趣味视频引导的康复呼吸操对支气管肺炎患儿肺功能及治疗依从性的影响

doi:10.19983/j.issn.2096-8493.20260037

摘要/Abstract

摘要：

目的: 探讨趣味视频引导的康复呼吸操对支气管肺炎患儿肺功能及治疗依从性的影响。方法: 回顾性选取2023年8月至2024年7月福建省莆田市第一医院收治的支气管肺炎患儿65例作为对照组,选取2024年8月至2025年7月福建省莆田市第一医院收治的支气管肺炎患儿70例作为观察组。对照组患儿给予支气管肺炎的常规护理,观察组在对照组护理的基础上,给予趣味视频引导的康复呼吸操训练,对照组和观察组均持续护理2周。情绪状态采用儿童焦虑性情绪障碍筛查量表评估,于护理前及护理2周后由经过培训的医护人员通过一对一访谈结合患儿表现(低龄儿童由监护人协助评定)收集数据;治疗依从性采用基于Frankl量表改编的自行设计量表评估,于护理2周后通过医护人员观察、与患儿及家长沟通并参考监护人反馈收集数据。在护理前后记录患儿的临床症状缓解时间(退热时间、咳嗽缓解时间、肺部啰音缓解时间)、肺功能指标[肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in 1 second,FEV₁)、呼气峰流速(peak expiratory flow,PEF)]、情绪状态以及护理依从性。结果: 护理后,观察组患儿的FVC[(83.34±9.35)L]、FEV₁[(80.48±9.36)L]、PEF[(186.74±39.49)L/min]、依从性良好比例[87.14%(61/70)]均明显高于对照组[分别为(76.89±8.37)L、(73.65±8.23)L、(162.45±35.45)L/min、[66.15%(43/65)]],差异均有统计学意义(t=4.211,P<0.001;t=4.488,P<0.001;t=3.750,P<0.001;χ²=2.830,P=0.005)。观察组患儿的退热时间[(3.63±1.53)d]、咳嗽缓解时间[(5.28±1.12)d]、肺部啰音缓解时间[(5.01±1.17)d]、焦虑情绪评分[(26.12±3.47)分],均明显低于对照组[分别为(4.91±1.88)d、(5.84±1.32)d、(5.72±1.24)d、(29.45±3.23)分],差异均有统计学意义(t=4.352,P<0.001;t=3.140,P=0.002;t=3.423,P<0.001;t=5.759,P<0.001)。结论: 趣味视频引导的康复呼吸操对支气管肺炎患儿能够有效缩短临床症状缓解时间,促进肺功能的恢复,降低患儿焦虑程度,提升患儿在护理过程中的依从性,为支气管肺炎患儿的临床护理提供了一种有效、可行的方法,具有较高的临床应用价值。

关键词: 康复护理, 支气管肺炎, 儿童, 病人依从

Abstract:

Objective: To investigate the effect of rehabilitation breathing exercise guided by interesting videos on pulmonary function and treatment compliance in children with bronchopneumonia. Methods: Retrospectively, 65 children with bronchopneumonia admitted to the First Hospital of Putian City, Fujian Province from August 2023 to July 2024 were selected as control group, and 70 children with bronchopneumonia admitted to the same hospital from August 2024 to July 2025 were selected as observation group. Children in the control group received routine nursing care for bronchopneumonia, while those in the observation group were given rehabilitation breathing exercise training guided by interesting videos on the basis of routine nursing care applied to the control group. Both groups received continuous nursing care for 2 weeks. Their emotional states were assessed by the scale of Screen for Child Anxiety Related Emotional Disorders (SCARED). Data were collected by trained medical staff through one-on-one interviews combined with observation of the children’s performances (guardians assisted in the evaluation for young children) before nursing intervention and 2 weeks after nursing intervention. Treatment compliance was assessed by a self-designed scale adapted from the Frankl Scale, and data was collected 2 weeks after nursing intervention through the observation of medical staff, communication with children and their parents, and reference to guardian feedback. The relief time of clinical symptoms (fever resolution time, cough relief time, relief time of pulmonary rales), pulmonary function indicators (forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), peak expiratory flow (PEF)), emotional state and nursing compliance were recorded before and after nursing intervention in both groups. Results: After nursing intervention, the average FVC ((83.34±9.35) L), FEV₁ ((80.48±9.36) L), PEF ((186.74±39.49) L/min) and the proportion of children with good compliance (87.14% (61/70)) in the observation group were significantly higher than those in the control group ((76.89±8.37) L, (73.65±8.23) L, (162.45±35.45) L/min, 66.15% (43/65); t=4.211, P<0.001; t=4.488, P<0.001; t=3.750, P<0.001; χ²=2.830, P=0.005). The average fever resolution time ((3.63±1.53) d), cough relief time ((5.28±1.12) d), relief time of pulmonary rales ((5.01±1.17) d) and anxiety score ((26.12±3.47) points) in the observation group were significantly lower than those in the control group ((4.91±1.88) d, (5.84±1.32) d, (5.72±1.24) d, (29.45±3.23) points; t=4.352, P<0.001; t=3.140, P=0.002; t=3.423, P<0.001;t=5.759,P<0.001). Conclusion: Rehabilitation breathing exercise guided by interesting videos can effectively shorten the relief time of clinical symptoms, promote pulmonary function recovery, reduce the anxiety level of children with bronchopneumonia and improve their compliance with nursing care. It provides an effective and feasible method for the clinical nursing of children with bronchopneumonia and has high clinical application value.

