外周动静脉全自动同步换血治疗新生儿重症高胆红素血症的护理  

作　　者：曲颖波[1] 张敏[2] 

机构地区：[1]哈尔滨医科大学附属第一医院新生儿科,150001 [2]黑龙江中医药大学附属第一医院儿科,哈尔滨150040

出　　处：《中华现代护理杂志》2012年第30期3648-3650,共3页Chinese Journal of Modern Nursing

摘　　要：目的探讨外周动静脉全自动同步换血治疗新生儿重症高胆红素血症的临床护理方法。方法选择2009年1月至2011年1月32例重症高胆红素血症患儿为研究对象。所有患儿均采用外周动静脉全自动同步换血方法，由两名专业护士配合完成，1名护士进行动脉处理，1名进行静脉处理，血袋中剩余约30ITll血量时停止排血，至剩余血量输完，停止输血，换血整个过程控制在3h以内。结果治疗后患者总胆红素[（312．2±13．2）μmol／L比（521．3±14．2）μmol／L]、间接胆红素[（263．6±12．3）μmoL／L比（466．5±13．8）μmol／L]、直接胆红素[（12．1±8．4）μmol／L（44．2±7．0）μmol／L]含量明显低于治疗前，差异有统计学意义（t值分别为3．32，4．28，4．06；P〈0．05）。患者治疗前后生命体征指标以及血清电解质指标比较差异无统计学意义（P〉0．05）。结论外周动静脉换血治疗新生儿重症高胆红素血症具有较好的临床效果，护理时应注意换血前、中、后的系统性护理。Objective To investigate the nursing method of automatic synchronous exchange transfusion through peripheral arteries and veins to cure newborns with severe hyperbilirubinemia.Methods 32 newborns with severe hyperbilirubinemia from January 2009 to January 2011 were investigated.All newborns were treated with the method of automatic synchronous exchange transfusion through peripheral arteries by two professional nurses,one to transfuse through arteries and one through veins.Blood ejection was stopped when 30 ml was left in the blood bag,and blood transfusion was stopped when the blood was used out.And the whole process was controlled within 3 hours.Results Patients' total bilirubin was (312.2 ± 13.2) μmol/L after the treatment,lower than (521.3 ± 14.2) μmol/L before the treatment,indirect bilirubin was (263.6 ± 12.3) μmol/L after the treatment,lower than (466.5 ± 13.8) μmol/L before the treatment,and direct bilirubin was (12.1 ±8.4) μmol/L after the treatment,lower than (44.2 ± 7.0) μmol/L before the treatment.All differences were statistically significant (t ＝3.32,4.28,4.06,respectively; P ＜ 0.05).And patients' vital signs and serum electrolytes indictor were not statistically different before and after the treatment (P ＞ 0.05).Conclusions The method of automatic synchronous exchange transfusion through peripheral arteries and veins has preferable clinical effect,and systematical nursing before,during and after exchange transfusion should be paid more attention to.

关 键 词：护理 高胆红素血症 新生儿 全自动同步换血 外周动静脉 

分 类 号：R473.72[医药卫生—护理学]