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目的分析体位更换在新生儿高胆红素血症光疗治疗中的应用效果。方法选取2015年6月-2016年6月该院收治的200例高胆红素血症新生儿作为研究对象,随机分为观察组(90例)和对照组(110例),观察组采取俯、侧、仰卧位交替,对照组采取仰卧位。观察比较两组患儿光疗前后的心率、血氧饱和度,新生儿经皮胆红素值、身体状态,家长依从性及不良反应情况。结果光疗前两组患儿的心率及血氧饱和度差异无统计学意义(P>0.05),光疗2~10 h后患儿心率逐渐降低并趋于平稳,血氧饱和度逐渐升高且平稳;治疗后3 d的经皮胆红素水平值低于治疗后1 d,且观察组低于对照组;观察组患儿哭闹、拒乳、异常体温等身体状态所占比例低于对照组,不良反应总发生率低于对照组(14.44%vs.51.82%),安睡时间≥10 h的比例高于对照组(86.67%vs.71.82%);家长的依从性高于对照组(100%vs.93.64%),两组比较差异有统计学意义(P<0.05)。结论新生儿高胆红素血症光疗中采取俯、侧、仰卧位交替,可提高新生儿舒适度,减少哭闹及不良事件发生率,其疗效显著优于单一的仰卧位治疗。
Objective To analyze the effect of body position replacement in phototherapy of neonatal hyperbilirubinemia. Methods A total of 200 neonates with hyperbilirubinaemia admitted to our hospital from June 2015 to June 2016 were randomly divided into observation group (n = 90) and control group (n = 110) , Side, supine position alternating, the control group supine position. The heart rate, oxygen saturation, transcutaneous bilirubin, neonatal transcutaneous bilirubin, physical status, parental compliance and adverse reactions were compared between the two groups before and after phototherapy. Results There was no significant difference in heart rate and oxygen saturation between the two groups before phototherapy (P> 0.05). After 2 to 10 hours phototherapy, the heart rate gradually decreased and stabilized in the children, and the oxygen saturation gradually increased and stabilized ; The level of transcutaneous bilirubin at 3 days after treatment was lower than that at 1 day after treatment, and the observation group was lower than that of the control group; the proportion of physical state such as crying, refusing milk and abnormal body temperature in the observation group was lower than that of the control group (14.44% vs.51.82%), and the rate of sleeping time≥10 h was higher than that of the control group (86.67% vs.71.82%). The compliance rate of parents was higher than that of the control group (100% vs.93.64%), the difference between the two groups was statistically significant (P <0.05). Conclusions The treatment of neonatal hyperbilirubinemia phototherapy in the prone, lateral and supine position can improve the comfort of neonate, reduce the incidence of crying and adverse events, and its curative effect is significantly better than that of single supine position.