Key words: Rehabilitation nursing, Bronchopneumonia, Children, Patient compliance

中图分类号:

R563.1+2

陈淑花, 郑晓花. 趣味视频引导的康复呼吸操对支气管肺炎患儿肺功能及治疗依从性的影响[J]. 结核与肺部疾病杂志, 2026, 7(2): 249-254. doi: 10.19983/j.issn.2096-8493.20260037

Chen Shuhua, Zheng Xiaohua. The effect of rehabilitation breathing exercise guided by interesting videos on pulmonary function and treatment compliance in children with bronchopneumonia[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(2): 249-254. doi: 10.19983/j.issn.2096-8493.20260037

图/表 4

表1

表2

表3

表4

参考文献 19

[1]	朱希达. 孟鲁司特钠治疗小儿呼吸系统反复感染的效果分析——评《儿科呼吸治疗学》. 中国实验方剂学杂志, 2023, 29(24):121.
[2]	吉祥灵, 雷智贤, 吴守业, 等. 儿童肺炎支原体感染支气管肺炎与大叶性肺炎临床及血液学特征. 中华医院感染学杂志, 2021, 31(2):281-285. doi:10.11816/cn.ni.2021-201703.
[3]	苏苗赏, 张海邻. 呼吸康复在儿童重症肺炎中的作用及前景. 中国实用儿科杂志, 2025, 40(8):676-679. doi:10.19538/j.ek2025080610.
[4]	罗梅, 胡园芳, 王龙燕, 等. 互动式健康教育模式在喘息性支气管肺炎患儿中的应用效果. 中国防痨杂志, 2024, 46(S2):403-404.
[5]	郑贝, 郑燕. 自制趣味视频指导干预对哮喘患儿心理状态、自护能力及呼吸训练依从性的影响. 中国健康心理学杂志, 2021, 29(7):1028-1032. doi:10.13342/j.cnki.cjhp.2021.07.016.
[6]	胡亚美, 江载芳. 诸福棠实用儿科学. 8版. 北京: 人民卫生出版社,2015:396-408.
[7]	焦敏, 杜亚松. 儿童焦虑性情绪障碍筛查量表的临床应用. 上海精神医学, 2005, 17(2):72-74. doi:10.3969/j.issn.1002-0829.2005.02.003.
[8]	谢明珠, 林燕, 夏丹丹. 学龄前支气管哮喘患儿创伤后成长对社会适应行为和治疗依从性的影响. 中国妇幼保健, 2022, 37(4):620-622. doi:10.19829/j.zgfybj.issn.1001-4411.2022.04.012.
[9]	徐曼, 卢丽, 杜双双, 等. 游戏化在慢性病自我管理中的开发与应用进展. 护理学杂志, 2025, 40(18):115-120. doi:10.3870/j.issn.1001-4152.2025.18.115.
[10]	刘祎, 黄翔毓. 连花清瘟颗粒辅治儿童咳嗽变异性哮喘合并肺炎支原体感染的临床效果. 临床合理用药, 2023, 16(17):9-12. doi:10.15887/j.cnki.13-1389/r.2023.17.003.
[11]	吕一宁, 麻彬彬, 郑美凤, 等. 腹式呼吸康复训练联合布地奈德对妊娠期社区获得性肺炎患者的临床研究. 中国防痨杂志, 2025, 47(S1):250-253.
[12]	李华文, 袁启艳. 趣味性健康教育对上呼吸道感染患儿治疗依从性和疾病认知水平的影响. 中国健康教育, 2023, 39(10):933-936,954. doi:10.16168/j.cnki.issn.1002-9982.2023.10.013.
[13]	杨莉莉, 李传景. 支原体肺炎患儿免疫指标与肺功能的关系及诊断效能. 国际检验医学杂志, 2025, 46(2):221-224. doi:10.3969/j.issn.1673-4130.2025.02.018.
[14]	沈丹, 褚文娟, 黄薇伊, 等. 学龄期儿童眼科局麻手术术前焦虑的影响因素分析. 军事护理, 2023, 40(9):43-47. doi:10.3969/j.issn.2097-1826.2023.09.011.
[15]	芦淑媛, 胡婷. 童趣式教育干预对学龄期疝微创手术患儿健康知识掌握度及不良情绪的影响. 中国健康心理学杂志, 2023, 31(3):321-326. doi:10.13342/j.cnki.cjhp.2023.03.001.
[16]	刘曦璇, 刘玉琳, 刘莎, 等. 学龄期支气管哮喘患儿呼吸康复操的研制及效果评价. 中华护理杂志, 2025, 60(9):1043-1050. doi:10.3761/j.issn.0254-1769.2025.09.003.
[17]	贾元敏, 伊默, 王晶晶, 等. 学龄期哮喘患儿症状控制水平的影响因素及路径分析. 中华护理杂志, 2022, 57(24):3004-3011. doi:10.3761/j.issn.0254-1769.2022.24.009.
[18]	Zhang W, Li H, Yuan J, et al. Effects of the Plan-Do-Check-Act Nursing Model on Improving Treatment Adherence and Lowering Nosocomial Infection in Elderly Bronchopneumonia Patients: A Randomised Controlled Trial. Scand J Caring Sci, 2025, 39(4):e70145. doi:10.1111/scs.70145.
[19]	Alexander-Ruff JH, Ruff SA, Roper C, et al. The Teddy Bear Clinic: Engaging School-Aged Children in Health Education. NASN Sch Nurse, 2024, 39(2):97-103. doi:10.1177/1942602X231184574.

组别	例数	护理前焦虑情绪评分	护理后焦虑情绪评分
对照组	65	47.45±5.32	29.45±3.23
观察组	70	47.41±5.46	26.12±3.47
t值		0.043	5.759
P值		0.966	<0.001

组别	例数	依从性良好	依从性一般	依从性差
对照组	65	43(66.15)	16(24.62)	6(9.23)
观察组	70	61(87.14)	6(8.57)	3(4.29)
χ²值			2.830
P值			0.005