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目的探讨新生儿换血术中常见的护理问题及护理措施,为新生儿换血护理提供参考。方法回顾性分析2014年12月1日-2015年5月31日收治的110例行动静脉同步换血术的新生儿的临床资料,总结在新生儿外周同步动静脉换血术中常见的护理问题,并探讨相应的临床护理措施。结果 1换血前患儿总胆红素为194.7~918.0μmol/L,换血后总胆红素为125.7~335.9μmol/L;2次换血者6例。2动脉一次穿刺成功者101例,成功率91.82%。9例穿刺失败后给予第2次穿刺成功。3动脉放血不畅者8例,发生率为7.27%。4换血过程中烦躁者98例,给予安抚后安静者18例,使用药物镇静者80例。5所有患者儿均未发生感染、低体温、动脉排出端堵塞等并发症。结论新生儿换血过程中常见的护理问题包括动脉穿刺困难、动脉放血不畅、烦躁、感染、低体温以及动脉排出端堵塞,护士要熟练掌握动脉穿刺方法和技巧,换血过程中保持患儿安静,做好感染防护措施,防止低体温发生及动脉排出端堵塞;密切监测生命体征及血清胆红素的变化等,保证新生儿换血过程顺利完成。
Objective To explore the common nursing problems and nursing measures during the neonatal transplanting and provide a reference for the newborn blood transfusion. Methods The clinical data of 110 newborns who underwent IVFH from December 1, 2014 to May 31, 2015 were retrospectively analyzed. The common nursing problems in neonatal peripheral synchronous arteriovenous shunts were summarized. Explore the appropriate clinical care measures. Results 1 The total bilirubin before transfusion was 194.7 ~ 918.0μmol / L, the total bilirubin after transfusion was 125.7 ~ 335.9μmol / L, and the other 2 transfusions were 6 cases. 2 arterial puncture successful 101 cases, the success rate of 91.82%. The second puncture was successful in 9 cases of failed puncture. 3 poor arterial bleeding in 8 cases, the incidence was 7.27%. 4 swallowing process irritability in 98 cases, given to pacify after pacification in 18 cases, the use of drug sedation in 80 cases. 5 All patients had no infection, hypothermia, arterial discharge blockage and other complications. Conclusion The common nursing problems in neonatal blood transfusion include difficult arterial puncture, poor blood flow in the artery, irritability, infection, hypothermia and blockage of the arterial discharge end. The nurses should master the methods and techniques of arterial puncture, keep the children quiet during blood exchange, Make infection protection measures to prevent the occurrence of hypothermia and arterial discharge blocked; close monitoring of vital signs and changes in serum bilirubin, etc., to ensure the successful completion of neonatal blood exchange process.