不同护理干预方式对早产儿病理性黄疸的影响

Effect of different nursing intervention ways on the pathologic jaundice of premature children

目的 探讨早期护理干预对早产儿病理性黄疸的影响.方法 将转入NICU的110例早产儿作为研究对象,随机分为观察组（n=55）和对照组（n=55）.观察组在出生后6 h内给予温生理盐水洗肠通便、生理盐水洗胃、胃肠减压,建立母乳胃肠内营养及抚触疗法.对照组按传统的方法实施常规护理,对出生后48 h内不能哺乳、腹胀、未排胎便者给予针对性对症护理.比较两组患儿腹胀情况、喂养耐受情况、体重增长情况及高胆红素血症的发生率.结果 两组患儿黄疸出现时间（4.37±1.23）d、黄疸持续时间（5.74±1.32）d、消退时间（8.74±2.07）d、黄疽指数（9.05±2.72）μmol/L、血清胆红素值（118.60±28.42）μmol/L;对照组患儿黄疸出现时间（2.17±1.02）d、黄疽持续时间（11.62±2.57）d、消退时间（11.35±3.72）d、黄疽指数（15.62±3.51）μmol/L、血清胆红素值（210.49±30.27）μmol/L;两组比较差异均有统计学意义（P＜0.01）;观察组患儿腹胀、喂养不耐受、呼吸暂停、高胆红素血症发生率低于对照组（P＜0.01）;腹胀缓解时间、吸吮吞咽功能建立时间、体重增长及达足量喂养时间优于对照组（P＜0.01）;观察组患儿住暖箱时间、住院时间、医疗费用均少于对照组（P＜0.01）.结论 早期护理干预减少了早产儿病理性黄疸的发生率,达到了预期效果.

Objective To study the effects of early preventive nursing intervention on the hyperbilirubinemia for premature children.Methods Divided 110 premature children in ICU into the observation group （55 cases） and the control group （55 cases） randomly.Routine nursing care was used in the control group,while early nursing intervention was used in the observation group,and then compared the incidence rate of hyperbilirubinemia between the two groups.Results There was statistically significant difference between observation group and control group in emergence time（4.37±1.23,2.17±1.02）d,duration（5.74±1.32,11.62±2.57） d,regression time of jaundice （8.74±2.07,11.35±3.72） d,icteric index （9.05±2.72,15.62±3.51） umol/1,and serum bilirubin （118.60±28.42,210.49±30.27） μmol/l.（P〈0.01）,The incidence of abdominal distension,feeding intolerance,apnea,hyperbilirubinemia of observation group was lower than that in control group （P〈0.01）,and the alleviate time of abdominal distension,buildup time of swallowing function,velocity of weight gain,time of achieve adequate feeding were significantly better than in control group.Duration of stay in incubator and hospitalization time of the observation group were significantly shorter than in control group （P〈0.01）,and medical costs was less than in control group （P〈0.01）.Conclusions Early nursing intervention can effectively prevent premature children from hyperbilirubinemia.