闭塞性细支气管炎患儿肺康复训练系统的研发与应用

doi:10.3761/j.issn.0254-1769.2024.14.002

摘要/Abstract

摘要：

目的研发闭塞性细支气管炎患儿肺康复训练系统，并探讨其应用效果。方法构建闭塞性细支气管炎患儿肺康复训练方案，并以此为基础研发闭塞性细支气管炎患儿肺康复训练系统。采用便利抽样法，选取2022年1月—12月在湖南省某三级甲等儿童专科医院呼吸内科住院的44例闭塞性细支气管炎患儿作为研究对象，按病区将其分为试验组和对照组各22例。试验组采用肺康复训练系统进行训练，对照组通过护士示范、指导的方式实施肺康复。在干预前、干预4周及12周时，比较两组的临床症状严重程度、肺功能、肺康复依从性及肺康复相关不良事件的发生情况。结果试验组无脱落病例，对照组脱落1例，最终试验组纳入22例、对照组纳入21例。重复测量方差分析结果显示，两组不同时间点临床症状严重程度、肺功能比较，时间、组间及交互作用均具有统计学意义（P<0.05）。简单效应分析结果显示，干预4周、12周后，试验组临床症状严重程度轻于对照组，差异具有统计学意义（P<0.001）；干预12周时，试验组第1秒用力呼气容积、用力肺活量、最高呼气流速等肺功能指标均高于对照组，差异具有统计学意义（P<0.001）。干预4周、12周时，试验组肺康复依从性均高于对照组，差异具有统计学意义（P<0.05）；干预12周时，试验组肺康复相关不良事件少于对照组，差异具有统计学意义（P=0.026）。结论使用闭塞性细支气管炎患儿肺康复训练系统能有效缓解患儿的临床症状，改善其肺功能，提高肺康复依从性并减少相关不良事件的发生。

关键词: 闭塞性细支气管炎, 肺康复, 情景模拟, 依从性, 儿科护理学

Abstract:

Objective To develop a pulmonary rehabilitation training system based on scenario simulation for children with bronchiolitis obliterans，and to explore its application effect. Methods A pulmonary rehabilitation training program for children with bronchiolitis obliterans was constructed，and on the basis of this program，a pulmonary rehabilitation training system based on scenario simulation was developed for children with bronchiolitis obliterans，with real-time monitoring of relevant data. 44 children with bronchiolitis obliterans who were hospitalized in the Department of Respiratory Medicine of a tertiary A children’s specialized hospital in Hunan Province from January to December 2022 were selected by convenience sampling method，and the subjects were divided into an experimental group and a control group with 22 cases in each group. The experimental group adopted a pulmonary rehabilitation training program based on scenario simulation，and the control group implemented pulmonary rehabilitation through nurse demonstration and guidance. At pre-intervention，4 weeks，and 12 weeks of intervention，the 2 groups were compared in terms of clinical symptom severity，pulmonary function，adherence to pulmonary rehabilitation，and the occurrence of pulmonary rehabilitation-related adverse events. Results There were no shedding cases in the experimental group and a case in the control group，and 22 cases were finally included in the experimental group and 21 cases in the control group. The results of repeated measures ANOVA showed that the comparison of clinical symptom severity and pulmonary function between the 2 groups at different time points was statistically significant in terms of time，between groups and interaction（P<0.05）. Simple effect analysis showed that after 4 and 12 weeks of intervention，the severity of clinical symptoms in the experimental group was lighter than that in the control group，and the difference was statistically significant（P<0.001）. At 12 weeks of intervention，pulmonary function indexes，such as exertional expiratory volume in the first second，exertional lung volume，and maximum expiratory flow rate，were higher in the experimental group than those in the control group，and the difference was statistically significant（P<0.001）. At 4 and 12 weeks of intervention，the compliance of pulmonary rehabilitation in the experimental group was higher than that of the control group，and the difference was statistically significant（P<0.05）. At 12 weeks of intervention，the occurrence of adverse events related to pulmonary rehabilitation in the experimental group was less than that in the control group，and the difference was statistically significant（P=0.026）. Conclusion The use of a scenario simulation-based pulmonary rehabilitation training system for children with bronchiolitis obliterans can effectively alleviate the clinical symptoms of children，improve their pulmonary function，increase compliance，and reduce the occurrence of pulmonary rehabilitation-related adverse events.

Key words: Bronchiolitis Obliterans, Pulmonary Rehabilitation, Scenario Simulation, Compliance, Pediatric Nursing

易敏, 吴霞, 谭小艳, 钟丽娜, 杨琴, 陈艳萍, 刘花艳. 闭塞性细支气管炎患儿肺康复训练系统的研发与应用[J]. 中华护理杂志, 2024, 59(14): 1678-1686.

YI Min, WU Xia, TAN Xiaoyan, ZHONG Lina, YANG Qin, CHEN Yanping, LIU Huayan. Development and application of a pulmonary rehabilitation training system for children with bronchiolitis obliterans[J]. Chinese Journal of Nursing, 2024, 59(14): 1678-1686.

图/表 5

表1 闭塞性细支气管炎患儿肺康复训练方案

Table 1 Pulmonary rehabilitation protocol for children with bronchiolitis obliterans

表2 两组一般资料比较

Table 2 Baseline information of participants in 2 groups

表3 两组临床症状严重程度比较（分，$\bar{x}±s$）

Table 3 Comparison of the clinical symptom severity between the 2 groups（score，$\bar{x}±s$）

表4 两组肺功能比较结果（$\bar{x}±s$）

Table 4 Pulmonary function comparison between the 2 groups（$\bar{x}±s$）

表5 两组肺康复依从性及肺康复相关不良事件的发生情况比较[例（百分率，%）]

Table 5 Comparison of pulmonary rehabilitation completion and the occurrence of related adverse events[cases（percentage，%）]

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