撫觸護(hù)理對(duì)高膽紅素血癥新生兒睡眠質(zhì)量及心理運(yùn)動(dòng)功能的影響分析

趙小榮 陳利玲 束君艷

【摘要】 目的：分析撫觸護(hù)理對(duì)高膽紅素血癥新生兒睡眠質(zhì)量及心理運(yùn)動(dòng)功能的影響。方法：將2018年3-10月在筆者所在醫(yī)院醫(yī)院產(chǎn)科出生的70例高膽紅素血癥新生兒，根據(jù)護(hù)理方法不同分為撫觸組（n=40）、對(duì)照組（n=30），均給予常規(guī)對(duì)癥支持治療配合基礎(chǔ)護(hù)理，前者另給予撫觸護(hù)理，評(píng)價(jià)護(hù)理效果。結(jié)果：撫觸組治療依從性優(yōu)于對(duì)照組（P<0.05）。兩組干預(yù)第1天膽紅素、睡眠時(shí)間比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），第3、6天均顯著改善，但撫觸組第3、6天膽紅素低于對(duì)照組，每日睡眠時(shí)間長(zhǎng)于對(duì)照組（P<0.05）。兩組干預(yù)前Gesell嬰兒發(fā)育診斷量表評(píng)估結(jié)果差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），干預(yù)后兩組心理適應(yīng)性、大運(yùn)動(dòng)、精細(xì)運(yùn)動(dòng)、語(yǔ)言、社會(huì)行為評(píng)分均明顯升高，但撫觸組顯著高于對(duì)照組（P<0.05）。結(jié)論：撫觸護(hù)理可提高高膽紅素血癥新生兒治療依從性，有效降低膽紅素水平，并改善睡眠質(zhì)量及心理運(yùn)動(dòng)功能。

【關(guān)鍵詞】 撫觸護(hù)理; 高膽紅素血癥; 新生兒; 睡眠質(zhì)量; 心理運(yùn)動(dòng)功能

doi：10.14033/j.cnki.cfmr.2019.18.032 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2019）18-00-03

【Abstract】 Objective：To analyze the effect of touch nursing on sleep quality and psychomotor function of neonates with hyperbilirubinemia.Method：A total of 70 neonates with hyperbilirubinemia who were born in obstetrics department of the hospital from March to October 2018 were divided into the touch group （n=40） and the control group（n=30） according to different nursing methods.All of them were given routine symptomatic supportive treatment and basic nursing.The former was additionally given touch nursing.Nursing effect was evaluated.Result：The treatment compliance of the touch group was significantly better than that of the control group（P<0.05）.There was no significant difference in bilirubin or sleep time between the two groups at the 1st day of intervention（P>0.05），but they were significantly improved at the 3rd and 6th day.Bilirubin in the touch group was significantly lower than that in the control group at the 3rd and 6th day，and the sleep time was significantly longer than the control group（P<0.05）.There was no significant difference in the evaluation results of Gesell infant development diagnosis scale between the two groups before intervention（P>0.05）.The psychological adaptability，gross motor，fine motor，language and social behavior scores were significantly increased after intervention，and the scores of touch group were significantly higher than those of the control group（P<0.05）.Conclusion：Touch nursing can improve the treatment compliance of neonates with hyperbilirubinemia，effectively decrease the bilirubin level，and improve sleep quality and psychomotor function.

【Key words】 Touch nursing; Hyperbilirubinemia; Neonate; Sleep quality; Psychomotor function

First-authors address：Xiantao First Peoples Hospital，Xiantao 433000，China

新生兒疾病以高膽紅素血癥最為多見(jiàn)，由血清膽紅素異常升高所致，發(fā)病機(jī)制尚未完全明確，但高濃度的未結(jié)合膽紅素進(jìn)入血腦屏障對(duì)新生兒生長(zhǎng)發(fā)育的不利影響已得到證實(shí)，尤其是膽紅素腦損傷，嚴(yán)重時(shí)可遺留新生兒神經(jīng)系統(tǒng)后遺癥，如聽視力障礙、腦性癱瘓、椎體外系運(yùn)動(dòng)障礙及神經(jīng)行為異常等[1]。藍(lán)光照射簡(jiǎn)單、安全，是高膽紅素血癥的常用療法，但實(shí)際臨床中治療效果常受到新生兒的不適應(yīng)、哭鬧、睡眠質(zhì)量等影響[2]。基于此，筆者所在醫(yī)院參考現(xiàn)代臨床經(jīng)驗(yàn)，對(duì)新生兒實(shí)施撫觸護(hù)理，發(fā)現(xiàn)效果滿意，現(xiàn)報(bào)道如下。