. Results  The incidence of adverse reactionin the observation group was lower than that in the control group （3.23% vs. 25.81%）， and the satisfaction rate of family members in the observation group was higher than that in the control group（93.55% vs 70.97%）， the differences were statistically significant（P<0.05）. After nursing intervention， the score of Pittsburgh sleep quality index （PSQI） in the two groups reduced， and that in the observation group was lower than that in the control group （P<0.05）. The scores of Self-rating anxiety scale （SAS） and Self-rating depression scale （SDS） of family members in the two groups all decreased， and those in the onservation group were lower than the control group （P<0.05）. Conclusion  Perioperative case nursing combined with new silicone earmuff has a better nursing effect on children with congenital microtia， which is conducive to the recovery of children after surgery. It is worthy of clinical application.

Key words： perioperative case nursing; new silicone earmuffs; congenital microtia; total ear reconstruction; negative emotion

先天性小耳畸形是一种新生儿发育异常所致的颅面畸形，严重影响患儿生活质量，同时也增加了家长的心理负担[1]。全耳再造术是先天性小耳畸形患儿的有效治疗方法，但是治疗过程中仍然存在较多的护理问题，探究如何提高护理质量是当下医学工作者的难题[2]。围术期个案护理是对患儿自身及家庭情况制定的具有针对性和全面性的护理方案[3]，新型硅胶耳罩是一种以硅胶为制作材料的再造耳保护罩，能够有效对再造耳进行保护，减少护理不当造成的损伤[4]。目前在临床中二者联合应用的研究较少，对患儿护理效果不甚明确，故设立本次研究，观察其在患儿围术期的运用效果，报道如下。

1  资……