Catamnestic Observation of Premature Newborns with Nervous System Injury in the Kyrgyz Republic

Background: Recently, among child disability disorders nervous system diseases are prevailing 19.5%, while mental disorders are 14.3% and congenital malformations 21%. In most cases, children’s neurological disability is associated with pathology during the perinatal period, while 24% of patients have a cerebral impairment. Premature newborns perished 30 to 35 times more often than in-time newborns, and perinatal mortality in case of premature pregnancies is 30 to 40 times higher than in term delivery. Aim: This article is studying catamnestic observation of premature newborns with nervous system injury and with perinatal pathology in Kyrgyzstan for the period 2020-2021. Preterm newborns’ anthropometric characteristics and main diagnoses associated with diseases in the gestational period were shown. Methods: A comprehensive clinical and laboratory examination including premature newborns health dynamic monitoring with gestational age from 28 to 36 weeks, who were treated in the neonatal pathology department of the Regional Maternity Hospital in Osh for the period from 2020-2021 were carried out. Literature review analysis from PubMed database, MEDLINE, EMBASE, Science Direct, Google Scholar, and clinical trials performed. Results: after clinical examination, it was revealed that pregnancy and childbirth in all mothers of the studied group passed with complications. In mothers of the studying group, the most common pathologies during pregnancy were chronic fetal hypoxia 49 (58.4%), acute respiratory infections 28 (33.4%), the threat of termination of pregnancy 20 (23.9%), preeclampsia 16 (19.11%), sexually transmitted infections 9 (10.8%), pyelonephritis 14 (16.7%), polyhydramnios 9 (10.8%), 71 children (84.6%) were born with asphyxiation and 25 children extracted by cesarean section with varying degrees of severity. Conclusions: Depending on the severity of the perinatal lesion of the nervous system and pathological factor effects, it is very important to start early habilitation measures with preterm newborns who are at risk of developmental delay deviations, and to exit disabling disorders.

Prevalence, Risk Factors and Intra-Hospital Outcomes Relating to Peri-Intraventricular Hemorrhage in Premature Newborns of Gestational Age Less than 34 Weeks

Peri-intraventricular hemorrhage is one of the main causes of neurological impairment in premature newborns. To control their risk factors is necessary in view of the increasing survival of extreme preterm infants. Objective: To evaluate the prevalence of peri-intraventricular hemorrhage in premature newborns, identify the risk factors and observe the frequencies of intra-hospital outcomes of interests. Methods: This study was done in Brazil. This was an observational, analytical longitudinal and prospective study. The subjects included were newborns of gestational age less than 34 weeks who were admitted to two public hospitals between May and November 2015. To assess possible associated factors, obstetric, perinatal and neonatal data were analyzed (chorioamnionitis, antenatal corticosteroids, gestational age, newborn weight, Apgar score at 1 and 5 minutes, resuscitation in the delivery room, surfactant in the delivery room, newborn transferred from another hospital, respiratory distress syndrome: RDS, sepsis, umbilical vein catheterization, assisted ventilation, exogenous surfactant in the Neonatal ICU, use of sodium bicarbonate, inotropic agents, adrenaline, volume expanders and blood products). The hospital outcomes studied were assisted ventilation time, hospital stay and death. The data analysis was performed by chi-square test or Fisher’s test, with a significance level of 5%. Results: Out of 156 newborns, 46 (29.9%) presented peri-intraventricular hemorrhage and 28.2% of these had a severe form of the disease. There were significant associations (p < 0.05) with the following risk factors: gestational age, birth weight, low Apgar score, delivery room resuscitation, RDS, surfactant use, sepsis, packed red blood cell transfusion, mechanical ventilation and umbilical vein catheterization. The newborns with peri-intraventricular hemorrhage presented longer times on assisted ventilation, longer hospital stays and higher risk of death. Conclusion: The prevalence of peri-intraventricular hemorrhage was high in the population studied, especially the severe form. Perinatal and neonatal risk factors were associated with a higher risk of developing the disease and the outcomes studied were more evident in these newborns.

