循证护理在胎膜早破合并感染低体重早产儿中的应用

Application of evidence-based nursing for premature rupture of membranes combined with infection of low birth weight premature infants

目的探讨循证护理在胎膜早破合并感染低体重早产儿中的应用效果。方法选择2015年6月至2017年1月我院新生儿科室及门诊就医的100例胎膜早破合并感染低体重早产儿,按照就医时家长的自愿原则进行建档,等分为观察组和对照组。选择同期的50例足月儿作为健康对照组。对照组采用常规护理模式,观察组患儿给予循证护理模式。采用患儿神经行为发育评估法对两组早产儿在矫正月龄3,6,9,12个月行神经行为发育评估,健康对照组同时进行发育评估。三组患儿在12个月时进行发育商测评。统计分析患儿不同模式下神经行为发育的情况及12个月后两组患儿成活率比较。结果(1)观察组与对照组在3,6个月时植物神经调节系统、行为调节系统、运动发育评分显著改善但仍低于健康对照组(P<0.05)。(2)三组智力发育指数(MDI)、运动发育指数(PDI)变化在12个月时指标变化比较均有显著性差异,对照组PDI,MDI明显低于观察组和健康对照组(P<0.05);观察组与对照组比较MDI,PDI明显升高。(3)观察组患儿12个月后成活率高于对照组,差异有统计学意义(P<0.05)。结论对胎膜早破合并感染低体重早产儿采用循证护理模式,可以明显提高低体重早产儿的成活率,同时改善了患儿神经行为发育,更好地保证了产妇及患儿的后期健康。

Objective To investigate the application effect of evidence-based nursing for premature rupture of membranes combined with infection of premature infants low birth weight premature infants.Methods To select 100 cases of low birth weight premature infants undergoing premature rupture of membranes combined with infection who were treated in the neonatal department and outpatient department of our hospital from June 2015 to January 2017.According to the parents'voluntary principle,the filing was performed,and they averagely were divided into observation group and control group.Fifty full-term infants in the same period were selected as the healthy control group.The control group was given the routine nursing mode,and the observation group was given evidence-based nursing mode.The neurobehavioral development assessment method was used to evaluate the neurobehavioral development of preterm infants of the two groups at 3,6,9,and 12 months of correct months,and three groups of children patients underwent developmental quotient evaluation at 12 months.Statistical analysis of neurobehavioral development in different models of children patients and comparison of survival rates were performed between the two groups after 12 months.Results The autonomic nervous system,behavioral regulation system,and motor development scores of the observation group and the control group were significantly improved at 3 and 6 months,but still lower than those of the healthy control group(P<0.05).The changes in the mental development index(MDI)and psychomoter developmental index(PDI)of the three groups were significantly different at 12 months.The MDI and PDI in the control group were significantly lower than those in the observation group and the healthy control group(P<0.05).The MDI and PDI in the observation group were significantly higher than those of the control group.The survival rates in the observation group was higher than that in the control group after 12 months,and the difference was statistically significant(P<0.05).Conclusion The application of evidence-based nursing model for premature rupture of membranes combined with infection of low birth weight premature infants could significantly improve the survival rate of low birth weight premature infants,improve the neurobehavioral development of children patients,and better ensure the Late health of maternal and children patients.