循证证据下预警、抚触护理联...儿智力发育和神经功能的影响_张娜.pdf

171临床研究 2023 年 03 月第 31 卷第 03 期作者简介：张娜，女，主管护师，本科。研究方向：早产儿护理方面。4李清娟,邱圣红,魏球娣,等.整体护理在宫颈癌放疗患者中的应用效果观察J.按摩与康复医学,2018,9(3):72-74.5张立新,张立华,倪东华.正念减压干预对宫颈癌放化疗患者心理应激、癌因性疲乏及睡眠质量的影响J.国际护理学杂志,2022,41(9):1673-1676.6中华人民共和国国家卫生健康委员会.宫颈癌诊疗规范(2018年版)J.肿瘤综合治疗电子杂志,2020,6(3):33-43.7王征宇,迟玉芬.焦虑自评量表(SAS)J.上海精神医学,1984(2):73-74.8王征宇,迟玉芬.抑郁自评量表(SDS)J.上海精神医学,1984(2):71-72.9路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析J.重庆医学,2014,43(3):260-263.10周琳,孟琼,杨铮,等.基于FACT-Cx(V4.0)量表的宫颈癌患者生命质量影响因素分析J.中华疾病控制杂志,2017,21(9):926-929,938.11彭定珊,沈莹莹.早期心理护理对宫颈癌患者治疗依从性及生活质量的影响分析J.中国实用医药,2019,14(11):167-169.12罗改凤,王琳,刘淑娟.正念减压干预对宫颈癌放化疗患者自我感受负担、疼痛相关指标和炎性因子的影响J.癌症进展,2021,19(10):1066-1070.13张彩虹,郝聪,张文娜.整体干预模式在宫颈癌伴梅毒护理中的应用效果J.临床医学研究与实践,2018,3(36):191-193.14许恩钰,王瑞婷.责任制整体护理对年轻Ia期宫颈癌患者宫颈锥切术后生活质量的影响J.肿瘤基础与临床,2020,33(6):541-543.15张宏,杨凌艳,童茜,等.心理护理干预影响宫颈癌术后患者生存质量及心理状态的meta分析J.中国计划生育和妇产科,2018,10(8):8-14.16夏静蕊,韩雪梅,杨燕君.责任制优质护理全程追踪模式在宫颈癌化疗癌性疲乏与睡眠质量中的价值分析J.系统医学,2017,2(7):137-139.17曾志芳.探讨疼痛护理联合心理护理对宫颈癌患者围手术期负性情绪及睡眠质量的影响J.中国保健营养,2019,29(4):211-212.18安冬,魏清风,龚湖萍,等.正念减压疗法对宫颈癌同步放化疗患者自我感受负担及症状群的影响J.广东医学,2018,39(21):3288-3291.临床护理循证证据下预警、抚触护理联合亚低温干预对 HIE 患儿智力发育和神经功能的影响张娜(周口市中心医院 新生儿重症监护室，河南 周口 466000)摘要：目的 探讨循证证据下预警、抚触护理联合亚低温干预对新生儿缺氧缺血性脑病(HIE)患儿智力发育和神经功能的影响。方法 选取 2020 年 1 月至 2021 年 1 月周口市中心医院收入新生儿缺氧缺血性脑病(HIE)患儿 78 例，按照随机数字表法分为观察组与对照组各 39 例，其中观察组给予循证证据下预警、抚触护理联合亚低温干预，对照组给予常规护理+亚低温干预，两组患儿均干预 6 个月，干预结束后，比较两组患儿干预前后智力发育情况 智力发育指数(MDI)、运动功能发育情况 运动发育指数(PDI)、神经功能发育情况 新生儿行为神经测定(NBNA)量表 及生长发育指标(身高、体质量、每日摄入奶量)变化，观察两组患儿干预期间不良后遗症发生情况差异，并比较两组患儿干预后症状改善时间差异。结果 两组患儿干预后 MDI、PDI 评分均高于本组干预前，且观察组高于对照组，差异有统计学意义(P 0.05)。两组患儿干预后原始反射、一般反射、被动肌张力、主动肌张力、行为能力各项 NBNA评分均高于同组干预前，且观察组高于对照组，差异有统计学意义(P 0.05)。两组患儿干预后身高、体质量、每日摄入奶量等各项生长发育指标均优于同组干预前，且观察组优于对照组，差异有统计学意义(P 0.05)。两组患儿干预期间不良后遗症发生率比较，差异无统计学意义(P 0.05)。观察组患儿肌张力恢复、反射恢复、惊厥改善、意识恢复、吮吸恢复改善时间均短于对照组，差异有统计学意义(P 0.05)。结论 在 HIE 患儿中应用循证证据下预警、抚触护理联合亚低温干预可有效改善患儿生长发育，改善智力、运动及神经功能，加快症状改善及预后转归。关键词：循证证据；预警、抚触护理；亚低温干预；新生儿缺氧缺血性脑病中图分类号：R473.72文献标志码：B DOI：10.12385/j.issn.2096-1278(2023)03-0171-04Effect of early Warning,Touch Nursing combined with mild Hypothermia Intervention on Intelligence Development and neurological Function of HIE Children under evidence-based EvidenceZHANG Na(Newborn intensive-care unit,Zhoukou Central Hospital,Zhoukou Henan 466000,China)Abstract:Objective To explore the effect of early warning,touch nursing combined with mild hypothermia intervention on intellectual development and neurological function of neonates with hypoxic-ischemic encephalopathy(HIE)under evidence-based evidence.Methods A total of 78 neonates with HIE from January 2020 to January 2021 in Zhoukou Central Hospital were randomly divided into the observation group and the control group with 39 patients in each group according to the random number 172Clinical Research,Mar.2023,Vol.31 No.03table.The observation group was given evidence-based early warning,touch nursing and mild hypothermia intervention,and the control group was given routine nursing and mild hypothermia intervention.The two groups were both intervened for 6 months.After the intervention,intellectual development mental development index(MDI),motor function development psychomotor development index(PDI),neurological development neonatal behavioral neurological assessment(NBNA)scale and growth and development indicators(height,body mass index,daily milk intake)change before and after the intervention between the two groups were compared,the difference of adverse sequelae between the two groups was observed,and the time difference of symptom improvement was compared between the two groups after intervention.Results After intervention,the scores of MDI and PDI in the two groups were higher than those before intervention,and the observation group was higher than those in the control group,the difference was statistically significant(P 0.05).After intervention,the NBNA scores of primary refiex,general refiex,passive muscle tension,active muscle tension and behavioral ability of children in the two groups were higher than those in the same group before intervention,and the observation group was higher than those in the control group,the difference was statistically significant(P 0.05).After the intervention,the height,body mass index,daily intake of milk and other growth and development indicators of the two groups were better than those of the same group before the intervention,and the observation group was better than the control group,the difference was statistically significant(P 0.05).There was no significant difference in the incidence of adverse sequelae between the two groups during the intervention period(P 0.05).The improvement time of muscle tension recovery,refiex recovery,convulsion improvement,consciousness recovery and sucking recovery in the observation group was shorter than that in the control group,and the difference was statistically significant(P0.05).Conclusion Evidence-based early warning,touch nursing and mild hypothermia intervention can effectively improve the growth and development of children with HIE,improve intelligence