Congenital Gangrene in a Premature Newborn: A Case Report

Introduction: Congenital limb gangrene is a rare pathology. In the majority of cases, no cause is identified and its treatment is not codified. Observation: 29-week premature newborn, female from poorly followed twin pregnancy. Clinical examination at admission found an unstable neonate, the presence of necrosis of the left hand and forearm well limited, with absent humeral pulse and absence of hand movement. Surgical treatment was scheduled for amputation of the limb after the agreement of the parents whose postoperative follow-ups were simple. Conclusion: Congenital gangrene remains a rare entity in neonatology.

A Premature Baby’s Nursing Care Plan

Introduction: Baby T, is in the 46th day of his life has a 26-year-old mother who has suffered from about hypotyroid and preeclampsia during her pregnancy was born as a preterm baby when he was in 27 weeks’ gestation age by CS. Purpose: This article aimed to introduce the Nursing care plan. Materials and Methods: Place of work: Neonatal Intensive Care Unit/Balcali Research and Education Hospital in Adana, Turkey. Nursing Care Plan for the clinical period from 23.02.2015 till 11.03.2015. Informed consent was obtained from the baby’s family. Results: In addition to this, parents have blood incompatibility, therefore, such combinations of diseases impacted baby in the uterus and delivery happened earlier than expected date. His birth weight was 820 gr (0% - 5% percentile), height 34 cm (10% - 25% percentile), head-circumference 24 cm (10% percentile). The following healthcare needs were identified upon assessment;intubation, oxygene and stimulant support, monitorization, taking blood samples. Apical pulse is rapid and irregular within normal range 148 bpm, weight is 1605 gr, body is long, thin, limp with a slight potbelly. Initially suck/swallow reflex was absent/uncoordinated that’s why he was taking expressed breastmilk throughout orogastric catheter, it has started also oral giving for the couple of days with the development of sucking and swallowing. Reflexes depend on gestational age;rooting well established by 32 weeks’ gestation;coordinated reflexes for sucking, swallowing, and breathing usually established by 32 weeks;first component of Moro’s reflex (lateral extension of upper extremities with opening of hands) appears at 28 weeks;second two components (anterior flexion and audiblecry) appear at 32 weeks. Dubowitz examination indicates gestational age between 24 and 37 weeks. Consequently, this infant shows, palmar grasp, plantar grasp, moro reflex;the only response is the opening of the hand due to 27 gestational age. Apgar score was 4 - 7 (average, need oxygene and stimulant). Respiration was shallow, maintain neutral thermal environment, prevent or reduce risk of potential irregular, diaphragmatic with intermittent breathing 58/min. Conclusion: Nursing priorities should be promote optimal respiratory functioning, complications, maintain homeostasis, foster development of healthy family unit.

早产儿先天性结核1例

本文报道了1例早产儿先天性结核的诊断及治疗过程。患儿系胎龄29+1周阴道娩出,生后立即收入武汉大学中南医院新生儿重症监护室(neonatal intensive care unit,NICU)负压隔离病房单独隔离。患儿母亲自孕15~16周出现低热、咳嗽,产前确诊为“亚急性血行播散型肺结核、结核性脑膜炎”并接受抗结核治疗27天。患儿生后第1天胃液检出少量结核杆菌,痰液检出结核DNA,结核抗体阳性,生后第2天血液标本T-SPOT试验阳性。入院后置负压病房隔离,予以呼吸及营养支持等治疗,生后第2天开始予以异烟肼、利福平、吡嗪酰胺三联抗结核治疗。患儿病情逐渐好转,未出现结核感染的严重症状,于生后第52天(纠正胎龄36^(+4)周)离氧出院,现持续随访中。对疑似先天性结核感染的新生儿,及早诊断和规范化治疗可避免不必要的死亡和残疾发生。

