目的 探讨虚拟现实技术联合小丑照护对门诊伤口换药患儿应用效果。 方法 便利抽样法选取合肥市某儿童医院门诊换药的80例外伤及烧伤患儿为研究对象。按照入院顺序分为对照组和观察组，每组各40例。对照组采用常规护理方法，观察组采用虚拟现实技术联合小丑照护方法。比较两组患儿在换药及包扎时Wong-Baker面部表情疼痛量表(faces pain scale，FPS)评分、换药及包扎时的心率及患儿依从性情况，并比较患儿家属满意度及焦虑程度。 结果 观察组患儿在换药及包扎时的FPS评分及心率均低于对照组；观察组患儿依从性及家属满意度均高于对照组，且家属焦虑程度低于对照组，差异均有统计学意义（均P＜0.05）。 结论 虚拟现实技术联合小丑照护，能有效缓解患儿换药过程中的疼痛，提高其换药依从性和家属满意度，改善家属焦虑情绪。

Objective To explore the application effect of virtual reality technology combined with clown care in pediatric patients undergoing wound dressing change in the Emergency Department. Methods A total of 80 children with trauma and burn in a children’s hospital in Hefei were selected by the convenience sampling method.According to the order of admission,the patients were divided into the control group and the experimental group,with 40 cases in each group.The control group was treated with conventional nursing method,and the experimental group was treated with virtual reality technology combined with clown care nursing method. Compared two groups of children at dressing and bandaging Wong Baker facial pain scale (faces pain scale, FPS) score, dressing and the wound of heart rate and the patients compliance, satisfaction and anxiety levels and compare with their families. Results The FPS score and heart rate of the observation group during dressing change and dressing were lower than those of the control group.The compliance and family satisfaction of the observation group were higher than that of the control group, and the family anxiety was lower than that of the control group, the differences were statistically significant. (P＜0.05). Conclusions Virtual reality technology combined with clown care can effectively relieve pain during dressing change,improve children’s dressing change compliance and family satisfaction,and improve family anxiety.

R473.72

安徽省自然科学基金（1808085MH277）