无缝隙护理在极低出生体重儿脐静脉置管联合PICC中的应用效果分析  

Analysis of the application effects of seamless nursing combined with umbilical vein catheter and PICC in extremely low birth weight neonates

作　　者：王冬雁[1] 张爽 夏颖[1] 万会莲 李晓旭 尚敏[1] 张贺玲[1] 常晓丹[1] 严士杰[1] WANG Dongyan;ZHANG Shuang;XIA Ying(The Second Central Hospital of Baoding City,Hebei,Baoding 072750,China)

机构地区：[1]河北省保定市第二中心医院,072750

出　　处：《河北医药》2018年第22期3508-3511,共4页Hebei Medical Journal

基　　金：保定市社发类项目(编号:17ZF315)

摘　　要：目的研究无缝隙护理在极低出生体重儿脐静脉置管与经外周静脉穿刺中心静脉置管(PICC)联合中的应用效果。方法应用数字随机表法将76例极低出生体重新生儿随机分为对照组和观察组,每组38例。这76例极低出生体重新生儿均经脐静脉置管联合PICC置管给予输液治疗,在置管期间,对照组采取常规护理模式干预,观察组采取无缝隙护理模式干预,比较2组新生儿出生即刻、出生后1、2、4周的体重变化,比较2组新生儿的置管不良事件、并发症发生率、持续带管时间、住院时间,并比较2组新生儿家属的负性情绪评分、护理满意度。结果在出生后2、4周,观察组新生儿的体重高于对照组(P <0. 05);出生后2、4周,观察组新生儿体重均较出生即刻体重更高(P <0. 05),而对照组新生儿体重仅在出生后4周才高于出生即刻(P <0. 05)。观察组新生儿的置管不良事件、并发症发生率总发生率低于对照组(P <0. 05)。观察组新生儿的持续带管时间较对照组延长(P <0. 05),住院时间缩短(P <0. 05)。护理后,2组家属的焦虑及抑郁评分均较护理前下降(P <0. 05),而观察组的焦虑及抑郁评分低于对照组(P <0. 05)。观察组家属的总满意率高于对照组(P <0. 05)。结论在极低出生体重儿经脐静脉置管联合PICC置管输液治疗中,应用无缝隙护理模式可有效促进新生儿体重增长,还可减少置管不良事件和并发症,延长带管时间,缩短住院时间,还可减轻新生儿家属的负性情绪,使其对护理服务更加满意。Objective To investigate the application effects of seamless nursing combined with umbilical vein catheter and PICC in extremely low birth weight neonates.Methods A total of 76 extremely low birth weight neonates who were treated in our hospital from March 2015 to March 2016 were enrolled in the study.According to random digital table method,these neonates were divided into control group(n=38)and observation group(n=38).The patients in both groups were given infusion therapy via umbilical vein catheter with PICC catheter,and the patients in control group were treated by conventional nursing intervention during the period of catheter,however,the patients in observation group were treated by seamless intervention nursing mode.The changes of body weight,immediately after the birth and at 1w,2w,4w after birth were observed and compared between the two groups,moreover,the neonatal catheter adverse events,complications,duration with tube,length of hospital stay,and neonatal family negative sentiment score,nursing satisfaction degree were observed and compared between the two groups.Results The neonatal body weight at 2w,4w after birth in observation group was significantly higher than that in control group(P>0.05),which in observation group was significantly higher than that in instant of birth(P<0.05).However the neonatal body weight only at 4w after birth in control group was significantly higher than that in instant of birth(P<0.05).Moreover the total incidences of neonatal catheter adverse events and complications in observation group were significantly lower than those in control group(P>0.05),and the duration with tube in observation group was prolonged,as compared with that in control group(P<0.05),however the length of hospital stay in observation group was shortened(P<0.05).After nursing the anxiety and depression scores of family menbers were decreased in both groups,as compared with those before nursing(P<0.05),moreover,which in observation group were significantly lower than those in control group(P>0.05).I

关 键 词：极低出生体重儿 脐静脉置管 经外周穿刺中心静脉置管 无缝隙护理 

分 类 号：R473.72[医药卫生—护理学]