1例极早早产儿并发呼吸窘迫综合征的呼吸支持护理
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摘要
极早早产儿是指胎龄22~25周,出生体质量400~750 g的早产儿。极早早产儿极易发生呼吸窘迫综合征(RDS),多由于缺乏肺泡表面活性物质(PS)所引起,临床表现为出生后不久即出现进行性的呼吸困难和呼吸衰竭,是早产儿死亡原因的重要原因之一。本研究回顾性分析1例极早早产儿并发RDS的临床资料。患儿应用肺表面活性物质(PS)联合持续气道正压通气呼吸支持,护理措施包括PS的给药护理、体温管理、病情观察、气道管理及持续气道正压通气呼吸支持护理等,经过积极治疗和精心护理,患儿病情好转出院。回顾性分析1例极早早产儿并发呼吸窘迫综合征的临床资料。患儿应用肺表面活性物质(PS)联合持续气道正压通气呼吸支持,护理措施包括PS的给药护理、体温管理、病情观察、气道管理及持续气道正压通气呼吸支持护理等,经过积极治疗和精心护理,患儿病情好转出院。
The very preterm infant refers to the infant whose gestational age between 22 and25 weeks and birth weight between 400 ~ 750 g. The Very preterm infant is highly vulnerable to respiratory distress syndrome( RDS) induced by insufficient secretion of pulmonary surfactant( PS),which may cause progressive dyspnea,respiratory failure even death. This study retrospectively analyzed the clinical data of a very preterm infant with RDS. The infant was treated with pulmonary surfactant and continuous positive airway pressure( CPAP). The nursing interventions mainly included medication care on pulmonary surfactant,body temperature management,disease symptoms monitoring,airway management,and CPAP-related respiratory support. The infant was discharged from hospital successfully after receiving positive treatment and intensive care. This study retrospectively analyzed the clinical data of a very preterm infant with respiratory distress syndrome( RDS). The infant was treated with pulmonary surfactant and continuous positive airway pressure( CPAP). The nursing interventions mainly included medication care on pulmonary surfactant,body temperature management,disease symptoms monitoring,airway management,and CPAP-related respiratory support. The infant was discharged from hospital successfully after receiving positive treatment and intensive care.
The very preterm infant refers to the infant whose gestational age between 22 and25 weeks and birth weight between 400 ~ 750 g. The Very preterm infant is highly vulnerable to respiratory distress syndrome( RDS) induced by insufficient secretion of pulmonary surfactant( PS),which may cause progressive dyspnea,respiratory failure even death. This study retrospectively analyzed the clinical data of a very preterm infant with RDS. The infant was treated with pulmonary surfactant and continuous positive airway pressure( CPAP). The nursing interventions mainly included medication care on pulmonary surfactant,body temperature management,disease symptoms monitoring,airway management,and CPAP-related respiratory support. The infant was discharged from hospital successfully after receiving positive treatment and intensive care. This study retrospectively analyzed the clinical data of a very preterm infant with respiratory distress syndrome( RDS). The infant was treated with pulmonary surfactant and continuous positive airway pressure( CPAP). The nursing interventions mainly included medication care on pulmonary surfactant,body temperature management,disease symptoms monitoring,airway management,and CPAP-related respiratory support. The infant was discharged from hospital successfully after receiving positive treatment and intensive care.
引文
[1]SANDRI F,PLAVKA R,ANCORA G,et al.Prophylactic or Early Selective Surfactant Combined With n CPAP in Very Preterm Infants[J].Pediatrics,2010,125(6):1402-1409.
[2]CDC.National Vital Statistics Reports[EB/OL].(2010-08-09)[2011-06-10].https://www.cdc.gov/nchs/products/nvsr.htm.
[3]胡晓静,张玉侠,陈超,等.2例超低体质量极早早产儿的早期生命支持[J].护理学杂志,2011,26(21):65-67.
[4]中华医学会儿科分学会新生儿学组.早产儿管理指南[J].中华儿科杂志,2006,3(44):188-191.
[5]SWEET D,CARNIELLI V,GREISEN G,et al.European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update[J].Neonatology,2014,97(4):402-417.
[6]刘敬,孔祥永,李秋平,等."欧洲早产儿呼吸窘迫综合征管理指南(2010年)"及解读[J].中华围产医学杂志,2011,14(3):156-160.
[7]余加林.新生儿呼吸窘迫综合征的防治[J].中国实用儿科杂志,2003,18(11):643-646.
