输液泵控制换血术治疗50例新生儿重症黄疸的护理

Nursing Care for 50 Cases of Neonate Hyperbilirubinemia Treated with Pump Controlled Exchange Transfusion

目的总结输液泵控制换血治疗新生儿重症黄疸的护理经验。方法应用输液泵控制换血疗法,对50例重症黄疸新生儿实施换血。术前予患儿必要的镇静、血液适度加温,行外周动、静脉留置针穿刺,形成封闭的换血回路;术中由输液泵控制出、入血量的速度,密切观察生命体征和出入血量的变化,动态监测血pH值、血糖、血生化、血清总胆红素浓度等;术后继续监测生命体征,加强兰光治疗的护理。结果50例换血过程顺利,平均换血时间(154.2±20.78)min;血清总胆红素浓度换血前为(478.36±59.25)μmol/L,换血后为(237.75±43.42)μmol/L,总胆红素换出率为50.30%。结论输液泵控制换血治疗新生儿重症黄疸安全实用、操作简便、疗效显著。精心、细致、周到的护理是换血成功的保证。

Objective To sum up the experiences of nursing care for hyperbilirubinemia neonates treated with pump controlled exchange transfusion. Methods Pump controlled exchange transfusion was administered to 50 cases of neonate hyperbilirubinemia. Before the operation, necessary sedation should be conducted and the blood bag should be properly heated and loop of transfusion would be formed via puncture of the peripheral artery and vein; In the course of the operation, the speed was controlled by the pump, the vital signs and the change of blood volume were closely observed,the pH value of blood, blood sugar,blood biochemistry and the concentration of serum total bilirubin had been dynamically monitored;After the operation,vital signs were continuously monitored and the nursing care for phototherapy was enforced. Results 50 cases of transfusion were all successful. The average time of transfusion was （154.2±20.78）minutes. Before the transfusion the level of serum total bilirubin was （478.36±59.25）μmol/L which dropped to （237.75±43.42）μmol/L after the transfusion. The exchange rate of serum total bilirubin was 50.30~. Conclusion The treatment of pump controlled exchange transfusion has a remarkable efficacy on the neonates with hyperbilirubinemia, and elaborate and delicate nursing is essential for its success.