多学科协作干预方案对预防胎龄<32 周早产儿低血糖及低体温的影响 ①
李月玲 a ,黄 芳 a② ,梁春燕 a ,唐英姿 b ,赵文飘 b ,唐丽春 c
(广西壮族自治区妇幼保健院 a.护理部;b.新生儿科;c.产科,广西 南宁 530000)
摘要 目的:探讨多学科协作干预方案在预防早产儿低血糖、低体温中的效果。 方法:选取在本院分娩的胎龄<32 周的早产儿,其中 2019 年 3 月至 8 月 50 例为对照组,2019 年 10 月至 2020 年 3 月 50 例为干预组。 对照组实施常规护理,干预组在对照组基础上采用多学科协作干预方案,比较两组早产儿入新生儿科时、入科后 4 h 及 8 h 血糖和体温。 结果:干预组入科时低血糖、低体温发生率低于对照组(P<0.05);干预组入科时、入科后 4 h 血糖及体温高于对照组(P<0.05);入科后 8 h 两组血糖及体温比较无统计学差异(P>0.05)。 结论:多学科协作干预方案可改善胎龄<32 周早产儿早期血糖及体温水平。
关键词: 多学科协作;早产儿;低血糖;低体温
中图分类号:R722 文献标志码:A 文章编号:1008-2409(2022)03-0089-05
Multidisciplinary collaborative intervention program to prevent hypoglycemia and hypothermia in premature infants of gestational age less than 32 weeks ①
LI Yueling a , HUANG Fang a② , LIANG Chunyan a , TANG Yingzi b , ZHAO Wenpiao b , TANG Lichun c .(a. Dept. of Nursing; b. Dept. of Neonatology; c. Dept. of Obstetrics; Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, China)
Abstract Objective: To investigate the effects of a multidisciplinary collaborative intervention program in preventing hypoglycemia and hypothermia in premature infants. Methods: Premature infants of gestational age less than 32 weeks delivered in our hospital were selected, of whom, 50 cases from March to August 2019 were included in the control group, and another 50 cases from October 2019 to March 2020 in the intervention group. The control group performed routine nursing care, while the intervention group adopted the multidisciplinary collaborative intervention program on the basis of the control group. The blood glucose and body temperature levels of the premature infants when they were first admitted to the neonatology department, and at 4 h and 8 h after being admitted were compared between both groups. Results: The incidence of hypoglycemia and hypothermia in the intervention group was lower than that in the control group when admitted at first(P<0.05); the blood glucose and body temperature in the intervention group were higher than that of the control group when admitted and at 4 h after being admitted(P<0.05); and there was no significant difference in blood glucose and body temperature at 8 h after admission(P>0.05). Conclusion: Multidisciplinary collaborative intervention program can improve the early blood glucose and body temperature levels of preterm infants of gestational age less than 32 weeks.
Keywords: multidisciplinary collaborative intervention; premature infants; hypoglycemia; hypothermia
参考文献:
[1] 国家卫生和计划生育委员会办公厅.早产儿保健工作规范[J].中华围产医学杂志,2017,20(6):401-406.
[2] 何叶,傅万海,覃晓菲,等.234 例早产儿低血糖临床特点分析[J].吉林医学,2014,35(10):2047-2048.
[3] JAMES-TODD T,MARCH M I,SEIGLIE J,et al. Racial differences in neonatal hypoglycemia among very early preterm births[J].J Perinatol,2018,38(3):258-263.
[4] MANK A,VAN ZANTEN H A,MEYER M P,et al.Hypothermia in preterm infants in the first hours after birth:occurrence,course and risk factors[J]. PLoS One,2016,11(11):e0164817.
[5] 钟庆华,段江,梁琨,等.早产小于胎龄儿生长代谢的临床研究[J].中国当代儿科杂志,2019,21(5):458-462.
[6] 柳艳丽,周薇,唐震海,等.塑料薄膜包裹对极低出生体重儿入院体温的影响[J]. 中华围产医学杂志,2014,17(4):244-248.
[7] 王勤,赵敏慧,庄薇,等.早产儿低体温发生情况的调查[J].解放军护理杂志,2015,32(14):22-24.
[8] 阮毅燕,王金秋,陈瑜毅,等.新生儿低血糖对神经发育的远期影响[J].实用医学杂志,2016,32(24):4051-4054.
[9] YU YH,WANG L,HUANG L,et al.Association between admission hypothermia and outcomes in very low birth weight infants in China:a multicentre prospective study[J].BMC Pediatr,2020,20(1):321.
[10] 李芳,杨平,蒋维连,等.多学科团队合作干预对老年慢性心力衰竭患者自我管理及液体潴留的影响[J].中国实用护理杂志,2020,36(15):1127-1133.
[11] 杨蓉,蔡宇星,李蔚,等.多学科合作护理模式对慢性阻塞性肺疾病患者急性加重次数及肺功能改善效果观察[J].中国实用护理杂志,2018,34(13):975-979.
[12] 冯升,成磊,冯一,等.护士主导的多学科团队在重症患儿营养管理中的作用[J].护理学杂志,2018,33(8):1-4.
[13] ADAMKIN D H.Neonatal hypoglycemia[J].Semin Fetal Neonatal Med,2017,22(1):36-41.
[14] 丁玲莉,余艮珍,叶天惠,等.多专科协作护理专案预防早产儿低体温[J].护理学杂志,2020,35(10):10-13.
[15] BÜLBÜL A,BAHAR S,USLU S,et al.Riskfactor assessment and the incidence of neonatal hypoglycemia in the postnatal period[J].Sisli Etfal Hastan Tip Bul,2019,53(4):389-394.
[16] 金叶.新生儿低血糖的临床特点及危险因素分析[J].中国医院统计,2019,26(4):253-255.
[17] 姚慧梅,邓晓麟,潘玩兰.高危新生儿低血糖的临床观察与护理[J].护理实践与究,2016,13(12):91-92.
[18] 邱秋香.早期护理干预对新生儿出生后 2 h 低血糖情况的影响[J].数理医药学杂志,2015,28(04):590-591.
[19] 王焕焕,程湘玮,王培红,等.妊娠期糖尿病产妇分娩新生儿低血糖管理的最佳证据总结[J].护理学报,2020,27(3):31-36.
[20] TAYLOR C,ATKINS L,RICHARDSON A,et al.Measuring the quality of MDT working:an observational approach[J]. BMC Cancer,2012,12,202.
[21] 朱晓莉,俞蓉,张晶晶,等.基于规范化管理模式的新生儿低血糖管理方案改进与实践[J].护理研究,2019,33(12):2113-2117.
[22] 胡静,李信群,沈颂娜.应用质量改进团队模式降低新生儿低体温的研究[J].护理管理杂志,2020,20(2):103-107,116.
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