造血干细胞移植患儿运动康复分级护理方案的构建与应用研究

doi:10.3761/j.issn.0254-1769.2025.09.002

摘要/Abstract

摘要：

目的构建造血干细胞移植（hematopoietic stem cell trans plantation，HSCT）患儿运动康复分级护理方案并进行应用，旨在为医护人员指导HSCT患儿进行运动康复提供依据。方法通过文献分析及德尔菲专家函询，构建HSCT患儿运动康复分级护理方案。采用便利抽样法，于2023年6月—12月，选取苏州市某三级甲等儿童医院血液科的HSCT患儿作为研究对象，其中2023年9月—12月的26例HSCT患儿作为试验组，2023年6月—8月的23例HSCT患儿作为对照组。试验组应用运动康复分级护理方案，对照组应用常规护理，运动干预8周后比较两组的心肺功能及不良事件发生情况，并统计试验组运动干预方案的依从性。结果构建的HSCT患儿运动康复分级护理方案包括6个一级条目、20个二级条目、44个三级条目。最终，试验组21例、对照组23例完成该研究。干预后，试验组6 min步行距离较对照组增加，差异具有统计学意义（P<0.001）；试验组85.71%的患儿运动依从性良好；两组均无不良事件发生。结论构建的HSCT患儿运动康复分级护理方案科学合理、安全可行，可改善HSCT患儿的心肺能力，为其运动康复提供依据。

关键词: 造血干细胞移植, 运动, 德尔菲技术, 康复护理, 儿科护理学

Abstract:

Objective To construct a graded nursing program for exercise rehabilitation of children with hematopoietic stem cell transplantation（HSCT） and carry out a preliminary application，aiming to provide a basis for healthcare personnel to guide the exercise rehabilitation of children with HSCT. Methods Literature analysis and Delphi expert correspondence were used to construct a graded nursing program of exercise rehabilitation for children with HSCT. Through the convenience sampling method，children with HSCT in the hematology department of a tertiary-level children’s hospital in Suzhou City were selected as the study subjects from June-December 2023，of which 26 children with HSCT from September-December 2023 served as an experimental group，and 23 children with HSCT from June-August 2023 as a control group. The experimental group was applied with the graded nursing program of exercise rehabilitation，and the control group was applied with the conventional nursing care. The comparison of cardiorespiratory fitness and adverse events between the 2 groups after 8 weeks of exercise intervention was conducted，and the adherence to the exercise intervention programme in the experimental group was recorded. Results The final constructed graded care program of exercise rehabilitation for children with HSCT included 6 primary indicators，20 secondary indicators，and 44 tertiary indicators. Finally，21 children in the experimental group and 23 children in the control group were included in the study. After the intervention，the 6 min walking distance of the experimental group increased compared with that of the control group，and the difference was statistically significant（P<0.001）. 85.71% of children in the experimental group had good exercise compliance，and there was no adverse events in both groups. Conclusion The constructed graded nursing program of exercise rehabilitation for children with HSCT is scientific，reasonable，safe and feasible，which can improve the cardiorespiratory capacity of children with HSCT and provide the basis for their exercise rehabilitation.

Key words: Hematopoietic Stem Cell Transplantation, Exercise, Delphi Technology, Rehabilitation Nursing, Pediatric Nursing

阎寅至, 闻芳, 王敏, 周雪梅, 马金玲, 吴惠芳, 姚文英. 造血干细胞移植患儿运动康复分级护理方案的构建与应用研究[J]. 中华护理杂志, 2025, 60(9): 1036-1042.

YAN Yinzhi, WEN Fang, WANG Min, ZHOU Xuemei, MA Jinling, WU Huifang, YAO Wenying. Construction and application of a graded nursing program for exercise rehabilitation in children with hematopoietic stem cell transplantation[J]. Chinese Journal of Nursing, 2025, 60(9): 1036-1042.

图/表 3

表1 造血干细胞移植患儿运动康复分级护理方案

Table 1 The graded nursing program for exercise rehabilitation in children with HSCT

表2 两组一般资料的比较

Table 2 Comparison of general data between 2 groups

表3 两组6 min步行距离的比较（m，$\bar{x} \pm s$）

Table 3 Comparison of 6 minute walking distance between 2 groups（m，$\bar{x} \pm s$）

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