母乳喂养比例与早产儿新生儿坏死性小肠结肠炎临床特征的关系研究

目的:分析不同母乳喂养比例及部分母乳喂养量与早产儿新生儿坏死性小肠结肠炎(necrotizing enterocolitis, NEC)临床特征之间的关系,为早产儿的喂养护理和NEC的预防及诊疗提供参考依据。方法:回顾性分析2012年1月—2022年1月新生儿重症监护室收治的77例早产儿NEC的临床资料,根据母乳喂养量占肠内喂养总量的百分比将77例早产儿NEC分为5组:母乳喂养量占比100%组(全母乳喂养组)、母乳喂养量占比70%~<100%组(高母乳喂养组)、母乳喂养量占比30%~<70%组(中母乳喂养组)、母乳喂养量占比>0~<30%组(低母乳喂养组)及母乳喂养量占比0组(无母乳喂养组)。同时以母乳喂养量占肠内喂养总量的30%为界限,分为母乳喂养量占比<30%组和母乳喂养量占比≥30%组。比较不同组间NEC患儿一般资料、基础疾病、临床特征和疾病转归情况。结果:共纳入早产NEC患儿77例,5组间早产NEC患儿阿氏(Apgar)评分和呼吸系统疾病以及NEC的发病日龄、确诊日龄、肠道病理损伤严重程度和住院生长率比较差异有统计学意义(P<0.05);母乳喂养量占比<30%组和≥30%组的早产儿NEC确诊日龄和肠道病理损伤严重程度比较差异有统计学意义(P<0.05)。结论:母乳喂养比例与早产儿NEC临床特征之间存在相关性。随着母乳喂养比例的增高,早产儿NEC呈现出确诊日龄较晚,肠道病理损伤严重程度较轻,疾病转归情况较好,为早产儿的喂养护理和NEC的预防和临床诊疗提供参考依据。

临床药师参与成功治疗1例超早产儿解脲支原体感染病例分析

目的:分析临床药师参与的使用阿奇霉素成功救治1例解脲支原体(UU)感染患儿的治疗过程,为优化该类疾病的治疗提供经验。方法:临床药师通过对阿奇霉素用于新生儿UU感染的风险和获益评估,参与抗感染方案的制定。结果:单药阿奇霉素可用于新生儿UU感染的治疗。结论:临床药师利用药学专业知识协助医师制定用药方案,深入临床实施用药指导,可充分提高临床治疗效果及药物治疗的安全性和有效性。

新生儿抚触配合早期微量喂养预防早产儿经口喂养不耐受的效果

目的 分析对早产儿采取抚触联合早期微量喂养的干预措施在降低新生儿经口喂养不耐受发生率等方面的影响。方法 选取2022年9月至2023年9月在我院出生的早产儿80例,以随机信封法对其分组,其中40例新生儿仅接受早期微量喂养干预,设为对照组,其余40例新生儿在早期微量喂养干预的基础上接受抚触干预,设为观察组;对比每日摄入奶量、热量以及恢复出生体重用时、每日体重增长情况、胃肠外营养时间、达足量肠内喂养时间、经口喂养不耐受发生情况。结果 观察组新生儿每日摄入奶量及热量均比对照组新生儿高(P <0.05);观察组新生儿恢复出生体重用时比对照组新生儿用时要短,每日体重增长量比对照组新生儿多(P <0.05);观察组新生儿胃肠外营养时间以及达足量肠内喂养时间用时均比对照组新生儿用时短(P <0.05);观察组新生儿经口喂养不耐受发生率比对照组新生儿低(P <0.05)。结论 对早产新生儿在早期微量喂养的同时增加抚触护理可促进新生儿胃肠功能尽快发育成熟,并可改善新生儿胃肠动力,提高新生儿经口喂养耐受性。

