Abstract:

Objective　To explore the effect of therapeutic nursing process based on continuous blood purification (CBP) risk control in children with severe sepsis in pediatric intensive care unit (PICU). Methods　A retrospective analysis was performed on 78 children with severe sepsis admitted to the PICU of Henan Children's Hospital from January 2022 to January 2024, who were divided into two groups with 39 cases in each group according to different nursing methods. In the control group, 20 boys and 19 girls, aged (9.95±0.54) years, received routine nursing. In the observation group, 22 boys and 17 girls, aged (9.98±0.57) years, received therapeutic nursing process based on CBP risk control. Both groups received continued nursing until the children were discharged from hospital. The severity of disease, levels of inflammatory factors, quality of life, family satisfaction, and incidence of complications were compared between the two groups. χ² test and t test were used for statistical analysis. Results　After nursing, the Acute Physiology and Chronic Health Evaluation Ⅱ score and levels of C-reactive protein, tumor necrosis factor-α, and procalcitonin in the observation group were lower than those in the control group [(21.15±3.07) points vs. (28.64±3.12) points, (20.03±4.46) mg/L vs. (25.99±5.31) mg/L, (45.33±22.65) µg/L vs. (66.39±25.15) µg/L, (0.95±0.22) mg/L vs. (1.47±0.45) mg/L], with statistically significant differences (t=10.686, 5.367, 3.886, and 6.483, all P<0.001); the scores of physiological function, emotional function, social function, and role function of the Children's Quality of Life Universal Core Scale (PedsQL 4.0) and nursing satisfaction were higher than those in the control group (all P<0.05). The total complication rate of the observation group was lower than that of the control group [5.13% (2/39) vs. 20.51% (8/39)] (χ²=4.129, P=0.042). Conclusion　Therapeutic nursing process based on CBP risk control can improve the illness and inflammatory factor levels in PICU children with severe sepsis, reduce the incidence of complications, effectively ensure the safety, improve their quality of life, to gain higher satisfaction with family members.

Key words:

Severe sepsis, Continuous blood purification, Risk control, Therapeutic nursing process, Children

摘要：

目的　探讨基于连续性血液净化（CBP）风险控制的治疗性护理程序在儿科重症监护病房（PICU）严重脓毒症患儿中的应用效果。方法　回顾性分析河南省儿童医院郑州儿童医院2022年1月至2024年1月PICU收治的严重脓毒症患儿78例，依照护理方法不同分为两组，各39例。对照组男20例，女19例，年龄（9.95±0.54）岁，采取常规护理。观察组男22例，女17例，年龄（9.98±0.57）岁，实施基于CBP风险控制的治疗性护理程序。两组均持续护理至患儿出院。比较两组患儿的病情严重情况、炎症因子水平、生活质量、家属满意度以及并发症发生率。统计学方法采用χ²检验、t检验。结果　护理后，观察组的急性生理学和慢性健康状况评价Ⅱ评分低于对照组［（21.15±3.07）分比（28.64±3.12）分］，C-反应蛋白、肿瘤坏死因子-α、降钙素原水平均低于对照组［（20.03±4.46）mg/L比（25.99±5.31）mg/L、（45.33±22.65）µg/L比（66.39±25.15）µg/L、（0.95±0.22）mg/L比（1.47±0.45）mg/L］，差异有统计学意义（t=10.686、5.367、3.886、6.483，均P<0.001）；儿童生活质量普适性核心量表（PedsQL 4.0）的生理功能、情感功能、社会功能、角色功能评分和护理满意度的各项评分均高于对照组（均P<0.05）。观察组并发症总发生率低于对照组［5.13%（2/39）比20.51%（8/39）］，差异有统计学意义（χ²=4.129，P=0.042）。结论　基于CBP风险控制的治疗性护理程序可改善严重脓毒症患儿的病情和炎症因子水平，降低并发症发生率，有效保障患儿生命安全，改善其生活质量，提高患儿家属的护理满意度。

关键词:

严重脓毒症, 连续性血液净化, 风险控制, 治疗性护理程序, 儿童