摘要
目的探讨家属个性化认知干预对新疆少数民族先天性脑积水患儿的影响。方法随机抽取2016年新疆医科大学第一附属医院小儿外科收治的新疆少数民族先天性脑积水患儿35例及其家属50例作为试验组,另选取本院2015年收治的新疆少数民族先天性脑积水患儿30例及其家属40例作为对照组。对照组患儿家属接受常规认知宣教,试验组患儿家属在对照组基础上接受个性化认知干预;两组患儿均随访12个月。比较两组患儿随访12个月存活情况、预后,出院前、出院后6个月及12个月营养状况〔包括年龄别身高Z评分(HAZ)、年龄别体质量Z评分(WAZ)及身高别体质量Z评分(WHZ)、铁蛋白〕,干预后患儿家属护理能力(包括营养膳食、功能康复锻炼、管道管理及基础护理),记录两组患儿随访12个月不良事件发生情况。结果(1)两组患儿随访12个月存活率、预后不良率比较,差异无统计学意义(P>0.05)。(2)时间与方法在HAZ、WHZ及铁蛋白水平上存在交互作用(P<0.05);时间、方法在HAZ、WAZ、WHZ及铁蛋白水平上主效应显著(P<0.01)。试验组患儿出院后6、12个月HAZ、WAZ、WHZ及出院后12个月铁蛋白水平高于对照组(P<0.01)。(3)干预后试验组患儿家属营养膳食、管道管理、基础护理评分及护理能力总分高于对照组(P<0.05),而两组患儿家属功能康复锻炼评分比较,差异无统计学意义(P>0.05)。(4)随访12个月两组患儿癫痫、压疮、感染发生率及再次行分流术者所占比例比较,差异无统计学意义(P>0.05);试验组患儿分流管意外发生率低于对照组(P<0.05)。结论家属个性化认知干预可有效改善新疆少数民族先天性脑积水患儿营养状况,有助于提高患儿家属护理能力,减少患儿不良事件的发生,但并未有效改善患儿预后。
Objective To explore the impact of individualized cognitive intervention for family members on children with congenital hydrocephalus in Xinjiang ethnic minorities.Methods In the Department of Pediatric Surgery,the First Affiliated Hospital of Xinjiang Medical University,35 congenital hydrocephalus children in Xinjiang ethnic minorities and their 50 family members were randomly chose as test group,meanwhile 30 congenital hydrocephalus children in Xinjiang ethnic minorities and their 40 family members were randomly chose as control group.Family members in control group were given routine cognitive education,while family members in test group were given individualized cognitive intervention;both groups were followed-up for 12 months.Surviving status and prognosis of children 12 months after follow-up,nutritional status〔including Height Age-specific Z score(HAZ),Weight Age-specific Z score(WAZ),Weight Height-specific Z score(WHZ)and ferritin〕of children before discharge,6 and 12 months after discharge,nursing competence(including nutritional diet,functional rehabilitation exercise,pipeline management and basic nursing)of family members after intervention,and incidence of adverse events during the 12-month follow-up were compared between the two groups.Results(1)There was no statistically significant difference in surviving rate or poor prognosis ratio between the two groups after 12-month followup(P>0.05).(2)There was statistically significant interaction between time and method in HAZ,WHZ and ferritin;main effects of time and method were statistically significant in HAZ,WAZ,WHZ and ferritin(P<0.01).HAZ,WAZ and WHZ 6 and 12 months after discharge,and ferritin 12 months after discharge in test group were statistically significantly higher than those in control group(P<0.01).(3)Nutritional diet score,pipeline management score,basic nursing score and total nursing competence score of family members in test group were statistically significantly higher than those in control group(P<0.05),but there was no statistically significant difference in functional rehabilitation exercise score of family members between the two groups(P>0.05).(4)There was no statistically significant difference in incidence of epilepsy,pressure sores or infection,or proportion of children received shunt again between the two groups(P>0.05),while incidence of shunt accident in test group was statistically significantly lower than that in control group(P<0.05).Conclusion Individualized cognitive intervention for family members can effectively improve the nutritional status in children with congenital hydrocephalus in Xinjiang ethnic minorities,which is helpful to improve the nursing competence of family members and reduce the risk of adverse events in children,but without effective improvement on prognosis of children.
作者
陈桂花
陈金荣
汪永新
CHEN Guihua;CHEN Jinrong;WANG Yongxin(The First Ward of Department of Pediatric Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Sports Medicine Ward of the Fourth Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;The Third Ward of Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《实用心脑肺血管病杂志》
2019年第10期87-90,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家自然科学基金委员会资助项目(81660543)
关键词
脑积水
个性化认知干预
营养状况
自护能力
Hydrocephalus
Individualized cognitive intervention
Nutritional status
Self-protection ability