基于产科资料和血清学指标构建足月妊娠胎膜早破胎儿/新生儿并发症的预测模型

目的基于产科资料和血清学指标构建足月妊娠胎膜早破(PROM)胎儿/新生儿并发症的预测模型,以期为临床早期预测及预防胎儿/新生儿发生并发症提供参考。方法将2019年1月至2020年12月该院收治的240例足月PROM产妇分为建模组162例和验证组78例,收集所有研究对象的临床资料并检测血清人绒毛膜促性腺激素(β-HCG)、C-反应蛋白(CRP)、金属蛋白酶-3(MMP-3)水平。根据是否发生并发症将建模组分为发生组和未发生组。采用多因素Logistic回归分析建模组足月PROM胎儿/新生儿发生并发症的影响因素,构建列线图预测模型,并绘制受试者工作特征(ROC)曲线、决策曲线对该模型进行评估验证。结果建模组中发生并发症60例(发生组),未发生并发症102例(未发生组)。发生组PROM孕周37周0~6 d、内检次数≥3次、阴道炎、破膜至分娩时间24~72 h产妇占比及血清β-HCG、CRP、MMP-3水平高于未发生组(P<0.05);多因素Logistic回归分析结果显示,PROM孕周37周0~6 d、内检次数≥3次、破膜至分娩时间24~72 h及血清β-HCG、CRP、MMP-3水平升高是足月PROM胎儿/新生儿发生并发症的独立危险因素(P<0.05)。基于以上指标构建建模组中足月PROM胎儿/新生儿发生并发症的列线图预测模型,该模型在建模组和验证组中的一致性指数分别为0.891、0.877。ROC曲线显示,该列线图在建模组和验证组中预测的曲线下面积分别为0.976(95%CI:0.858~0.990)、0.938(95%CI:0.875~0.962)。决策曲线显示,当建模组高风险阈值在0.0~0.8时、验证组高风险阈值在0.0~0.8时,该列线图具有较好的临床净收益。结论足月PROM胎儿/新生儿发生并发症的影响因素包括PROM孕周、内检次数、破膜至分娩时间和血清β-HCG、CRP、MMP-3水平,基于以上因素构建的列线图预测模型对高危人群具有一定的预测效能,可能改善妊娠结局。

分析抚触护理联合睡眠管理对早产儿睡眠质量及生长发育的影响

目的:分析抚触护理联合睡眠管理对早产儿睡眠质量及生长发育的影响。方法:选取2020年1月至2021年12月泉州市儿童医院妇幼保健收治的早期早产儿100例作为主要研究对象,按照随机数字表法将患儿分为对照组和观察组,每组50例。对照组早产儿实施常规护理干预,观察组在对照组的基础上增加抚触护理联合睡眠管理护理干预,比较2组患儿的生长发育指标的差异,并比较2组患儿每日睡眠时间、夜间持续睡眠时间。结果:干预后,观察组患儿28 d时测量的头围显著高于对照组,观察组患儿体质量显著高于对照组,观察组患儿入院时的每日睡眠时间显著长于对照组,观察组入院时的夜间持续睡眠时间显著高于对照组,差异均有统计学意义(均P<0.05)。结论:早产儿护理工作中,抚触护理与睡眠管理相结合能够起到更好的干预效果,既有利于促进早产儿的身体生长发育,又可以改善其睡眠质量,值得临床推广应用。

Impact of Delivery Mode on Morbidity in Preterm Infants with Very Low Birth Weights (<1500 Grams)

The mode of delivery and gestational age for very-low-birth-weight (VLBW) preterm infants are not yet well established and are constant topics of debate. Objective: To analyze the impact of delivery mode on morbidity in preterm infants weighing less than 1500 g. Results: Among 21,957 births, 81 were analyzed;53 were delivered vaginally, and 28 were delivered by cesarean section. The median maternal age, gestational age and body mass index among those delivered vaginally and by cesarean section were 20 years and 22.5 years, 27.6 weeks and 30.1 weeks, and 26.0 kg/m2 and 27.8 kg/m2, respectively. With respect to neonatal blood gas parameters, for those born vaginally and by cesarean section, the median pH was 7.32 and 7.24, the pCO2 was 41.5 mmHg and 51.1 mmHg, and the pO2 was 22.3 mmHg and 16 mmHg. The median fetal weight among those born by cesarean section and vaginally were 1180 g and 955 g, respectively. The median Apgar scores at the first and fifth minutes among those born by cesarean section and vaginally were 5.00 and 8.00 and 4.50 and 7.00, respectively. Conclusion: There was no significant difference between the results of vaginal and cesarean delivery for VLBW infants. Thus, further studies on this subject are needed.

