影响新生儿硬肿症预后因素分析及护理体会  

Analysis of the influencing factors and the nursing effects of the neonatal sclerema

作　　者：庄婵芝[1] 谢泽娟[1] 张少燕[1] 林玲[1] 

机构地区：[1]汕头大学医学院第一附属医院新生儿科,515041

出　　处：《中国实用医药》2013年第5期198-200,共3页China Practical Medicine

摘　　要：目的通过分析住院新生儿硬肿症的不同预后及死亡原因,探讨导致新生儿硬肿症不同预后的原因,以提高新生儿硬肿症抢救成功率及护理效果。方法收集在我科住院203例新生儿硬肿症的临床资料,分析预后、死亡原因、护理效果。结果治愈及好转148例,死亡55例,病死率37.2%。早产儿、极低及低出生体重儿、中重度硬肿症、冬春季发病者、在乡镇地区发病者病死率高于足月儿、正常出生体重儿、轻度硬肿症、夏秋季发病者、在市区发病者。直接导致死亡病因:弥散性血管内凝血并肺出血、呼吸衰竭、肾功能衰竭、严重心力衰竭、呼吸机相关性肺炎、败血症并中毒性脑病等。结论新生儿硬肿症不良预后与胎龄、体重、硬肿程度、发病季节、原发病等有密切关系,窒息、感染、早产、低体重、低温、乡镇地区出生等是影响新生儿硬肿症预后的重要因素,应加强围产期保健、提倡住院分娩、注意新生儿体温护理、预防感染、加强病情观察等,以减少新生儿硬肿症的发生及死亡。Objective Through analysis of the influencing factors to the morbidity and mortality of the neonatal sclerema to explore the causes which lead to different prognoses of the neonates with slerema and to promote the effective treatments and nursing methods. Methods The clinical data of hospitalized 203 neonates with sclerema were collected and the prognoses, causes of death, nursing effects were summarized. Results 148 neonates were cured or improved and 55 of them were dead. The fatality rate was 37. 2%. The preterm infants, very low and low birth weight infants, infants with moderate and severe type of sclerema,infants who developed sclerema during winter and spring and who were born at rural areas had higher fatality rate than those who were term, had normal birth weight, had mild type of sclerema, developed sclerema during summer and autumn and were born at urban areas. The direct causes of death included disseminated intravascular coagulation with pulmo- nary hemorrhage, respiratory failure, renal failure, heart failure, severe ventilator-associated peumonia, septicemia with toxic encephalopathy and so on. Conclusion Poor prognoses of the neonatal sclerema were related with gestational age, birth weight, seasons and primary diseases. Asphyxia, infections, prematurity, low birth weight and low temperature were the main factors which may lead to poor outcome. Improvement of the prenatal health care, advocation of hospitalized childbirth, prevention of infections and careful nursing of the newborn infants may be helpful to decrease the morbidity and mortality of neonatal sclerema.

关 键 词：新生儿 硬肿症 护理 

分 类 号：R473.72[医药卫生—护理学]