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[目的]观察按摩、针刺及护理干预小儿热性惊厥疗效。[方法]使用随机平行对照方法,将68例住院患者按抽签法简单随机分为两组。对照组34例常规护理:1取去枕仰卧位,衣领解开,头部向一侧偏并将口腔污染物及呼吸道内分泌物清除,压舌板纱布包裹放在上下牙齿间,避免唇舌被咬破,必要情况下可将舌头拔出,避免舌头后坠窒息;2就地抢救,予地西泮、苯巴比妥、10%水合氯醛等止惊药物,对呼吸抑制等现象进行观察;3呼吸不畅,耗氧量增加,极易出现脑组织缺氧,进而导致脑组织水肿等,加重惊厥,需进行低流量持续供氧,必要予地塞米松等药物;4加强安全防护,予退热药物,物理降温,同时迅速建立静脉通道,避免脑水肿。5加强心率、瞳孔、心律、血压、意识等生命体征观察,异常反应立即告知主治医生抢救,同时安抚家属,指导配合抢救。治疗组34例按摩针刺:手指按压水沟、百会、十宣、合谷、涌泉等穴;手指按压无效进行针刺,严格掌握针刺深度,进针后捻转或提插,刺激上述穴位,2~3min/次,1次/d;常规护理同对照组。连续护理7d为1疗程。观测临床症状、抽出停止时间、意识恢复时间、平均住院时间、不良反应。连续护理3疗程,判定疗效。[结果]治疗组痊愈30例,有效4例,无效0例,总有效率100.00%。对照组痊愈25例,有效3例,无效6例,总有效率82.35%。治疗组疗效优于对照组(P<0.05)。时间指标治疗组优于对照组(P<0.05)。[结论]按摩、针刺及护理干预小儿热性惊厥效果显著,值得推广。
[Objective] To observe the therapeutic effect of massage, acupuncture and nursing on children with febrile seizures. [Methods] Using randomized parallel control method, 68 inpatients were randomly divided into two groups according to random selection method. The control group of 34 cases of routine care: 1 take the pillow supine position, the collar untied, the head to one side and the oral contaminants and respiratory secretions cleared, tongue depot gauze wrapped in the upper and lower teeth, to avoid the tongue and tongue was Bite broken, if necessary, the tongue can be pulled out to avoid suffocation after the tongue fall; 2 rescue on the ground, to diazepam, phenobarbital, 10% chloral hydrate and other shock drugs, respiratory depression and other phenomena were observed ; 3 poor breathing, increased oxygen consumption, prone to brain tissue hypoxia, which led to edema of the brain, aggravating convulsions, the need for low-flow continuous oxygen supply, necessary to dexamethasone and other drugs; 4 to enhance safety and security, To antipyretic drugs, physical cooling, while rapid establishment of venous access, to avoid cerebral edema. 5 to strengthen the heart rate, pupil, heart rate, blood pressure, consciousness and other vital signs observed, anomalous response immediately told the attending physician to rescue, while comforting family members, guidance and rescue. In the treatment group, 34 cases were massage acupuncture: fingers pressed ditch, Baihui, Xuanxuan, Hegu and Yongquan acupoints; finger acupuncture was ineffective for acupuncture, strictly controlled acupuncture depth, twirled or inserted after acupuncture treatment, Acupoints, 2 ~ 3min / time, 1 time / d; routine care with the control group. Continuous care 7d for a course of treatment. Observation of clinical symptoms, withdrawal time to stop, consciousness recovery time, average length of stay, adverse reactions. Continuous treatment of 3 courses to determine the efficacy. [Results] The treatment group cured 30 cases, 4 cases effective, 0 cases ineffective, the total effective rate 100.00%. Control group, 25 cases were cured, effective in 3 cases, 6 cases, the total effective rate was 82.35%. The treatment group was better than the control group (P <0.05). The time index treatment group was better than the control group (P <0.05). [Conclusion] The effects of massage, acupuncture and nursing intervention on children with febrile convulsion are remarkable and worth promoting.