早产新生儿万古霉素血药谷浓度达标的影响因素研究

目的分析导致早产新生儿万古霉素血药谷浓度不达标或超标的影响因素,为临床用药提供参考。方法回顾性收集2016年12月—2021年3月接受万古霉素静脉治疗的早产新生儿血药谷浓度监测数据,根据《中国万古霉素治疗药物监测指南(2020更新版)》推荐,将万古霉素稳态谷浓度<5 mg/L的患儿纳入不达标组,5~15 mg/L的纳入达标组,>15 mg/L的纳入超标组。利用SPSS软件统计分析不同分组间临床特征差异,分析各因素对血药谷浓度达标情况的影响。结果82例早产新生儿中,万古霉素的中位谷浓度为12.50(7.95,18.05)mg/L。达标患儿47例,占57.32%,谷浓度中位数为10.90(7.80,13.30)mg/L;超标患儿27例,占32.93%,中位数为21.80(18.00,23.80)mg/L;不达标患儿仅8例,占9.75%,中位数为4.10(2.48,4.60)mg/L。单因素分析结果表明,不达标组与达标组患儿在矫正胎龄和当前体重方面,差异有统计学意义(P<0.05);超标组与达标组患儿在血肌酐值和给药间隔方面的差异具有统计学意义(P<0.01)。多因素logistic回归分析结果显示,血肌酐值(OR=1.063,95%CI:1.024~1.102,P=0.001,截断值:62μmol/L)和给药间隔(OR=6.693,95%CI:1.604~27.920,P=0.009)是导致万古霉素血药谷浓度超标的独立危险因素。结论在现行说明书给药方案下,仅有半数早产新生儿的血药谷浓度达到指南推荐范围,用药时应综合患儿矫正胎龄、当前体重、日剂量及血清肌酐值等情况,优化万古霉素给药方案,开展血药浓度监测以确保用药安全和有效。

绒毛膜羊膜炎与新生儿相关疾病的研究进展

绒毛膜羊膜炎(chorioamnionitis, CAM)是指病原体感染胎盘的绒毛膜羊膜和蜕膜而形成的炎症。CAM会导致早产,使新生儿发生呼吸窘迫综合征、支气管肺发育不良等不良结局的风险增加,以及使新生儿围产期的死亡率上升。因此,早期识别、诊断及治疗CAM对于提高孕产妇及新生儿的救治成功率、改善新生儿的生存质量及疾病预后具有重要意义。该综述旨在阐述CAM与新生儿相关疾病的关系及防治的研究现状,为更好管理CAM相关新生儿提供临床治疗新思路。

5307例新生儿眼底筛查结果及眼底疾病相关因素分析

目的:探讨5 307例新生儿眼底筛查结果及眼底疾病的相关因素。方法:选取2022-01/12在我院眼科进行眼底筛查的新生儿5 307例,采用RetCamⅢ系统进行眼底检查,记录眼底异常情况,分析足月儿发生视网膜出血和早产儿发生早产儿视网膜病变(ROP)的影响因素。结果:纳入新生儿眼部异常发生率为27.17%,其中视网膜出血发生率最高(61.23%),其次为视网膜渗出(22.95%)、ROP和ROP样视网膜病变(10.68%),牵牛花综合征(0.21%)、白化病性眼底(0.21%)和永存胚胎血管(PFV)(0.28%)发生率较低。足月儿眼部异常发生率低于早产儿(26.30%vs 30.08%,P<0.05),足月儿视网膜出血、视网膜渗出发生率均高于早产儿(P<0.05),早产儿ROP和ROP样视网膜病变发生率高于足月儿(P<0.05)。顺产是足月儿发生视网膜出血的危险因素(P<0.05)。胎龄(32-34、30-31周)、出生体质量(1 500-2 499、<1 500 g)、奶粉喂养、吸氧是早产儿发生ROP的危险因素(均P<0.05)。结论:本院新生儿眼部异常发生率较高,通过眼底筛查可及早发现新生儿眼部异常。

