新生儿烧伤与高胆红素血症的相关性及蓝光照射治疗护理对策  

Study on correlation between burn and hyperbilirubinemia and nursing countermeasure with Blu-ray treatment in newborns

作　　者：丁小美[1] 辛洪霞[2] 龚飞燕[2] 熊艳华[2] 李华钏[3] 

机构地区：[1]南昌大学第二附属医院耳鼻咽喉-头颈外科,江西南昌330006 [2]南昌大学第二附属医院儿内科,江西南昌330006 [3]解放军第174医院烧伤整形科,福建厦门336000

出　　处：《现代预防医学》2014年第13期2362-2364,2368,共4页Modern Preventive Medicine

摘　　要：目的分析新生儿烧伤后发生高胆红素血症（Hyperbilirubinemia）的因素,总结烧伤后高胆红素血症的蓝光治疗护理经验、护理要点,提高护理质量,改善预后。方法通过检测62例普通黄疸及27例烧伤合并黄疸新生儿血清胆红素水平,对比分析烧伤新生儿与普通新生儿黄疸的程度及持续时间,并对烧伤新生儿烧伤程度与胆红素水平进行相关性分析,采取相应的护理措施及蓝光照射疗法。结果烧伤新生儿较普通新生儿更易发生黄疸（84.37%）,尤以病理性黄疸发生率高;烧伤组总胆红素、间接胆红素均高于对照组（P〈0.01）;烧伤组黄疸持续时间高于对照组（P〈0.01）;烧伤程度与总胆红素水平、间接胆红素水平、黄疸持续时间呈正相关（rs=0.846,0.831,0.862;均P〈0.05）;烧伤组患儿经蓝光治疗、积极护理在1~2.5周内,肉眼观察皮肤黄疸消退,血清胆红素下降,无一例出现胆红素脑病。结论烧伤与新生儿高胆红素血症相关,加强烧伤新生儿高胆红素血症的观察,尽早行蓝光照射治疗,有助于尽快而有效地降低血清胆红素,防止胆红素脑病的发生,并有效减少新生儿烧伤并发症。Objective To analyze factors of hyperbilirubinemia after burn among newborns and to summarize nursing experience with Blu-ray treatment for newborns with hyperbilirubinemia after burn, and to improve quality of nursing care and prognosis.Methods By comparatively detecting bilirubin of 62 newborns with general jaundice and 27 ones with jaundice after burn, the jaundice levels and lasting time were studied. The correlation between the bilirubin levels and the degree of burn was analyzed. The appropriate nursing countermeasure and Blu-ray treatment were used. Results The rate of jaundice in newborns after burn was higher than that of general newborns（84.37%）. Pathological jaundice was more common in newborns after burn. The serum total bilirubin and indirect bilirubin levels were signally higher in the burned group than those in the control group（P〈0.01）, as well as duration of jaundice was longer in the burned group（P〈0.01）. The degree of burn was positively correlated with serum total bilirubin,indirect bilirubin levels and duration of jaundice（rs=0.846, 0.831, 0.862; all P〈0.05）. The babies who had been burned were treated by blu-ray and promptly nursing. Afterwards, the degree of jaundice relieved, and the level of serum bilirubin dropped in1-2.5 weeks. None of them had bilirubin encephalopathy. Conclusion There is an obvious association between burn and hyperbilirubinemia in newborns. Improving observation of neonatal jaundice and early Blu-ray treatment help to reduce serum bilirubin more effectively, and avoid bilirubin encephalopathy. What＇s more, it effectively reduces complications of burn in newborns.

关 键 词：新生儿 烧伤 高胆红素血症 相关性 蓝光治疗 护理 

分 类 号：R17[医药卫生—妇幼卫生保健]