循证护理方案应用于缺血缺氧性脑病新生儿的效果

Effects of evidence-based nursing schemes on neonates with hypoxic-ischemic encephalopathy

目的 探讨缺血缺氧性脑病(HIE)新生儿应用循证护理,对其神经、体格发育的影响。方法 回顾性分析2018年6月至2020年6月厦门市妇幼保健院收治的116例HIE新生儿的临床资料。根据护理方法的不同将所有患儿分为对照组和观察组,各58例。对照组实施常规护理,观察组在常规护理的基础上加用循证护理。比较2组患儿的神经行为、应激反应指标、体格发育水平及智能发育商(DQ)。结果 干预1个月后,2组的血浆皮质醇、促肾上腺皮质激素释放激素和D-乳酸水平均较干预前降低(P均<0.05),且观察组均较对照组更低(P均<0.05)。干预1个月后,2组的新生儿行为神经测定(NBNA)各项评分均较干预前升高(P均<0.05),且观察组均较对照组更高(P均<0.05)。干预1个月后,2组的身长、体重和头围均大于干预前(P均<0.05),且观察组均大于对照组(P均<0.05)。观察组在6月龄和12月龄的各能区DQ评分均高于对照组(P均<0.05)。结论 循证护理能提高HIE新生儿的神经、体格和智能发育,并改善患儿预后。

Objective To investigate the effect of evidence-based nursing on the neurological and physical development of neonates with hypoxic-ischemic encephalopathy(HIE).Methods The clinical data of 116 HIE neonates admitted to Xiamen Maternal and Child Health Hospital from June2018 to June 2020 were retrospectively analyzed.According to the different nursing schemes,the neonates were assigned into control and observation groups.Both groups contained 58 cases.The control group received routine nursing,and the observation group received evidence-based nursing on the basis of routine nursing.The neurobehavior,stress response indicators,physical development level,and developmental quotient(DQ)were compared between the two groups.Results After 1 month of intervention,the levels of plasma cortisol,corticotropin-releasing hormone,and D-lactic acid in both groups were lower than those before intervention(all P<0.05),and the levels of the observation group were lower than those of the control group(all P<0.05).After 1 month of intervention,the scores of each item of neonatal behavioral neurological assessment(NBNA)in both groups were higher than those before intervention(all P<0.05),and the scores of the observation group were higher than those of the control group(all P<0.05).After 1 month of intervention,the length,weight,and head circumference of both groups were greater than those before intervention(all P<0.05),and the indicators of the observation group were greater than those of the control group(all P<0.05).The DQ scores of each item at 6 and 12 months of age in the observation group were higher than those in the control group(all P<0.05).Conclusion Evidence-based nursing can improve the neurological,physical,and intellectual development of neonates with HIE,and improve their prognosis.