组织学绒毛膜羊膜炎对胎龄小于34周早产儿临床结局的影响:一项倾向性评分匹配研究

目的 探讨组织学绒毛膜羊膜炎(HCA)对胎龄小于34周早产儿临床结局的影响。方法 回顾性收集2019年1月—2022年12月青岛市妇女儿童医院住院的497例胎龄<34周早产儿及孕母资料。根据胎盘病理是否诊断为HCA分为HCA组(257例)及对照组(240例)。采用倾向性评分匹配方法进行1︰1匹配,将胎龄、出生体质量、性别、剖宫产、妊娠期糖尿病、妊娠期高血压、胎盘早剥、胎膜早破、产前糖皮质激素及辅助生殖等10项指标进行匹配。比较2组早产儿主要并发症及存活率的差异。结果 156对早产儿匹配成功。匹配前HCA组早发败血症(EOS)和支气管肺发育不良(BPD)发生率显著高于对照组(26.1%vs. 7.5%,45.1%vs. 25.8%,P<0.01)。匹配后HCA组EOS发生率显著高于对照组(24.4%vs. 7.7%,P<0.01),新生儿呼吸窘迫综合征(NRDS)发生率显著低于对照组(34.0%vs.46.8%,P<0.05)。匹配前后2组早产儿存活率及其他并发症发生率差异无统计学意义(P>0.05)。结论 经倾向性评分匹配后,暴露于HCA的早产儿合并EOS风险更高,但NRDS的发病风险降低。HCA对早产儿的存活率及其他并发症无显著影响。

改良式遮光毯在新生儿重症监护病房的应用效果

目的探讨改良式遮光毯在新生儿重症监护病房(NICU)的应用效果。方法选取2021年1月至2023年7月安徽省合肥市第一人民医院NICU收治的104例早产儿为研究对象,按照简单随机数字表法分为两组,每组52例。两组均给予常规护理,对照组置于覆盖普通遮光毯的新生儿暖箱内,观察组置于覆盖改良式遮光毯的新生儿暖箱内。比较两组暖箱内噪声水平、心率、经皮血氧饱和度、日均体重增长和家属满意度。结果观察组暖箱内噪声水平低于对照组,心率慢于对照组,经皮血氧饱和度高于对照组,日均体重增长重于对照组,差异有统计学意义(P<0.05)。两组家属满意度比较,差异无统计学意义(P>0.05)。结论改良式遮光毯覆盖于新生儿暖箱能有效控制NICU暖箱内噪声和光线的污染,改善心率、体重日均增长幅度及经皮血氧饱和度,有效促进新生儿的生长发育,提高家属满意度。

眼底成像系统筛查15283例新生儿眼底病的临床分析

目的:探讨阜阳市颍州区新生儿眼底疾病的检出率和影响因素。方法:选取进行眼底病变筛查的新生儿15283名作为研究对象,根据胎龄分为足月组11692名和早产组3591名。比较2组新生儿眼底疾病的检出率,分析新生儿视网膜出血的影响因素。结果:2组新生儿眼底疾病总检出率差异有统计学意义(P<0.01)。2组检出率最高的眼底疾病类型均为视网膜出血,2组检出率差异有统计学意义(P<0.01)。单因素和多因素logistic回归分析显示,出生胎龄、分娩方式、出生体质量和母亲妊娠期并发症均为新生儿发生视网膜出血的影响因素(P<0.05~P<0.01)。不同出生胎龄、出生体质量新生儿的早产儿视网膜病变检出率差异均有统计学意义(P<0.01)。结论:阜阳市颍州区新生儿视网膜出血等眼底疾病检出率较高,出生胎龄、分娩方式、出生体质量和母亲妊娠期并发症均为新生儿发生视网膜出血的独立影响因素。

