体位护理在新生儿呼吸窘迫综合征治疗中的应用

Application of Posture Nursing in the Treatment of Neonatal Respiratory Distress Syndrome

目的对新生儿呼吸窘迫综合征患儿护理中体位护理的效果进行观察。方法选取2015年1月—2016年1月期间86例新生儿呼吸窘迫综合征患儿进行研究,随机分为观察组与对照组,每组43例。两组患者均采用机械通气治疗,对照组采取常规仰卧位,观察组采用仰卧位、俯卧位、侧卧位变换,对比两组相关指标。结果护理前,观察组患儿PaO2(46.19±4.27)mmHg、pH(7.17±0.11)、PaCO2(65.37±8.34)mmHg、OI(215.34±33.65)与对照组相比差异无统计学意义(P>0.05)。护理后,观察组患儿PaO2(57.04±7.23)mmHg、pH(7.35±0.06)及OI(277.64±43.76)高于对照组,PaCO2(53.97±5.62)mmHg低于对照组,差异有统计学意义(P<0.05)。护理前,观察组TC(41.23±3.68)mL/cmH2O、R(9.12±2.08)cmH2O/L·s、CVP(7.53±2.06)cmH2O、MAP(76.68±10.51)mmHg、HR(101.42±5.08)次/min与对照组相比差异无统计学意义(P>0.05)。护理后,观察组TC(45.76±4.74)mL/cmH2O、R(13.89±3.24)cmH2O/L·s高于对照组,差异有统计学意义(P<0.05),CVP(7.72±2.34)cmH2O、MAP(77.04±10.07)mmHg、HR(98.27±4.73)次/min与对照组相比差异无统计学意义(P>0.05)。观察组肺通气时间(2.86±0.28)d、氧疗时间(8.07±1.64)d及住院时间(20.27±3.51)d均少于对照组,差异有统计学意义(P<0.05)。结论对新生儿呼吸窘迫综合征患儿治疗期间,实施体位变换护理,对患儿氧合状态有提升作用,可有效改善患儿呼吸动力学及血气分析指标,有利于患儿尽早康复,值得推广应用。

Objective To observe the effect of posture nursing in the nursing of children with neonatal respiratory distress syndrome.Methods From January 2015 to January 2016,86 children with neonatal respiratory distress syndrome were selected for the study,and they were randomly divided into observation group and control group,with 43 cases in each group.Both groups of patients were treated with mechanical ventilation,the control group was in the conventional supine position,and the observation group was in the supine,prone,and lateral positions to compare the relevant indicators of the two groups.Results Before nursing,there was no significant difference in PaO2(46.19±4.27)mmHg,pH(7.17±0.11),PaCO2(65.37±8.34)mmHg,OI(215.34±33.65)between the observation group and the control group(P>0.05).After nursing,PaO2(57.04±7.23)mmHg,pH(7.35±0.06)and OI(277.64±43.76)of children in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).PaCO2(53.97±5.62)mmHg was lower than the control group,the differenc e wasstatistically significant(P<0.05).Before nursing,the observation group had TC(41.23±3.68)mL/cmH2O,R(9.12±2.08)cmH2O/L·s,CVP(7.53±2.06)cmH2O,MAP(76.68±10.51)mmHg,HR(101.42±5.08)times/min compared with the control group,the difference was not statistically significant(P>0.05).After nursing,TC(45.76±4.74)mL/cmH2O and R(13.89±3.24)cmH2O/L·s in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05),and CVP(7.72±2.34)cmH2O compared with the control group,MAP(77.04±10.07)mmHg,HR(98.27±4.73)times/min were not statistically significant(P>0.05).The lung ventilation time(2.86±0.28)d,oxygen therapy time(8.07±1.64)d,and hospitalization time(20.27±3.51)d in the observation group were less than those in the control group,the difference was statistically significant(P<0.05).Conclusion During the treatment of children with neonatal respiratory distress syndrome,the implementation of postural care can improve the oxygenation status of the children,and can effectively improve the respiratory dynamics and blood gas analysis indexes of the children.It is beneficial to the children to recover as soon as possible.It is worthwhile promotion and application.