以家庭为中心的护理在NICU支气管肺发育不良早产儿中的应用研究

Application of parents chaperone for premature infants with bronchopulmonary dysplasia in neonatal intensive care unit

目的探讨在新生儿重症监护室支气管肺发育不良早产儿中实施以家庭为中心的护理的方法及效果。方法采用便利抽样法于2014年1月—2016年10月选择在某三级甲等医院新生儿重症监护室住院、诊断为支气管肺发育不良的早产儿41例,按入院时间先后分为实验组(n=22)和对照组(n=19)。实验组在患儿确诊为支气管肺发育不良时家长进入新生儿重症监护室陪护,在专科护士的指导下参与患儿的照护,进行生活护理、病情观察、协助治疗和早期干预等工作;对照组采用传统护理模式,由护士完成护理工作,家长每周3次、每次1 h隔窗探视。比较两组患儿出院前1 d家长的焦虑水平,出院后第3天、第7天、2周及4周时家长的随访依从性及患儿体重增长情况。结果实验组家长在出院前1 d的焦虑水平、出院后第3天、第7天、4周的随访依从性及患儿出院后体重增长方面均优于对照组,差异均有统计学意义(P<0.05)。结论在支气管肺发育不良早产儿住院期间实施以家庭为中心的护理可提高家长的照护能力,降低家长的焦虑水平,提高支气管肺发育不良患儿出院后的随访率和生存质量。

Objective To explore the methods and effects of parents chaperone for premature infants with bron- chopulmonary dysplasia（BPD）in neonatal intensive care unit（NICU）. Methods Convenience sampling method was used to recruit premature infants diagnosed with BPD admitted from January 2014 to October 2016 in NICU in a tertiary hospital,and 41 premature infants were recruited and divided into the control group （n=19） and the experimental group（n=22） according to the time sequence of admission. Infants in the experimental group was accompanied by parents when diagnosed as BPD,and under the guidance of specialty nurses,parents performed daily care,observation of condition,treatment assistance ,and early intervention;infants in the control group were provided traditional nursing mode,nurses performed nursing care,and parents were allowed to visit through the window for one hour each time,three times every week. Parental anxiety was compared between two groups at 1 day before discharge,and follow-up compliance and weight gain of infants were compared at 3 days,7 days,2 weeks,4 weeks after discharge. Results Parental anxiety at 1 day before discharge, and follow-up compliance and weight gain of infants in the experimental group were all better than those in the control group,and the differences were statistically significant（P〈0.05）. Conclusion Parents chaperone can improve parents＇ ability of caring,reduce parents＇ anxiety and improve follow-up compliance after discharge, so as to improve quality of life of premature infants with BPD.