多因素预测在新生儿黄疸预见性护理中的应用研究

Application research on multi-factor forecast in predictive nursing of neonatal jaundice

目的 探讨多因素预测在足月新生儿黄疸预见性护理中的应用效果.方法 将412例足月新生儿按时间顺序分为对照组185例和观察组227例,对照组采用新生儿小时胆红素百分位图表预测,观察组采用脐血胆红素、新生儿小时胆红素百分位图表和黄疸相关围产因素相结合的多因素预测,按照预测出的高中低危风险分别予针对性的预见性护理.统计新生儿黄疸发生风险的中高危阳性率及新生儿因黄疸住院人数,观察新生儿黄疸多因素预测分布情况,运用Logistic回归法筛选出提高评估足月新生儿黄疸的主要因素.结果 新生儿黄疸发生风险的中高危阳性率观察组高于对照组;新生儿因黄疸住院例数观察组低于对照组;影响足月新生儿黄疸评估的主要因素为脐血胆红素、黄疸相关围产因素、24～60小时胆红素值.结论 多因素预测能早期、准确地预测新生儿黄疸的发生风险,早期予预见性护理干预,减少新生儿因黄疸住院的发生率.

Objective To study the effect of multi--factor forecast in predictive nursing of neonatal jaundice for full-- term newborn. Method Divide 412 full--term newborn into control group （n=185） and observation group （n=227） ac- cording to birth order. Newborn in control group are predicted by neonatal hour--specific bilirubin nomogram. Newborn in observation group are predicted by multiple factors of umbilical cord blood bilirubin, neonatal hour--specific bilirubin nomo- gram combined with jaundice related perinatal factors, predictive nursing are given by predicted high, medium and low risk. Calculate positive rate of high risk in neonatal jaundice and number of hospitalization cases of neonatal jaundice. Observe dis- tribution condition of multi-- factor forecast. Screen the main factors improving evaluation of neonatal jaundice for full-- term newborn by Logistic regression analysis. Result Positive rate of high risk in neonatal jaundice is higher in observation than in control group. Observation group has less hospitalization cases of neonatal jaundice than control group. Main factors affecting neonatal jaundice evaluation are umbilical cord blood bilirubin, jaundice related perinatal factors and bilirubin level in 24～60 h. Conclusion Multi--factor forecast can predict risk of neonatal jaundice precisely in early stage. Early predic- tive nursing can reduce the incidence of hospitalization.