严格控制输液对干预早产儿发生硬肿、水肿的临床观察

Clinical observation of strictly control the infusion on the intervention of the premature infants＇ hard swelling and edema

目的探讨输液量及输液方式与新生儿硬肿、水肿发生的相关性，寻找适合早产儿输液的最佳方式。方法选取62例胎龄34—36^＋5周，体重≥2kg的早产儿为研究对象，通过新生儿室护士对新生儿输液量及输液速度的控制，比较不同输液方式是否对治疗有影响，按随机数字表法随机分为A、B、C三组。A组：控制总入量，按常规速度输液（5—6滴／min）；B组：采用微量注射泵控制输液速度；C组：采用微量注射泵24h持续泵人控制输液速度，然后在静脉留置针患儿中对比，观察其疗效。三组液体量控制方法均为生后1，3d总入量（包括奶量、饮水及输液量）分别为50ml／kg、60ml／kg、80ml／kg，4—7d100ml／kg，每天根据患儿摄入奶量和饮水量调整输液量，输液量也包括肠外营养液：氨基酸、脂肪乳，所有用量均参照新生儿静脉营养治疗要求配置浓度心。。结果C组（采用微量注射泵24h持续泵入）治疗效果最好，水肿、硬肿的程度及输液并发症减轻、患儿的总费用降低、平均住院时间缩短（P〈O．05）。此方法优于A组（控制总入量，按常规速度输液5—6滴／min）、B组（微量注射泵控制输液速度，液体输入完成后结束本日治疗，不需要24h持续泵入），值得临床推广应用。结论C组（采用微量注射泵24h持续泵入）疗效最好，水肿、硬肿并发症最轻。

Objective To explore the correlation between the infusion volume and infusion method with neonatal hard swelling, edema, looking for the best way to premature infusion. Methods A total of 62 cases of prematrue infants with gestational age ranged from 34 weeks to 36^＋5 weeks, and with weight equal or greater than 2kg were selected as the research objects. Compared different infusion method＇s efficacy through infusion speed control newborn room nurses on neonatal infusion volume. All the infants were randomly divided into A, B and C groups according to random number table method. Group A： the total volume was controlled, and infusion with conventional speed （5 -6 drops a minute）. Group B ： the speed was controlled by trace injection pump infusion. Group C ： the speed was controlled by 24 hours of continu- ous infusion pump, and then contrast in children with .intravenous indwelling needle, the curative effect was ob- servedl Three sets of liquid quantity control methods were for 1 - 3 clays after the total amount （including milk, water and transfusion volume） for 50 ml/kg, 60 mL/kg, 80 ml/kg, 4 -7 days 100 mL/kg, according to the daily intake of milk and water quantity adjusting infusion in children with quantity, infusion volume also includes parenteral nutrient solution： amino acids, fat milk, all consumption demand of reference to neonatal parenteral nutrition therapy concentration. Results Group C （in trace injection pump group 24 hours of continuous pumping） got best treatment effect, the degree of edema reduced, the swollen and complications of infusion reduced, the total cost reduced, the average hospitalization time of the child reduced （P〈0. 05） . This method was better than that of Group A （the total control quantity, and speed of conventional infusion （5 -6 drops/min） group） and Group B （control trace injection pump infusion speed, liquid in- put end of the day after the completion of treatment, do not need to 24 hours of continuous pumping group）. It is worthy of clinical popularization and application. Conclusions Trace injection pump （ in group C group 24 hours of continuous pumping） has best curative effect and the lightest edema and hard swollen complications.