精细化护理对于新生儿重症肺炎合并呼吸衰竭的影响研究

The effect of fine care on newborn with severe pneumonia combining with respiratory failure

目的:探讨精细化护理对于新生儿重症肺炎(SPIN)合并呼吸衰竭(RF)的影响。方法:选取60例SPIN合并RF患儿,按照护理方式的不同将其分为观察组与对照组。观察组28例,实施精细化护理后接受治疗,其中男患儿16例,女患儿12例,日龄10~28 d,平均日龄(18.26±4.16)d,体重(2.4~4.4)kg,平均体重(3.11±0.44)kg。对照组32例,实施常规护理后接受治疗,其中男患儿14例,女患儿18例,日龄(10~28)d,平均日龄(18.33±4.07)d,体重(2.4~4.4)kg,平均体重(3.08±0.46)kg。分别对两组患儿进行血气分析指标p H、动脉氧分压(PaO_2)、动脉二氧化碳分压(PaO_2)、呼吸频率(RR)、心率(HR)水平以及机械通气总时间、不良情况发生率和护理满意度进行分析。结果:观察组患儿实施精细化护理后p H值、PaO_2、Pa CO_2、RR及HR水平明显优于对照组,差异具有统计学意义(t=4.36,t=3.83,t=-2.23,t=-12.11,t=-5.45;P<0.05);两组患儿机械通气总时间对比,观察组患儿实施精细化护理后,机械通气总时间明显低于对照组,差异具有统计学意义(t=-7.63,P<0.05);观察组患儿再插管率明显低于对照组,差异具有统计学意义(x^2=3.83,P<0.05);观察组患儿家属对护理的满意度明显高于对照组,差异具有统计学意义(x^2=18.49,P<0.05)。结论:实施精细化护理能够有效改善SPIN合并RF患儿的血气分析指标、缩短机械通气治疗时间、缓解病情、降低再插管率,临床应用价值较高。

Objective： To discuss the influence of the fine care for newborn with severe pneumonia （SPIN） combining with respiratory failure （RF）. Methods： 60 cases of SPIN with RF were selected and divided into the observation group and the control group. 28 cases of SPIN with RF in the observation group were received fine care observation group after treatment, in which 16 cases were male children and 12 cases were female children. The ages of these children were from 10d to 28d day, and their average age was 18.26 ＋ 4.16 d. The weight was from 2.4kg to 4.4 kg, and their average weight was 3.11 ＋ / - 0.44 kg. 32 cases of SPIN with RF in the control group were received routine nursing, in which 14 cases were male children and 18 cases were female children. The ages of these children were from 10d to 28d and their age was （10 ~ 28） d. Their average age was （18.33 ＋ 4.07） d. The weight was from 2.4kg to 4.4 kg, and their average weight was 3.08 ＋ / - 0.46 kg. Then we analyzed espectively respectively on two groups of children with pH, arterial blood gas analysis index of oxygen partial pressure （PaO2）, arterial partial pressure of carbon dioxide （PaCO2）, respiratory rate （RR） and heart rate （HR） level and the total time of mechanical ventilation, the incidence of adverse circumstance and nursing satisfaction. Results： The observation group with pH, PaO2, PaCO2, RR and level of HR after fine care is superior to the control group, and the differences were statistically significant difference （t= 4.36, 3.83, 2.23, 12.11, 5.45; P 〈0.05）. The total time of mechanical ventilation in the observation group was significantly lower than the control group, and the difference was statistically significant difference （t=7.63, P〈0.05）. The reintubation rate of the observation group was obviously lower than the control group and the difference was statistically significant （x2=3.83, P〈0.05）. Family satisfaction of nursing in the observation group was obviously higher than that in the control group, and the difference was statistically significant （x2=18.49, P〈0.05）. Conclusion： Fine care can effectively improve the SPIN with RF with blood gas analysis index, shorten the time of mechanical ventilation therapy, alleviate the pain and reduce reintubation rate. It has higher clinical value.