目的:观察并比较非营养性吸吮(NNS)、母亲声音(MV)、母亲声音联合非营养性吸吮(MV＋NNS)在缓解新生儿足跟采血时疼痛的效果。方法:选取2017年12月至2018年10月在青岛大学附属医院新生儿科住院的患儿120例，按随机原则分为空白对照组和干预组(包括NNS组、MV组和MV＋NNS组)各30例。对照组行常规护理措施，干预组在常规护理措施基础上给予干预，干预时间从足跟采血前5 min开始至采血结束后10 min。应用新生儿疼痛评估量表(NIPS)对四组新生儿分别进行评分，判断新生儿疼痛程度；观察新生儿心率、血氧饱和度的波动情况。结果:患儿足跟采血期间均出现心率增快、血氧饱和度降低的情况，干预组与空白对照组之间心率、血氧饱和度差异有统计学意义( P<0.05)，其中MV＋NNS组心率、血氧饱和度变化幅度最小，较其他三组比较，差异有统计学意义( P<0.05)；干预组啼哭人数及NIPS评分均少于空白对照组，差异有统计学意义( P<0.05)。MV＋NNS组在啼哭人数及NIPS评分上与其他三组比较，差异有统计学意义( P<0.05)。 结论:母亲声音联合非营养性吸吮可明显缓解新生儿的疼痛反应，大大降低新生儿的疼痛程度，无不良反应的发生，在新生儿的临床护理工作中具有十分重要的意义。

目的 探讨常规综合护理治疗联合物理干预对早产儿喂养质量的改善效果.方法 2018年12月至2019年7月,在青岛大学附属医院新生儿重症监护病房收治的早产儿中,纳入102例为研究对象,随机分为干预组52例和对照组50例.所有早产儿均留置胃管,每3小时重力管饲喂养1次.对照组常规综合护理、口腔护理;干预组增加物理干预措施,包括初乳口腔护理、口腔运动干预以及腹部按摩,共10 d.记录并分析两组干预后的喂养质量及喂养进程的变化情况.采用t检验和χ2检验进行统计学分析.结果 ①基本情况:干预组与对照组在胎龄、性别、出生体重、呼吸机辅助通气、母亲疾病、产前激素使用及生后1周排便次数等方面比较,差异均无统计学意义(P>0.05).②喂养质量:研究第1天,干预组与对照组患儿的腹围、呕吐频率、胃潴留量、体重比较,差异均无统计学意义(P>0.05);研究第10天,干预组患儿的体重、奶量均高于对照组[体重(1775±401)与(1563±336)g,奶量(91±43)与(73±46)ml/(kg·d),P<0.05],腹围、胃潴留量均低于对照组[腹围(23.7±2.1)与(24.6±2.2)cm,胃潴留量(2.8±2.2)与(4.9±1.9)ml,P<0.05].③喂养进程:干预组早产儿的开始经口喂养时间及管饲时间均低于对照组[开始经口喂养时间[(11.5±10.0)与(18.5±15.0)d,管饲时间(18±15)与(26±17)d,P<0.05].结论 对早产儿早期进行初乳免疫疗法、口腔运动干预及腹部按摩等物理干预措施,可改善早产儿喂养质量,缩短管饲时间,促进喂养进程,从而改善预后.

Objective To explore the effects of individualized feeding, intervention training, breast feeding education and kangaroo nursing on the improvement of feeding time, transition time and average hospital stay of prema-ture infants. Methods A total of 586 hospitalized premature infants were selected as the control group who were admit-ted to the department before the adoption of tube feeding and feeding improvement measures for premature infants from July 2016 to December 2016. A total of 632 hospitalized premature infants admitted to this department after the imple-mentation of improvement measures were selected as the observation group from January 2017 to July 2017. The control group was fed with traditional tube feeding method, namely gastric tube injector injection method. However, the obser-vation group adopted the recommendations of extremely low birth-weight infant feeding proposed by McMaster university of Canada and formulated the improved measures of tube feeding and feeding of premature infants based on the long-term clinical experience of the department. The duration of tube feeding, transition time, average length of stay and nursing satisfaction of family members were compared between the two groups. Results Tube feeding time, transition time and average length of stay in the control group were compared with the observation group, and the differences were statisti-cally significant ( P<0. 05) . The nursing satisfaction of the observation group was compared with that of the control group, and the difference was statistically significant ( P<0. 05 ) . Conclusions The improvement measures of tube feeding and feeding of premature infants have a significant effect on improving tube feeding and feeding of premature in-fants, which can not only shorten the transition time and average length of hospitalization of tube feeding and feeding of premature infants, but also improve the quality of nursing and nursing satisfaction. It is worth further popularizing and applying in clinic to improve nursing satisfaction.

