預(yù)案管理在新生兒重度窒息搶救護理中的應(yīng)用研究

□ 韋婷 WEI Ting 王丹妮 WANG Dan-ni 趙馬丁 ZHAO Ma-ding

Objective To discuss the effect of plan management on newborn severe asphyxia rescue and clinical nursing, and to provide reference for the rescue and nursing management. Methods A total of 72 newborns with severe asphyxia in our hospital from January 2017～April 2018 were selected and divided into two groups according to whether they happened before or after launching plan management; 35 newborns of January to August 2017 when plan management was not launched were included as the control group, and 37 newborns of September 2017 to April 2018 were included as the observation group. The rescue success rate, Apgar score and the satisfaction of the family members before and after the implementation of the plan management of two groups were compared. Results The rescue success rate of the children in the observation group (100.00%) was significantly higher than that of the control group (68.57%), and the difference was statistically significant (p＜0.05). At 5 minutes after resuscitation, the Apgar score of both groups was higher than that before resuscitation (p＜0.05), and the Apgar score of the observation group was significantly higher than that of the control group (p＜0.05). The satisfaction rate (100%) of newborns' family of the observation group was significantly higher than that of the control group (77.14%), and the difference were statistically significant (p＜0.05). Conclusion The plan management can effectively improve the rescue success rate of newborn severe asphyxia,the physical condition of the newborns, and the satisfaction of the family members, proved to have high application value in the management of newborn severe asphyxia.

新生兒窒息是新生兒科中比較常見的疾病之一，指的是新生兒由于產(chǎn)前、產(chǎn)時或者產(chǎn)后的各種病因，引起胎兒缺氧而發(fā)生宮內(nèi)窘迫或者在娩出過程中出現(xiàn)呼吸、循環(huán)障礙，從而導(dǎo)致新生兒出生后一分鐘內(nèi)無自主呼吸或者未能建立規(guī)律呼吸的情況[1-2]。低氧血癥、高碳酸血癥以及酸中毒是新生兒窒息的主要病理生理改變，患兒搶救不及時的致殘率與致死率極高[3]。相關(guān)研究稱，給予重度窒息新生兒進行快速、準(zhǔn)確且有效的搶救和護理操作，能夠有效地提升患兒救治成功率，降低患兒死亡率，并對并發(fā)癥的發(fā)生起到預(yù)防作用[4]。隨著預(yù)案管理在臨床管理上的應(yīng)用，因其能夠顯著提高院內(nèi)醫(yī)護人員對突發(fā)事件、緊急事件的處理能力，最大限度地減少患者傷亡，故在新生兒重度窒息的搶救及護理中實施，對提高新生兒的搶救成功率意義重大[5]。因此，本研究主要討論預(yù)案管理應(yīng)用于新生兒重度窒息搶救和臨床護理中的效果。

資料與方法

1.一般資料。選擇2017年1月至2018年4月我院72例發(fā)生重度窒息的新生兒，2017年1月至8月未實施預(yù)案管理時收治的35例患兒作為對照組，其中男19例，女16例；胎齡30～42周，平均胎齡33.5±2.2周；出生時體重1750～4100g，平均出生體重3165.6±167.8g。另將2017年9月至2018年4月實施預(yù)案管理后收治的37例患兒作為觀察組，其中男20例，女17例；胎齡32～40周，平均胎齡33.2±2.3周；出生時體重1775～4120g，平均出生體重3178.2±171.5g。經(jīng)分析，兩組患兒性別、胎齡、出生體重等一般資料比較，差異無統(tǒng)計學(xué)意義(p＞0.05)，具有可比性。……