延续性护理对全肠外营养早产儿出院后营养、免疫功能及行为发育的影响

Effect of continuous nursing on nutrition condition, immune function and behavior development of premature infants with total parenteral nutrition after discharge

目的：探讨延续性护理对全肠外营养早产儿出院后营养、免疫功能与行为发育的影响。方法选取2014年8月至2015年9月我院收治的早产儿共84例作为研究对象,所有患儿临床资料齐全且均接受全肠外营养支持治疗。将所有患者随机分为观察组（42例）与对照组（42例）,其中对照组患者接受常规护理,观察组患者则在对照组基础之上接受延续性护理。记录两组患者治疗前及出院后的日平均体质量增长量、血清球蛋白、白蛋白、血液IgG、IgA、IgM、C-反应蛋白水平及行为发育情况,并进行对比分析。结果经过不同护理后,两组患儿白蛋白和球蛋白水平均高于治疗前（ P〈0.05）。两组间比较显示,观察组患儿的血清白蛋白和球蛋白水平均高于对照组（P〈0.05）。同时,观察组患儿日平均体质量增长为（24.8±5.8）g,高于对照组的（17.4±4.0）g。观察组IgG、IgA、IgM水平高于对照组,C-反应蛋白水平低于对照组（ P〈0.05）。观察组患者行为能力评分、原始反射评分、主动肌张力评分和被动肌张力评分亦高于对照组（ P〈0.05）。结论延续性护理模式能够显著改善全肠外营养新生儿出院后的营养状况及免疫功能,并促进其行为功能发育,提高患儿生活质量。

Objective To explore the effect of continuous nursing on nutrition condition, immune function and behavior development of premature infants with total parenteral nutrition after discharge. Methods A total of 84 prema-ture infants treated in our hospital from August 2014 to September 2015 were selected as the research objects, and all the infants received total parenteral nutrition treatment. These 84 premature infants were randomly divided into control group and observation group, 42 cases in each group. The control group were treated with general care, while the obser-vation group received continuous nursing based on general care. The average growth of weight, the level of serum globu-lin, albumin, IgG, IgA, IgM and CRP and the behavior development before treatment and after discharge were com-pared and analyzed. Results After different ways of nursing, the level of globulin and albumin of the two groups were both higher than that before the treatment （ P〈0. 05 ） . And the comparision between the two groups showed that the level of serum albumin and globulin of observation group were significantly higher than that of the control group （ P〈0. 05） . At the same time, the average daily weight increase of the observation group was （24. 8±5. 8） g, which was significantly higher than that of （17. 4±4. 0） g of the control group. The levels of IgG, IgA and IgM of the observation group were higher than that of the control group, and the level of C-reactive protein was lower than that of the control group （ P〈0. 05 ） , the behavior ability score, primitive reflex score, active muscle tension score and passive muscle tension score were also higher than that of control group （ P〈0. 05 ） . Conclusion Application of the continuous nurs-ing in treating premature infants with total parenteral nutrition can significantly improve the nutrition condition, immue function and promote the development of behavioral function.