综合康复护理对早产儿生活质量的影响

Effect of comprehensive rehabilitation nursing on quality of life of premature infants

目的通过全身运动(GMs)评估早期预测早产儿的神经发育结局并对评估结果异常的高危早产儿实施早期综合的康复护理干预及延续性护理,观察其临床效果。方法将2018年10月至2019年9月我院NICU病房收治的矫正胎龄46周前,经GMs评估为单调性扭动运动113例早产儿随机分为观察组56例和对照组57例。对照组实施早产儿常规护理,观察组在对照组常规护理基础上给予康复护理干预;上述患儿于矫正胎龄49周后再次进行GMs评估为正常不安运动的,继续分组干预及实施延续性护理,并在3、6、12个月进行随访,随访时应用Alberta婴儿运动量表、Gesell评定量表比较两组患儿干预后的效果。结果两组患儿3个月及6个月Alberta婴儿运动量表评定总分及百分位数比较差异无统计学意义(P>0.05);12个月时观察组Alberta婴儿运动量表评定总分高于对照组,差异有统计学意义(P=0.009),百分位数比较差异也有统计学意义(P<0.05)。Gesell评定结果两组患儿在适应能力和社交行为方面有差异,适应能力评分在12月龄时观察组高于对照组,差异有统计学意义(P<0.05);社交行为评分在6月龄、12月龄时观察组高于对照组,差异有统计学意义(P<0.05)。结论对高危早产儿实施综合康复护理干预对患儿适应能力、社交行为及动作完成质量方面有一定临床效果。

Objective GMs are used to evaluate early prediction of neurodevelopmental outcomes in preterm infants,and to implement early comprehensive rehabilitation nursing intervention and continuous nursing for premature infants with abnormal evaluation results,and observe their clinical effects.Methods The 113 preterm infants,who were admitted to the NICU ward of our hospital from October 2018 to September 2019 before the corrected gestational age of 46W and were evaluated by GMs as monotone writhing,were randomly divided into observation group(n=56)and control group(n=57).The control group received routine nursing care for premature infants,and the observation group received rehabilitation nursing intervention on the basis of routine nursing care for the control group.The above children who were assessed by GMs again as normal restless movement after the correction of gestational age of 49W were further treated with group intervention and continuous care,and were followed up at the age of 3 months,6 months and 12 months.During follow-up,the Alberta Infant Motor Scale(AIMS)and Gesell Rating Scale were used to compare the effects of intervention between the two groups.Results There was no statistical difference in Alberta scores or percentiles between the two groups at 3 months and 6 months(P>0.05).There were significant differences in Alberta total scores and percentiles between the two groups at 12 months of age,with the observation group being higher(P<0.05,P=0.009);Gesell evaluation results showed that there were differences in the adaptability and social behavior between the two groups.The adaptability was higher in observation group at 12 months old(P<0.05),the social behavior score was higher in observation group at 6 months old and 12 months old,which had statistical significance(P<0.05).Conclusion Comprehensive rehabilitation nursing intervention for high-risk premature infants has certain clinical effects on adaptability,social behavior and quality of completing action.