标题：临床护理路径结合预见性护理在新生儿黄疸蓝光治疗期间的应用

      作者：张小艳 1，程亚利 2，王万瑞 1    1.延安市中医医院儿科，陕西 延安 716000；2.延安市人民医院新生儿科，陕西 延安 716000

      卷次： 2023年34卷24期

      【摘要】 目的 探讨临床护理路径结合预见性护理在新生儿黄疸蓝光治疗期间的应用效果。方法 选择2019年10月至2022年10月于延安市中医医院行新生儿黄疸蓝光治疗的140例新生儿作为研究对象，采用随机数表法将新生儿分为观察组和对照组，每组 70例。对照组新生儿给予临床护理路径干预，观察组新生儿在此基础上结合预见性护理，均连续护理至出院。护理结束出院前，比较两组新生儿的护理效果及护理前后的黄疸指数、胆红素变化，并比较两组新生儿家属对护理的满意度及不良反应发生情况。结果 观察组新生儿的治疗总有效率为94.29%，明显高于对照组的 80.00%，差异有统计学意义(P<0.05)；护理前，两组新生儿的黄疸指数、胆红素比较差异均无统计学意义(P>0.05)；护理结束出院前，两组新生儿的黄疸指数、胆红素均显著降低，且观察组新生儿分别为(3.98±0.51)%、(187.35±10.47) ?mol/L，明显低于对照组的(5.28±0.47)%、(201.92±14.28) ?mol/L，差异均有统计学意义(P<0.05)；观察组新生儿家属对护理人员的服务态度、住院环境、病情解释、操作水平满意度评分分别为(86.29±4.35)分、(89.16±3.19)分、(88.13±2.95)分、(87.22±4.21)分，明显高于对照组的(83.21±3.98)分、(81.29±3.01)分、(82.18±3.01)分、(80.27±3.92)分，差异均有统计学意义(P<0.05)；观察组新生儿的不良反应发生率为5.71%，明显低于对照组的 17.14%，差异有统计学意义(P<0.05)。结论 临床护理路径结合预见性护理可减轻接受黄疸蓝光治疗的新生儿黄疸指数，降低其胆红素，提高家属对护理的满意度，减少不良反应发生率，临床应用效果较好。
      【关键词】 新生儿黄疸；临床护理路径；预见性护理；黄疸指数；胆红素；不良反应
      【中图分类号】 R473.72 【文献标识码】 A 【文章编号】 1003—6350（2023）24—3645—04

Application of clinical nursing pathway combined with predictive nursing during blue light therapy for neonataljaundice.
ZHANG Xiao-yan 1, CHENG Ya-li 2, WANG Wan-rui 1. 1.Department of Pediatrics, Yan'an Traditional ChineseMedicine Hospital, Yan'an 716000, Shaanxi, CHINA; 2. Department of Neonatology, Yan'an People's Hospital, Yan'an716000, Shaanxi, CHINA
【Abstract】 Objective To explore the application effect of clinical nursing pathway combined with predictivenursing during blue light therapy for neonatal jaundice. Methods A total of 140 newborns who underwent blue lighttherapy for neonatal jaundice at Yan'an Traditional Chinese Medicine Hospital from October 2019 to October 2022were selected as the research subjects. The newborns were randomly divided into an observation group and a controlgroup using a random number table method, with 70 cases in each group. The newborns in the control group receivedclinical nursing pathway intervention until discharge, while those in the observation group received clinical nursingpathway combined with predictive nursing until discharge. At the end of nursing and before discharge, the nursing ef-fectiveness were compared between the two groups, as well as the changes in jaundice index and bilirubin before andafter nursing care, family members' satisfaction with nursing, and incidence of adverse reactions. Results The totaleffective rate of treatment in the observation group was 94.29%, which was significantly higher than 80.00% in thecontrol group (P<0.05). Before nursing, there was no statistically significant difference in jaundice index and bilirubinbetween the two groups (P>0.05); at the end of nursing and before discharge, the jaundice index and bilirubin of the twogroups were significantly reduced, and the levels in the observation group were (3.98±0.51)% and (187.35±10.47) ?mol/L,respectively, significantly lower than (5.28±0.47)% and (201.92±14.28) ?mol/L in the control group (P<0.05). Thescores for family members' satisfaction with nursing in the observation group, including service attitude, hospitaliza-tion environment, disease explanation, and operational level, were (86.29±4.35) points, (89.16±3.19) points, (88.13±2.95) points, and (87.22±4.21) points, respectively, which were significantly higher than (83.21±3.98) points, (81.29±3.01) points, (82.18±3.01) points, and (80.27±3.92) points in the control group (P<0.05). The incidence of adverse reac-tions in the observation group was 5.71%, which was significantly lower than 17.14% in the control group (P<0.05).Conclusion The combination of clinical nursing pathway and predictive nursing can reduce the jaundice index of thenewborns treated with blue light, reduce bilirubin level, improve family members’satisfaction with nursing, reduce theincidence of adverse reactions, and achieve good clinical application results.
      【Key words】 Neonatal jaundice; Clinical nursing pathway; Predictive nursing; Jaundice index; Bilirubin; Ad-verse reactions