早产新生儿使用无创呼吸机的临床护理干预效果及并发症发生率情况

目的 早产新生儿使用无创呼吸机的临床护理干预效果及并发症发生率情况。方法 将64例在2020年1月1日至2023年3月31日期间于石狮市妇幼保健院分娩并接受无创呼吸机治疗的早产新生儿,按系统编号单双数分为两组,每组32例患者,纳入本研究。常规护理由对照组执行,临床护理干预由观察组执行。对比两组血气分析指标、住院时间、并发症发生率以及家属对护理满意度情况。结果 护理后,观察组动脉血二氧化碳分压(7.49±0.23)mmHg低于对照组动脉血二氧化碳分压(7.83±0.27)mmHg(t=5.427,P <0.05);组间动脉血氧分压、血氧饱和度对比,为观察组更高(P <0.05);组间住院时间对比,为观察组更低(P <0.05);组间新生儿并发症发生率对比,为观察组更低(P <0.05);两组患儿家属对护理满意度对比,为观察组更高(P <0.05)。结论 在接受无创呼吸机治疗的早产新生儿中实施临床护理干预,可有效提高血气分析指标,降低无创呼吸机并发症的发生风险,使其能够尽早出院,提高患儿家属满意度,临床应用价值显著。

GPER抑制星形胶质细胞活性减少OIR小鼠视网膜新生血管生成的机制研究

目的探究在氧诱导下的新生小鼠视网膜缺血模型(oxygen-induced retinopathy,OIR)中,G蛋白偶联雌激素受体(G proteincoupled estrogen receptor,GPER)减少OIR小鼠视网膜新生血管生成的机制。方法42只新生小鼠采用随机数字表法分为4组:常氧对照组(n=11)、OIR组(n=11)、G-1(GPER激动剂)组(n=10)和溶剂对照组(n=10)。出生后17 d(P17)时,眼球冰冻切片免疫荧光染色观察常氧对照组小鼠GPER在视网膜分布情况。G-1组和溶剂对照组在P12~P15时分别腹腔注射给予G-1[50μg/(kg·d)]或玉米油溶剂,P17时视网膜铺片免疫荧光染色观察视网膜血管标志物(IB4)、星形胶质细胞标志物胶质纤维酸性蛋白(glia fibrilary acidic protein,GFAP)表达,蛋白免疫印迹法定量检测视网膜血管内皮生长因子A(vascular endothelial growth factor A,VEGFA)、GFAP、炎症因子TNF-α、IGF-1、IL1-β蛋白表达情况。结果GPER存在于小鼠视网膜全层,在视网膜神经节细胞层与星形胶质细胞标志物GFAP共染。与常氧对照组相比,OIR组小鼠视网膜出现新生血管与无血管区,且GPER、VEGFA和GFAP表达增多,差异具有统计学意义(P<0.05);与溶剂对照组相比,G-1组视网膜新生血管生成减少,VEGFA、GFAP、TNF-α、IGF-1、IL1-β蛋白表达下降,差异具有统计学意义(P<0.05)。结论GPER能抑制星形胶质细胞活性,减少VEGFA、炎症因子释放,减少OIR小鼠视网膜新生血管生成。

人文理念下的鸟巢式照护模式在早产新生儿中的应用及对其生长发育指标的影响

目的在早产新生儿中应用人文理念下的鸟巢式照护模式,意在分析该护理模式对其生长发育指标的影响。方法以2022年1月至2023年6月于厦门市第三医院分娩的78例早产新生儿为研究对象,利用随机数字表法将78例新生儿分为两组,每组39例。给予对照组常规护理,在此基础上给予观察组人文理念下的鸟巢式照护模式护理。现统计两组临床相关指标,包括每日排便次数、每日奶量增加量、体温波动幅度、每日睡眠时间4项;分析两组早产新生儿生长发育指标,最后评估家属满意度。结果两组早产新生儿出生后4周的身长、体重、头围指标比出生时都高且观察组更高(P<0.05);观察组早产新生儿每日奶量增加量、每日睡眠时间、每日排便次数均高于对照组,体温波动幅度低于对照组(P<0.05);观察组家属满意度高于对照组(P<0.05)。结论在早产新生儿中应用人文理念下鸟巢式照护模式可以延长其睡眠时间,促进体温稳定,改善胃肠功能,促进消化吸收,继而有利于其生长发育,增加家属满意度。