Objective To investigate the effect of comprehensive feeding intervention on feeding quality and weight gain of premature infants. Methods Eighty-one premature infants admitted to the neonatal intensive care unit (NICU) of our hospital from September 2016 to December 2018 were selected and randomly divided into the intervention group (n=41) and the control group (n=40). Infants in the control group received routine nursing and infants in the intervention group were given comprehensive feeding intervention on the basis of routine nursing includingimproved Y type gastric tube, gravity tube feeding in prone position, oral movement intervention, colostrum oral immunotherapy and kangaroo nursing. The changes of feeding process were compared between the two groups and the occurrence of feeding intolerance in the two groups was observed. Results The duration of tube feeding and hospital stay were lower in the intervention group than in the control group (P<0.05). No statistically significant difference was found in birth weight and body weight at discharge between the two groups (P>0.05), but the average daily weight growth rate [g/ (kg·d) ] after 1 week and the milk volume [ml/ (kg·d) ] at 1 week were higher in the intervention group than in the control group (P<0.05). The incidence of gastric retention, abdominal distension and vomiting in the intervention group was lower than that in the control group, but only the difference in the incidence of gastric retention (24.4％ vs 47.5％) was statistically significant (P<0.05). The incidence of feeding intolerance was significantly lower in the intervention group than in the control group (24.39％ vs 47.50％, P<0.05). Conclusion Comprehensive nursing intervention can shorten the tube feeding time of premature infants, promote the weight growth of premature infants, improve the feeding quality, reduce the incidence of feeding intolerance, and reduce the hospital stay of premature infants, so as to reduce the hospitalization cost, improve the quality of life of premature infants, and increase the satisfaction of parents.

[目的]总结婴幼儿静脉输注夫西地酸钠的安全管理。[方法]在婴幼儿静脉输注夫西地酸钠的过程中通过合理选择血管、更换输液器、制作提示标志、加强巡视、发现外渗及时处理等加强安全管理。[结果]降低了血管炎的发生率,无一例患儿发生组织坏死。[结论]护士加强静脉输注夫西地酸钠的婴幼儿安全管理,可减少医源性损害的发生。

<正>随着围产医学技术的迅速发展,越来越多的早产儿的生命得到挽救。他们生后所面临的主要问题之一是营养。其中肠内营养(Enteral Nutrition,EN)支持在早产儿存活和正常的生长发育中起着重要作用,肠内营养的管理对于安全有效地完成肠内营养支持至关重要。如何护理也是儿科护士不断探索的问题。笔者查阅了大量的文献资料,现将近年来早产儿肠内营养支持的护理进展综述如下。

新生儿呼吸窘迫综合征(NRDS)是由于缺乏肺表面活性物质(PS)所引起,是发达国家和发展中国家儿科围生期患病率和病死率均较高的疾病。近30年来,PS的替代治疗已大大降低了NRDS所致呼吸衰竭的严重程度,PS已成为NRDS治疗的主要手段。因此为了减少其发病率和死亡率,其防治及治疗期间的管理就显得尤为重要,本文对PS防治NRDS的研究及管理进展作了详细综述。

Objective To study the prevention of adverse reactions caused by L-asparaginase in children with malignant tumors.Methods Fifty-five children with malignant tumors were involved in this study.Blood routine,clotting time,blood and urine glucose and amylase,ECG,renal and liver functions were detected with normal results before treatment.L-asparaginase of 6 000-10 000 U/(m2·day) in 100 mL NS,intravenous drip,every other day,for 6-10 doses.The side effects were closely observed.Results In 128 case/times treatments,the side effects showed as follows: allergic response(four patients),gastrointestinal reaction(11),hypoproteinemia(20) and abnormal hemagglutinin(37).No acute pancreatitis or diabetes was noted.No patients died of side effects because of effective nursing and in-time management.Conclusion To ensure smooth chemotherapy,an early and active intervention should be taken to avoid any adverse reactions caused by L-asparaginase.

儿童非肿瘤性发热并中性粒细胞减少是临床上比较常见的症状.2004年1月～2005年12月,我科共收治该病病儿80例,经过相应的治疗及护理均获得满意效果.现将护理体会报告如下.

肠道病毒(EV)属微小核糖核酸病毒科,是引起中枢神经系统(CNS)感染的重要病原[1-4].S-100b蛋白是神经组织蛋白的一种,以高浓度特异性地存在于CNS和周围神经系统的神经胶质细胞及某些神经元细胞中.

2002年2月～2003年2月,我科采用粒细胞集落刺激因子(G-CSF)液漱口治疗化疗所致口腔粘膜炎30例,取得了满意疗效.现报告如下.

原发性血小板减少性紫癜(ITP)是一种小儿常见的自身免疫性疾病,其独特的临床表现和病情变化的无规律性,给临床治疗和护理带来难以预测的困难.1999年1月～2001年6月,我科共收治急性型ITP病儿58例,由于诊断及时,治疗规范,加之我们精心护理,58例病儿均治愈出院,随访半年,无1例复发.现将护理体会报告如下.

儿童急性白血病并发阑尾炎后,病情凶险,处理困难,可危及生命,须慎重对待.我科自2000年2月至2002年7月,对6例白血病患儿化疗过程中并发阑尾炎的,进行了密切的临床观察及精心护理,取得了满意治疗效果,现报告如下.