干预性护理措施对有创通气下行全身亚低温治疗的重度缺氧缺血性脑病患儿的临床效果

何春; 陈礼娟; 黄凤枚; 侯彰华

doi:10.16766/j.cnki.issn.1674-4152.002967

干预性护理措施对有创通气下行全身亚低温治疗的重度缺氧缺血性脑病患儿的临床效果

doi: 10.16766/j.cnki.issn.1674-4152.002967

湘南学院第一附属医院郴州市第一人民医院NICU，湖南郴州 423000

详细信息

通讯作者:
侯彰华，E-mail：menglironger@163.com

中图分类号: R473.72 R722.12
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- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2022-08-11
- 网络出版日期: 2023-05-31

Clinical effect of interventional nursing measures for children with severe hypoxic ischemic encephalopathy treated with systemic mild hypothermia under invasive ventilation

NICU, First Affiliated Hospital of Xiangnan University, Chenzhou First People' s Hospital, Chenzhou, Hunan 423000, China

摘要

摘要: 目的探讨对有创通气下行全身亚低温治疗的重度缺氧缺血性脑病(HIE)患儿实施干预性护理措施的临床疗效。方法选取2017年2月—2020年2月郴州市第一人民医院收治的重度HIE患儿112例为研究对象，根据随机数字法随机分为观察组和对照组各56例。2组均在有创通气下行全身亚低温治疗，对照组行常规护理，观察组在常规护理基础上行干预性护理措施。观察和比较2组临床护理效果。结果观察组治疗期间尿潴留、压疮、硬肿症、呼吸道感染、心律失常、消化道出血等并发症总发生率为26.79%，对照组上述并发症总发生率为83.93%，观察组上述并发症总发生率明显低于对照组(P＜0.01)；观察组和对照组住院天数分别为(15.83±2.96)d和(22.92±2.87)d，住院费用分别为(16 295.31±175.67)元和(28 975.33±195.83)元，观察组住院天数和住院费用均明显低于对照组(均P＜0.001)。结论干预性护理措施能有效提高有创通气下行全身亚低温治疗重度HIE患儿的临床效果，减少治疗期间相关并发症的发生风险，缩短住院时间和节省住院费用，值得在临床推广和使用。
- 缺氧缺血性脑病 /
- 有创通气 /
- 全身亚低温治疗 /
- 干预性护理措施
Abstract: Objective To explore the clinical efficacy of interventional nursing measures for children with severe hypoxic ischemic encephalopathy (HIE) treated with systemic mild hypothermia under invasive ventilation. Methods A total of 112 children with severe HIE admitted to Chenzhou First People ' s Hospital from February 2017 to February 2020 were selected as the research objects, and randomly divided into observation group and control group with 56 cases each group according to random number method. Both groups were treated with systemic mild hypothermia under invasive ventilation, the control group received routine nursing, and the observation group received interventional nursing measures on the basis of routine nursing. The clinical nursing effect of the two groups were observed and compared. Results The total incidence of complications such as urinary retention, pressure ulcers, epiduria, respiratory tract infection, arrhythmia and gastrointestinal bleeding was 26.79% in the observation group, and 83.93% in the control group. The total incidence of complications in the observation group was significantly lower than that in the control group (P < 0.01). The hospitalization days of observation group and control group were (15.83±2.96) d and (22.92±2.87) d, respectively, and the hospitalization expenses were (16 295.31±175.67) yuan and (28 975.33±195.83) yuan, respectively. The hospitalization days and hospitalization expenses of the observation group were significantly lower than those of the control group (all P < 0.001). Conclusion Interventional nursing measures can effectively improve the clinical effect of systemic mild hypothermia under invasive ventilation for severe HIE children, reduce the risk of related complications during treatment, shorten the length of hospital stay and save treatment expenses, and it is worthy of clinical promotion and use.
- Hypoxic-ischemic encephalopathy /
- Invasive ventilation /
- Systemic mild hypothermia treatment /
- Interventional nursing measures

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表 1 2组重度HIE患儿一般临床资料比较

Table 1. Comparison of general clinical data between two groups of children with severe HIE

组别	例数	性别 (男/女，例)	胎龄 (x±s，月)	5 min Apgar评分 (x±s，分)	出生体重 (x±s，g)
观察组	56	31/25	38.86±1.82	4.12±0.23	3 285.72±138.82
对照组	56	32/24	38.78±1.81	4.17±0.18	3 275.61±150.89
统计量		0.036^a	0.233^b	1.281^b	0.369^b
P值		0.849	0.816	0.203	0.713
注：^a为χ²值，^b为t值。

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表 2 2组重度HIE患儿临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy between two groups of children with severe HIE[cases(%)]

组别	例数	显效	有效	无效	总有效
观察组	56	29(51.79)	25(44.65)	3(5.36)	53(94.64)
对照组	56	19(33.93)	22(39.28)	15(26.79)	41(73.21)
注：2组总有效率比较，χ²=9.532，P=0.002。

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表 3 2组重度HIE患儿住院天数及住院费用比较(x±s)

Table 3. Comparison of hospitalization days and hospitalization costs between the two groups of children with severe HIE(x±s)

组别	例数	住院时间(d)	住院费用(元)
观察组	56	15.83±2.96	16 295.31±175.67
对照组	56	22.92±2.87	28 975.33±195.83
t值		12.869	360.688
P值		＜0.001	＜0.001

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表 4 2组重度HIE患儿并发症比较[例(%)]

Table 4. Comparison of complications between two groups of children with severe HIE[cases(%)]

组别	例数	尿潴留	压疮	硬肿症	呼吸道感染	心律失常	消化道出血	合计
观察组	56	5(8.93)	1(1.79)	2(3.57)	2(3.57)	2(3.57)	3(5.36)	15(26.79)
对照组	56	9(16.07)	6(10.71)	8(14.29)	13(23.21)	9(16.07)	2(3.57)	47(83.93)
注：2组总不良反应发生率比较，χ²=36.996，P＜0.001。

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