邓菁　薛珍　游荣枫

[關键词] 急性呼吸窘迫综合征;专职化护理模式;机械通气;血气指标;并发症

[中图分类号] R473.56          [文献标识码] B          [文章编号] 1673-9701（2021）23-0185-04

Effect of professional nursing mode on blood gas index and prognosis of children with acute respiratory distress syndrome

DENG Jing    XUE Zhen   YOU Rongfeng

Ganzhou Maternal and Child Health Hospital，Ganzhou   341000，China

[Abstract] Objective To explore the effect of professional nursing mode on children with acute respiratory distress syndrome （ARDS）. Methods Eighty-six children with acute respiratory distress syndrome admitted to our hospital from January 2018 to January 2020 were selected and divided into two groups according to the random number table method，with 43 cases in each group.The control group was given routine nursing，while the observation group was given professional nursing mode.Blood gas index，multiple organ dysfunction score （Marshll），lung injury score （Murray），and complications were compared between the two groups. Results There was no statistically significant difference in blood gas index，Marshll and Murray scores between the two groups before intervention （P>0.05）.At discharge，PaCO2，Marshll and Murray scores of the two groups were lower than those before intervention，PaO2 and SpO2 were higher than those before intervention，and the differences were statistically significant （P<0.05）.At discharge，PaCO2 in the observation group was （43.62±4.58） mmHg，lower than that in the control group;PaO2 and SpO2 were （90.31±4.60） mmHg and （92.14±2.36） %，respectively，higher than that in the control group，with statistically significant differences （P<0.05）.The Marshll score （2.24±0.82） and Murray score （1.19±0.42） in the observation group were lower than those in the control group at discharge，and the difference was statistically significant （P<0.05）. The complication rate of the observation group was 4.65%，lower than that of the control group （18.60%），with a statistically significant difference （P<0.05）. Conclusion The professional nursing mode can relieve the dyspnea symptoms of children with acute respiratory distress syndrome，improve the blood gas index and lung function of children，and reduce the occurrence of complications，which is worthy of clinical application.

[Key words] Acute respiratory distress syndrome;Professional nursing mode;Mechanical ventilation;Blood gas index;Complications

急性呼吸窘迫综合征（Acute respiratory distress syndrome，ARDS）起病较急，病情发展迅速，预后较差，尤其对于免疫系统发育尚未完善儿童而言，造成的伤害性较大，甚至威胁其生命安全[1-2]。临床针对ARDS患儿在治疗原发病基础上多采取抗感染、镇静镇痛、补充营养以维持其身体机能，并结合持续供氧以改善缺氧情况[3]。但ARDS患儿病情变化快且较为复杂，治疗过程易发生诸多不良事件，影响患儿预后。护理措施的可行性、科学性可在一定程度上影响患者预后，已成为医院诊疗工作重要组成部分。专职化护理模式依托护理小组的形式完成组员培训，同时制定护理方案，以完成规范化、程序化护理过程[4]。本研究就专职化护理模式对ARDS患儿干预效果展开分析。现报道如下。

1资料与方法

1.1 一般资料

选取2018年1月至2020年1月我收治的86例急性呼吸窘迫综合征患儿，按随机数字表法分为两组，各43例。本研究经医学伦理委员会审核通过。观察组男27例，女16例;年龄1～12岁，平均年龄（6.01±1.20）岁;病程3～19 d，平均病程（8.92±2.16）d;急性生理与慢性健康状况评分：11.58～17.63分，平均评分（14.35±1.27）分。对照组男25例，女18例;年龄1～12岁，平均年龄（5.98±1.36）歲;病程2～20 d，平均病程（9.13±2.07）d;急性生理与慢性健康状况评分：11.41～17.24分，平均评分（14.50±1.09）分。两组一般资料比较，差异无统计学意义（P>0.05）。

1.2 入选标准

纳入标准：符合《小儿急性呼吸窘迫综合征诊疗技术规范》诊断标准[5];胸透提示肺部呈现斑状阴影，且患儿存在呼吸频率加快、呼吸窘迫等症状;均行机械通气;家属均知情同意。排除……