132例新生儿缺氧缺血性脑病早期诊断及护理体会

Early diagnosis and nursing experience of 132 cases with neonatal hypoxic ischemic encephalopathy

目的:探讨新生儿缺氧缺血性脑病(HIE)早期诊断及护理要点。方法:对132例HIE患儿临床症状和体征发生率和持续时间进行分析;并针对吸氧、保暖、病情观察、合理喂养、基础护理等护理要点进行分析。结果:生后12h以后仍出现兴奋、激惹症状;出现嗜睡、迟钝且持续时间长;产后出现哭声弱,持续24h以上;肢体张力减弱和拥抱、吸吮反射弱,且持续时间长可作为早期诊断HIE的参考依据;脑性尖叫、昏迷、脑干症状、抽搐、前囟张力增高可作为早期HIE的诊断依据;经早期诊断、及时治疗和有效护理,治愈96例;好转31例;自动出院5例。总有效率为96.2%。结论:早期诊断、治疗结合有效的护理措施是缺氧缺血性脑病治疗成功的保证。

Objective：To evaluate early diagnosis and nursing experience of neonatal hypoxic ischemic encephalopathy.Methods：The incidence and duration of clinical symptoms and signs of 132 cases were analyzed.In addition,the nursing points such as oxygen treatment,warm-keeping, reasonable feeding and basic nursing were analyzed.Results：It can be used as an reference for the early diagnosis of HIE that if he still exists symptoms of excitement and irritation 12 hours after birth and lethargy and slowness with a long duration.Besides,he cries weakly more than 24 hours after birth and displays decreased muscular tension and weak embrace reflect and sucking reflect.The following signs can be used as diagnosis of HIE such as cephalic cry,coma,symptom of brain stem,convulsion and increased tension of bregma.After early diagnosis,timely treatment and effective nursing measures,96 cases cured,31 cases improved and 5 cases ceased treatments.The total effective rate was 96.2%.Conclusion： Early diagnosis and treatment in combination with effective nursing measures are the keys for successful treatment of hypoxic ischemic encephalopathy.