目的分析南京地区婴儿发育性髋关节异常检出率的结果,对不同分度的发育性髋关节异常进行早期筛查,以便及早干预,并采取相应对策。方法应用黑白B超检查儿童发育性髋关节异常,结果用SPSS 16.0软件进行统计学分析。结果通过对南京地区3617例门诊儿童体检人员进行髋关节超声波检查发现,发育性髋关节异常的检出率为5.11%,髋关节不稳定检出率为4.40%,髋关节发育不良检出率为0.39%,髋关节半脱位检出率为0.28%,髋关节脱位检出率为0.03%。结论对不同分度的发育性髋关节异常进行早期干预,能改善预后。B超在早期筛查婴儿发育性髋关节异常中起到尤为重要的作用,为早期干预起到铺垫作用。
医务人员面临着两难的局面,一则是必须为病人提供高质量的服务,二则必须寻找方法减少病人支出和缩短住院天数.护理人员协同其他健康照顾专家通过运用临床路径能够保证病人及其家属接受完整的照顾,提高医疗护理质量,通过既定入院天数削减医疗费用是使得临床路径被广泛采用的两个特质.
Objective To study the effect of 25% oral glucose to alleviate neonatal pain caused by heel blood collection,and to provide the base for neonatal pain management. Method 25 newborns with heel blood collection for more than twice blood glucose testing were selected in this self controlled study..They were assigned to give 1 ml 25% glucose solution either at the first or second puncture time.Pain was evaluated based on NFCS,DAN,duration of crying and heart rate.Result NFCS scores during puncture and squeeze were remarkably reduced in the treatment group compared with the control group(P<0.01).The three dimension-DAN scores including facial expressions,limb movements,vocal expressions witnessed was significant difference in the two groups(P<0.01).In the recovery period following completion of the blood collection,the duration of crying is significantly less than that of the treatment group(P<0.05).Physical response of heart rate was significantly higher than that of the treatment group.The difference of heart rate at the time point of 0 sec,15 sec was significant difference compared with in the control group(P<0.05).Conclusion Oral 1ml 25% glucose was effective in reducing behavioral responses to pain,reducing duration of crying,but can not prevent the increase of heart rate.Combination of both behavioral and physical assessment tools in evaluation neonatal pain would be more rationale approach.
[目的]探讨嗅觉安抚措施对足跟采血所致新生儿疼痛的影响,为新生儿疼痛管理提供参考依据。[方法]选取22例需足跟采血测血糖两次以上的新生儿,进行自身对照,第1次足跟采血为常规组,全过程不给予任何干预措施;第2次足跟采血为干预组,采血前2h给予香兰素混合溶液熟悉气味。采用新生儿面部编码系统(NFCS)、新生儿急性疼痛行为评分量表(DAN)、哭泣时长、心率变化及回复基线心率所需时间作为疼痛评估指标。[结果]干预组新生儿NFCS评分在针刺、挤捏时、挤后1min和挤后2min分值明显低于常规组(均P<0.01);干预组新生儿DAN评分在面部表情、肢体运动、声音表现3方面分值均明显低于常规组(均P<0.01);干预组回复阶段哭泣时长显著短于常规组(P<0.01);干预组心率均值低于常规组,在足跟采血针刺后30s、45s、60s、75s、90s、105s、150s心率差异有统计学意义(P<0.05);干预组回复基线心率所需时间显著短于常规组(P<0.05)。[结论]足跟采血时给予嗅觉安抚措施可以显著缩短新生儿哭闹、疼痛评分分数、心率和回复基线心率所需时间。
