儿童先天性脊柱侧弯支具固定后的皮肤护理干预的方案研究及疗效

Study on the Skin Care Intervention Protocol and Its Efficacy Following Orthotic Fixation in Congenital Scoliosis of Children

摘要: 目的：探讨结构化皮肤护理干预对先天性脊柱侧弯支具固定患儿皮肤并发症及生活质量的影响。方法：采用随机对照试验设计，选取2022年1月至2024年8月收治的100例先天性脊柱侧弯支具固定患儿，随机分为观察组和对照组各50例。观察组实施结构化皮肤护理干预，包括3D定制衬垫、“评估–清洁–保护–监测”四步护理流程及系统化家属培训；对照组采用常规护理。主要观察皮肤损伤发生率(NPUAP分级)、舒适度(FLACC量表)。结果：观察组皮肤损伤发生率显著低于对照组(12.0% vs. 34.0%，P=0.007)，严重皮肤损伤减少(2.0% vs. 10.0%)。干预1周后FLACC评分即显著改善(3.1 ± 0.9 vs. 4.3 ± 1.2，P<0.001)，实际佩戴时间达19.1 ± 1.8小时/天。结论：结构化皮肤护理可有效降低支具相关皮肤并发症，提高治疗舒适度和依从性，具有重要临床推广价值。其系统化、规范化的干预模式为儿童支具治疗护理提供了新范式。

Abstract: Objective: To investigate the effects of structured skin care intervention on skin complications and quality of life in children with congenital scoliosis undergoing brace fixation. Methods: A randomized controlled trial was conducted, enrolling 100 children with congenital scoliosis undergoing brace fixation from January 2022 to August 2024. The participants were randomly divided into an observation group and a control group, with 50 cases in each group. The observation group received structured skin care intervention, including 3D custom liners, a four-step care process of “assessment-cleaning-protection-monitoring”, and systematic family training. The control group received routine care. The primary outcomes were the incidence of skin injury (classified by NPUAP grading) and comfort level (assessed using the FLACC scale). Results: The incidence of skin injury in the observation group was significantly lower than that in the control group (12.0% vs. 34.0%, P = 0.007), with a reduction in severe skin injuries (2.0% vs. 10.0%). The FLACC scores improved significantly one week after intervention (3.1 ± 0.9 vs. 4.3 ± 1.2, P < 0.001), and the actual daily wear time reached 19.1 ± 1.8 hours. Conclusion: Structured skin care can effectively reduce skin complications associated with brace treatment, enhance therapeutic comfort and adherence, and hold significant clinical value. The systematic and standardized intervention model provides a novel paradigm for pediatric brace treatment care.