医疗游戏辅导在儿童中心静脉导管相关性血栓预防中的应用研究

doi:10.3761/j.issn.2096-7446.2024.11.001

摘要/Abstract

摘要： 目的构建基于医疗游戏辅导的上肢大关节活动方案,评价该方案对降低儿童颈部中心静脉导管（central venous catheter,CVC）相关性血栓的有效性。方法采用便利抽样法,选取长春市某三级甲等医院儿童重症监护病房2022年1月—2023年11月颈部CVC置管患儿136例为研究对象,根据患儿入院时间先后顺序将其分为试验组（n=71）和对照组（n=65）。试验组在常规护理的基础上采取医疗游戏辅导上肢大关节活动,对照组给予血栓预防常规护理。结果试验组颈部CVC置管患儿上肢大关节活动后平均血流速优于对照组（P<0.05）,患儿颈部血栓发生率低于对照组（P<0.05）。结论基于医疗游戏辅导的上肢大关节活动可有效提高儿童颈内静脉血流速,降低颈内静脉血栓发生率。

关键词: 医疗游戏辅导, 上肢大关节, CVC导管, 血栓预防, 护理

Abstract: Objective To construct an activity program for upper limb large joints based on medical game guidance and evaluate the effectiveness of this program in reducing central venous catheter（CVC） associated thrombosis in children. Methods A total of 136 pediatric patients with cervical central venous catheter in the Pediatric Intensive Care Unit（PICU） of a tertiary Grade-A hospital in Changchun City from January 2022 to November 2023 were selected as the study objects by convenient sampling. According to the order of admission time,the children were divided into experimental group（n=71） and control group（n=65）. The control group was given routine nursing for thrombosis prevention,and the experimental group was given medical games to guide the movement of the large joints of the upper limbs based on routine nursing. Results The average blood flow rate after movement of the upper limb large joints in the experimental group was better than that of control group（P<0.05）,and the incidence of cervical thrombosis was lower than that of control group（P<0.05）. Conclusion The large joint movement of upper limb guided by medical games can effectively increase the blood flow rate of internal jugular vein and reduce the incidence of internal jugular vein thrombosis.

Key words: Medical Game Coaching, Large Joints of Upper Limbs, CVC Catheter, Thrombosis Prevention, Nursing Care

吴函书, 赵晓霜, 孙海瑞, 关汭昕, 张葆荣, 张丹. 医疗游戏辅导在儿童中心静脉导管相关性血栓预防中的应用研究[J]. 中华急危重症护理杂志, 2024, 5(11): 965-970.

WU Hanshu, ZHAO Xiaoshuang, SUN Hairui, GUAN Ruixin, ZHANG Baorong, ZHANG Dan. Application study of medical game guidance in the prevention of central venous catheter-related thrombosis in children[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(11): 965-970.

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