[8]晏玲.应用密闭式吸痰管注入固尔苏防治新生儿呼吸窘迫综合征的临床护理研究[J].检验医学与临床,2012,9(24):3048-3049.
[9]蔡丽娅,王惠良,卢赛丹,等.改进肺泡表面活性物质给药方式对呼吸窘迫综合征早产儿的影响[J].中华护理杂志,2011,46(7):707-708.
[10]梁存容.早产儿呼吸暂停的预防及护理[J].护理实践与研究,2009,6(12):46-47.
[11]罗春绸,曾丽丽,郑月惠,等.不同新生儿暖箱温湿度对早产儿体重的影响[J].齐鲁护理杂志,2013,19(17):47-49.
[12]杨春凤,吴芸,周应玲.体位干预对早产儿呼吸、循环及胃肠功能的影响[J].护理学杂志,2008,23(11):36-38.
[13]张小珍.肺表面活性物质在儿科疾病中的临床应用[J].右江民族医学院学报,2006,28(2):306-308.
[14]张静.循证护理在机械通气新生儿气管内吸痰中的应用[J].现代中西医结合杂志,2009,18(8):915-916.
[15]AMERICAN ASSOCIATION FOR RESPIRATORY CARE.AARC Clinical Practice Guidelines.Endotracheal suctioning of mechanically ventilated patients w ith artificial airw ays 2010[J].Respir Care,2010,55(6):758-764.
[16]MORROW B M,ARGENT A C.A comprehensive review of pediatric endotracheal suctioning:Effects,indications,and clinical practice[J].Pediatr Crit Care M ed,2008,9(5):465-477.
[17]李秋平,刘敬,孔祥永,等.欧洲早产儿呼吸窘迫综合征管理指南(2013)介绍及解读[J].中华实用儿科临床杂志,2013,28(24):1915-1920.
[2]CDC.National Vital Statistics Reports[EB/OL].(2010-08-09)[2011-06-10].https://www.cdc.gov/nchs/products/nvsr.htm.
[3]胡晓静,张玉侠,陈超,等.2例超低体质量极早早产儿的早期生命支持[J].护理学杂志,2011,26(21):65-67.
[4]中华医学会儿科分学会新生儿学组.早产儿管理指南[J].中华儿科杂志,2006,3(44):188-191.
[5]SWEET D,CARNIELLI V,GREISEN G,et al.European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update[J].Neonatology,2014,97(4):402-417.
[6]刘敬,孔祥永,李秋平,等."欧洲早产儿呼吸窘迫综合征管理指南(2010年)"及解读[J].中华围产医学杂志,2011,14(3):156-160.
[7]余加林.新生儿呼吸窘迫综合征的防治[J].中国实用儿科杂志,2003,18(11):643-646.
[8]晏玲.应用密闭式吸痰管注入固尔苏防治新生儿呼吸窘迫综合征的临床护理研究[J].检验医学与临床,2012,9(24):3048-3049.
[9]蔡丽娅,王惠良,卢赛丹,等.改进肺泡表面活性物质给药方式对呼吸窘迫综合征早产儿的影响[J].中华护理杂志,2011,46(7):707-708.
[10]梁存容.早产儿呼吸暂停的预防及护理[J].护理实践与研究,2009,6(12):46-47.
[11]罗春绸,曾丽丽,郑月惠,等.不同新生儿暖箱温湿度对早产儿体重的影响[J].齐鲁护理杂志,2013,19(17):47-49.
[12]杨春凤,吴芸,周应玲.体位干预对早产儿呼吸、循环及胃肠功能的影响[J].护理学杂志,2008,23(11):36-38.
[13]张小珍.肺表面活性物质在儿科疾病中的临床应用[J].右江民族医学院学报,2006,28(2):306-308.
[14]张静.循证护理在机械通气新生儿气管内吸痰中的应用[J].现代中西医结合杂志,2009,18(8):915-916.
[15]AMERICAN ASSOCIATION FOR RESPIRATORY CARE.AARC Clinical Practice Guidelines.Endotracheal suctioning of mechanically ventilated patients w ith artificial airw ays 2010[J].Respir Care,2010,55(6):758-764.
[16]MORROW B M,ARGENT A C.A comprehensive review of pediatric endotracheal suctioning:Effects,indications,and clinical practice[J].Pediatr Crit Care M ed,2008,9(5):465-477.
[17]李秋平,刘敬,孔祥永,等.欧洲早产儿呼吸窘迫综合征管理指南(2013)介绍及解读[J].中华实用儿科临床杂志,2013,28(24):1915-1920.