儿童便秘致重症粪嵌塞症的临床调养护理对策
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摘要
目的:探寻小儿便秘所致重症粪嵌塞的护理对策,减少因便秘带给儿童的身心伤害。方法:92例粪嵌塞症患儿随机分成试验组、对照组,试验组用通便治疗加综合法调养护理,对照组用单纯通便治疗。结果:两组病例在入组前资料比较,差异无统计学意义(P>0.05)。两组疗效比较,试验组治愈40例,显效3例、有效2例、无效1例(1例脱落病例算作无效病例),总有效率97.83%;对照组治愈33例、显效6例、有效7例、无效0例,总有效率100%。两组疗程治疗结束后随访6个月,试验组治愈病例中2例复发,复发率5.0%,对照组治愈病例中有13例复发,复发率39.4%,两组差异有统计学意义(P<0.05)。两组在远期疗效,恢复患儿自主排便,食欲改变,肛周局部清洁度,肛周局部皮损恢复情况,食欲改善,学习进步等方面有统计学意义。结论:通便治疗加综合调养护理法在恢复患儿自主排便、降低复发率、促进身心健康等方面优于单纯通便治疗组,有宣教推广意义。
Objective:To explore and find the nursing countermeasures of severe fecal impaction caused by constipation in children,which can reduce the physical and mental injury to children due to constipation.Methods:92 children with fecal impaction were randomly divided into experimental group and control group.The experimental group was nursed with laxative treatment and comprehensive method,while the control group was treated with simple laxative treatment.Results:There was no statistical significance on the data of the two groups before admission(P>0.05).Comparison of curative effects between the two groups.In the experimental group,40 cases were cured,3 cases were significantly effective,2 cases were effective and 1 case was ineffective(1 case of abscission was considered as invalid).The total effective rate was 97.83%.In the control group,33 cases were cured,6 cases were significantly effective,7 cases were effective and 0 cases were ineffective.The total effective rate was 100%.Following up for 6 months after the treatment of the two groups,2 of the cured cases in the test group relapsed,with a recurrence rate of 5.0%,while 13 of the cured cases in the control group recurred,with a recurrence rate of 39.4%.There was a significant difference between the two groups(P<0.05).In the long-term efficacy of the two groups,the recovery of children's spontaneous defecation,the changes of appetite,perianal local cleanliness,recovery of perianal local lesions,appetite improvement,learning progress and other things had statistical significance.Conclusion:The laxative treatment and comprehensive nursing method are better than the laxative treatment group in restoring children's independent defecation,reducing recurrence rate,promoting physical and mental health and other aspects,and it has propaganda and promotion significance.
Objective:To explore and find the nursing countermeasures of severe fecal impaction caused by constipation in children,which can reduce the physical and mental injury to children due to constipation.Methods:92 children with fecal impaction were randomly divided into experimental group and control group.The experimental group was nursed with laxative treatment and comprehensive method,while the control group was treated with simple laxative treatment.Results:There was no statistical significance on the data of the two groups before admission(P>0.05).Comparison of curative effects between the two groups.In the experimental group,40 cases were cured,3 cases were significantly effective,2 cases were effective and 1 case was ineffective(1 case of abscission was considered as invalid).The total effective rate was 97.83%.In the control group,33 cases were cured,6 cases were significantly effective,7 cases were effective and 0 cases were ineffective.The total effective rate was 100%.Following up for 6 months after the treatment of the two groups,2 of the cured cases in the test group relapsed,with a recurrence rate of 5.0%,while 13 of the cured cases in the control group recurred,with a recurrence rate of 39.4%.There was a significant difference between the two groups(P<0.05).In the long-term efficacy of the two groups,the recovery of children's spontaneous defecation,the changes of appetite,perianal local cleanliness,recovery of perianal local lesions,appetite improvement,learning progress and other things had statistical significance.Conclusion:The laxative treatment and comprehensive nursing method are better than the laxative treatment group in restoring children's independent defecation,reducing recurrence rate,promoting physical and mental health and other aspects,and it has propaganda and promotion significance.
引文
[1] 中华医学会小儿外科分会肛肠外科学组.儿童功能性便秘诊断标准与治疗流程[J].中华小儿外科杂志,2011,32(8):629-630.
[2] Bromley D.Abdominal massage in the management of chronic constipation for children with disability[J].Community Prac,2014,87(12):25-29.
[3] 中华中医药学会脾胃病分会.便秘中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(15):1345-1350.
[4] Osatakul S,Puetpaiboon A.Use of Rome II versus Rome III criteria for diagnosis of functional constipation in young children [J].Pediatr Int,2014,56(1):83-88.
[5] Koppen IJN,Vriesman MH,Saps M,et al.Prevalence of Functional Defecation Disorders in Children:A Systematic Review and Meta-Analysis[J].Pediatr,2018,198:121-130.
[6] 齐妍枫.儿童便秘的危害及治疗[J].中国医药指南,2013,(18):793-794.
[7] Kartal A,YacIn M,Citgez B,et al.The effect of chronic constipation on the development of inguinal herniation[J].Hernia.2017,21(4):531-535.
[8] Nimrouzi M,Zarshenas MM.Functional constipation in children:non-pharmacological approach[J].J Integr Med,2015,13(2):69-71.
[9] Lonkhuyzen MLVE,Bols EM,Benninga MA,et al.Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care[J].Gastroenterology,2017,152(1):82-91.
[2] Bromley D.Abdominal massage in the management of chronic constipation for children with disability[J].Community Prac,2014,87(12):25-29.
[3] 中华中医药学会脾胃病分会.便秘中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(15):1345-1350.
[4] Osatakul S,Puetpaiboon A.Use of Rome II versus Rome III criteria for diagnosis of functional constipation in young children [J].Pediatr Int,2014,56(1):83-88.
[5] Koppen IJN,Vriesman MH,Saps M,et al.Prevalence of Functional Defecation Disorders in Children:A Systematic Review and Meta-Analysis[J].Pediatr,2018,198:121-130.
[6] 齐妍枫.儿童便秘的危害及治疗[J].中国医药指南,2013,(18):793-794.
[7] Kartal A,YacIn M,Citgez B,et al.The effect of chronic constipation on the development of inguinal herniation[J].Hernia.2017,21(4):531-535.
[8] Nimrouzi M,Zarshenas MM.Functional constipation in children:non-pharmacological approach[J].J Integr Med,2015,13(2):69-71.
[9] Lonkhuyzen MLVE,Bols EM,Benninga MA,et al.Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care[J].Gastroenterology,2017,152(1):82-91.