医疗游戏联合预见性护理对学龄期骨折患儿围术期不良情绪、术后疼痛及康复效果的影响-现代医学

医疗游戏联合预见性护理对学龄期骨折患儿围术期不良情绪、术后疼痛及康复效果的影响

单位：1. 河北省儿童医院消毒供应中心, 河北石家庄 050000;
2. 河北省儿童医院神经康复科, 河北石家庄 050000;
3. 河北省儿童医院创伤外科, 河北石家庄 050000;
4. 河北省儿童医院骨科, 河北石家庄 050000;
5. 河北省儿童医院手术室, 河北石家庄 050000;

关键词：医疗游戏预见性护理学龄期骨折不良情绪疼痛

分类号：R473.72

出版年·卷·期（页码）：2025·53·第一期（117-122）

摘要：

目的: 探讨医疗游戏联合预见性护理对学龄期骨折患儿围术期不良情绪、术后疼痛及康复效果的影响。方法: 选取2020年6月至2023年6月我院收治的180例骨折患儿，采用随机数表法将患儿分为观察组(医疗游戏联合预见性护理)及对照组(常规护理)各90例。比较两组手术时间、唤醒时间、拔管时间、唤醒后Ramsay镇静评分、入院时及术前不良情绪[改良耶鲁术前焦虑量表(m-YPAS)]、术后疼痛[改良目的疼痛评分法(MOPS)]、依从性(Frankl依从性量表)、康复效果[骨折愈合时间，临床愈合时间、骨折线消失时间、功能独立性评定量表(FIM)]。结果: 两组手术时间、拔管时间比较差异无统计学意义(P>0.05)，观察组唤醒时间、唤醒后Ramsay镇静评分较低(P<0.05)；术前，观察组m-YPAS评分下降幅度较大(P<0.05)；术后返回病房、术后6 h及12 h，观察组MOPS均较低(P<0.05)；观察组依从性评分较高(P<0.05)；两组骨折愈合时间、临床愈合时间、骨折线消失时间、FIM比较差异无统计学意义(P>0.05)。结论: 医疗游戏联合预见性护理能够减轻学龄期骨折患儿围术期不良情绪、术后疼痛，提升患儿依从性。

Objective: To study the effects of medical games combined with predictive nursing on perioperative bad mood, postoperative pain and rehabilitation of school-age children with fractures. Methods: A total of 180 children with fractures treated in our hospital from June 2020 to June 2023 were chosen and separated into observation group(n=90, medical games+predictive nursing) and control group(n=90, routine nursing) by random number table method. The operation time, awaking time, extubation time, Ramsay sedation score after waking up, bad mood at admission and before surgery evaluated by modified Yale Preoperative Anxiety Scale(m-YPAS), postoperative pain evaluated by modified objective pain scale(MOPS), compliance evaluated by Frankl compliance scale, and rehabilitation effect, including fracture healing time, clinical healing time, fracture line disappearance time, evaluated by functional independence measure(FIM)scale, were compared between the two groups. Results: The operation time and extubation time of the two groups showed no statistically significant difference(P>0.05), but the observation group had lower awaking time and Ramsay sedation score(P<0.05). Before operation, the m-YPAS score in the observation group significantly decreased(P<0.05). The observation group had significantly lower MOPS score when they returned to the ward after surgery and at 6 h and 12 h after surgery(P<0.05), while compliance score was remarkably higher(P<0.05). The fracture healing time, clinical healing time, fracture line disappearance time and FIM of the two groups showed no statistically significant difference(P>0.05). Conclusion: Medical games combined with predictive nursing can reduce perioperative bad mood and postoperative pain in school-age children with fractures, and improve their compliance.

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