品管圈活动在超低出生体质量儿电解质紊乱早期胃肠外营养护理中的应用

Application of QCC intervention in the early parenteral nutrition nursing on ELBW infants with electrolyte disorder

目的：观察和评估品管圈活动在超低出生体质量儿电解质紊乱早期胃肠外营养护理中的应用效果。方法随机选取2014年1月—2015年1月新生儿重症监护病房收治的100例超低出生体质量儿，根据护理方案的不同分为干预组和对照组各50例，干预组患儿通过品管圈活动干预下指导早期胃肠外营养的护理工作，对照组不实施品管圈活动，仅给予常规早期胃肠外营养护理。对比分析两组患儿血K＋和血Ca2＋水平以及高钾血症和低钙血症发生率以及死亡率。结果干预组患儿血K＋水平显著低于对照组，血Ca2＋水平显著高于对照组，差异具有统计学意义（P＜0．05）；干预组患儿高钾血症和低钙血症的发生率均显著低于对照组，差异具有统计学意义（P＜0．05）；干预组无一例死亡，对照组6例因血K＋浓度纠正无效最终死亡，死亡率为12．00％。结论对超低出生体质量患儿进行品管圈活动指导早期胃肠外营养护理，可以有效纠正患儿电解质紊乱的状态，降低患儿高钾血症和低钙血症的发生率，降低患儿的死亡率。

Objective To observe and evaluate the application effects of quality control circle （ QCC） intervention in the early parenteral nutrition nursing on extremely low birth weight （ ELBW） infants with electrolyte disorder.Methods Totals of 100 of ELBW infants admitted to the Neonatal Intensive Care Unit （NICU） between January 2014 and January 2015 were collected randomly and equally divided into intervention group and control group based on different care regimens .Intervention group were given early parenteral nutrition under the guidance of QCC intervention while control group were only with routine early parenteral nutrition .Plasma K＋, Ca2＋levels, hyperkalemia, hypocalcemia incidence and mortality were compared between two groups .Results The serum K＋levels of intervention group were lower than the control group and the serum Ca 2＋levels were higher than that of control group significantly （ P ＆lt;0.05 ）; The hyperkalemia and hypocalcemia incidence of intervention group were lower than that of control group greatly （ P〈0 .05 ）; No death occurred in intervention group, while 6 cases in the control group died of invalid correction of serum K ＋concentrations eventually , of which the mortality was 12.00%.Conclusions Early parenteral nutrition nursing care with the guidance of QCC on ELBW infants , can effectively correct infants′electrolyte disorder state , reduce the incidence of hyperkalemia and hypocalcemia and mortality of the infants .