目的 探讨分析重症肺炎患儿父母焦虑、抑郁症状及影响因素.方法 选取2014年1月-2015年1月我院收治的98例重症肺炎患儿父母作为研究对象(观察组),同期选取82例一般住院患儿父母作为对照组,采用一般情况调查表、Zung的焦虑自评量表(SAS)和抑郁自评量表(SDS)对二组患儿父母进行调查,并对调查结果进行分析.结果 ①观察组患儿父母焦虑、抑郁得分均明显高于对照组患儿父母(t=8.269,P＜0.001;t=17.007,P＜0.001);②对照组患儿父母焦虑发生率(75.61％)、抑郁发生率(21.95％)均低于观察组(91.84％,78.57％)(x2=9.527,P=0.023;x2=57.427,P＜0.001);③女性焦虑程度高于男性,文化程度、疾病认知情况均与焦虑程度呈负相关,自费承担医疗费用与焦虑程度呈正相关;④女性抑郁程度高于男性,自费承担医疗费用与焦虑程度呈正相关.结论 重症肺炎患儿父母焦虑、抑郁症状发生率较高,应根据其焦虑、抑郁的影响因素制定针对性的措施,以改善其心理状况.

Objective: To explore the impact of graphic communication in nursing on negative emotion, pain degree and relations’ awareness of health atfer pediatric thoracotomy.Methods: A total of 76 children undergoing elective thoracotomy in our hospital were selected and randomly divided into observation group and control group, with 38 cases in each group. Both groups conducted routine nursing and the observation group with relations were additionally employed graphic communication in nursing. Children’s negative emotion before the operation and after the nursing was assessed by means of “Infant-toddler social and emotional assessment”. Scores of patients’ postoperative pain degree at different time point were compared between the two groups. Their relations’ awareness of health was also observed.Results: Before the operation the positive rates of externalizing, internalizing, deregulation and competence were not significantly different between the two groups (P>0.05). In the observation group the positive rates of the four dimensions decreased after the nursing, and were lower than that in the control group, and among which the difference in the T-score of internalizing was statistically significant (P<0.05). Postoperative pain degree scores were estimated immediately after the transfer to the ward and were not different between the two groups (P>0.05). hTe scores of FLACC in the observation group were 5.41±0.64, 4.02±1.44, 2.76±0.96 and 2.02±0.58 at 1, 3, 5, and 10 h after the operation, and they were all signiifcantly lower than that in the control group, which were respectively 6.11±0.73, 5.96±1.52, 4.88±0.81, and 3.97±0.77 (allP<0.05). hTe rates of relations’ awareness of health was 97.37% in the observation group, and was signiifcantly higher than in the control group, with whose rate was only 73.68% (P<0.05). hTe rate of unawareness increased from 5.26% to 15.79% at 3- and 9-month follow-up in the observation group, respectively, which were both signiifcantly lower than in the observation group, from 21.05% to 36.84% (P<0.05).Conclusion: Graphic communication in nursing is based on pediatric specialization and directly targeting patients and relations, which lowers pediatrics’ negative emotion and relief their postoperative pain degree, and enhances relations’ awareness of health. It has a higher clinical application and should be used widely.

目的：研究 ICU 中儿童重型颅脑外伤（TBI）行早期营养支持护理对患者治疗时间及预后的影响。方法随机选择240例明确患有 TBI 的儿童，每位患者均给予营养支持治疗，在治疗初期，未予以早期营养支持护理，治疗一段时间后，所有患者均行早期营养支持护理，同样的营养支持，对比护理前后儿童的营养状态，观察血清白蛋白、三酰甘油、血红蛋白、低蛋白血症发生率等，记录开始营养天数和达到完全热量摄入天数数据，并判断其与儿童预后的关系，根据儿童护理前后日常生活活动能力量表（ADL）评定护理工作在儿童 TBI 早期营养支持的作用。结果经过早期营养支持护理后，TBI 患者的营养状况改善明显，血清白蛋白、血脂、血红蛋白等均显著回升，颅内压、GCS 评分也有好转，护理前后差异有统计学意义（ P ＜0.05）；护理后 TBI 患者，ADL 评分的上升趋势较快，明显好于护理前，差异有统计学意义（ P ＜0.05）；通过改良儿童脑功能分级量表（pediatric cerebral performance category，PCPC）可知正常、残疾、昏迷/死亡各占66.3％、26.7％、7.0％，预后越差，开始营养天数和达到完全热量摄入天数越多，差异有统计学意义（ P ＜0.05）。结论护理工作在 TBI 早期营养支持中的应用，可明显减少治疗时间，促进儿童好转，改善预后，并可减少营养支持治疗产生的并发症，提高儿童日常生活活动能力。在临床中应用的价值高、效果好，应推荐。