旋转振动排痰仪对新生儿重症肺炎的治疗效果分析

目的探讨旋转振动排痰仪在新生儿重症肺炎治疗中的作用。方法以我院2011年1月至2013年1月间收治的80例新生儿重症肺炎患儿为研究对象．随机分为观察组与对照组各40例。观察组使用旋转振动排痰仪排痰,对照组使用传统的手动方式排痰,比较两组患儿的排痰量、治疗效果和临床效果相关指标。结果观察组患儿第1天、第3天、第5天排痰量均多于对照组（P均〈0．05）。观察组显效率为62．50％,显著高于对照组的40．00％（x^2=4．05,P〈0．05）。观察组住院时间为（10．15±1．39）天,显著少于对照组的（11．30±1．94）天（t=3．05,P〈0．05）。结论在新生儿重症肺炎治的疗过程中使用旋转振动排痰仪能有效提高治疗效果,降低患儿NICU住院时间,具有重要意义。     

Interventions aimed at reducing the stress of mother's whose infant is born premature: A scoping review

ObjectivesThe goal of this scoping review was to assess the effectiveness of interventions aimed at reducing the stress of mothers whose infant is born prematurely.MethodsA scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) framework was conducted. Four electronic databases, Medline, PsychINFO, CINAHL, and Embase, were searched with key search terms related to maternal intervention, neonatal intensive care unit, and stress was performed. Two independent reviewers performed the search strategy.ResultsA total of 18 articles were included in the review. Five categories of interventions emerged: Kangaroo Care (5/18, 28%), Education (5/18, 28%), Relaxation (3/18, 17%), Psychological Support (2/18, 11%), and Multimodal Approach (3/18, 17%). All the intervention categories had a positive influence on reducing maternal stress, with maternal education having the most consistent evidence.ConclusionThis review brings forth five categories of interventions aimed at reducing stress in mothers whose infant was born prematurely which may be used in clinical practice.     

Does skin-to-skin contact reduce stress during diaper change in preterm infants?

Background

Skin-to-skin contact reduces pain response in preterm infants subjected to minor painful procedures, such as heel lance. Diaper change is a procedure performed several times daily in hospitalized preterm infants. Routine care giving tasks such as diaper change may be stressful for the infant.

Aims

The purpose of this study was to investigate whether diaper change induces stress and if skin-to-skin contact could reduce such stress, measured by changes in skin conductance.

Study design

This was a randomized crossover pilot study in 19 preterm infants with gestational age between 28 and 34 weeks. The diaper change procedure was done twice in each infant, once during skin-to-skin contact, and once in incubator or bed with the mother present.

Outcome measures

During diaper change heart rate (HR), peripheral oxygen saturation (SpO₂), and changes in skin conductance (SC) peaks per sec, using the Skin Conductance Algesimeter (SCA), were registered.

Results

The mean SC peaks/sec increased/decreased significantly under/after change of diapers which thereby underpins that this is a stressful procedure for the preterm infant.Skin-to-skin contact (SSC) entails significantly lower stress levels (p < 0.05) compared to diaper changed in an incubator/bed measured by the SCA.

Conclusions

Diaper change is a stressful procedure for preterm infants and may be ameliorated by skin-to-skin contact.     

Auditory neural myelination is associated with early childhood language development in premature infants

Background

Auditory neural myelination (ANM) as evaluated by auditory brainstem evoked response (ABR) during the neonatal period has been used as a surrogate outcome for long-term neurodevelopment. The validity of ANM as a surrogate outcome for long-term neurodevelopment has not been well studied.

Aim

Evaluate the association of ABR I–V interpeak latency (IPL), an index of ANM, at 35 week postmenstrual age (PMA) with language outcome at 3 years of age.

Design

Prospective study.

Subjects

24–33 week gestational age (GA) infants were eligible if they did not meet exclusion criteria: craniofacial malformation, chromosomal disorders, deafness, auditory dys-synchrony, TORCH infection, or non-English speaking parents. Infants with malignancy, head injury, encephalopathy, meningitis, blindness, or who died or relocated were also excluded.

Outcome measures

ABRs were performed at 35 week PMA using 80 dB nHL and I–V IPL (ms) measured. Auditory Comprehension (AC) and Expressive Communication (EC) were evaluated by a speech-language pathologist at 3 years of age using Preschool Language Scale.

Results

Eighty infants were studied. The mean GA and birth weight of infants were 29.2 weeks and 1336 g, respectively. There was association of worse ear I–V IPL and better ear I–V IPL with AC (Coefficient − 5.4, 95% CI: − 9.8 to − 0.9 and Coefficient − 5.5, 95% CI: − 10  to−0.9, respectively) and EC (Coefficient − 5.6, 95% CI: − 9.5  to−1.8 and Coefficient − 6.7, 95% CI: − 10.6  to−2.7, respectively) after controlling for confounders.

Conclusion

The neonatal I–V IPL is a predictor of language development at 3 years of age in preterms.     

��������֢�໤���ٴ�Σ��ֵ����������

??Objective To analyze the clinical characteristics of critical values in NICU and help to make the proper diagnosis and treatment plans of NICU. Methods Retrospective analysis was performed on all the critical values in NICU collected from July 1st??2012 to November 30th??2012 in Children′s Hosptial of Chongqing Medical University. The gestional ages and birth weights of these babies?? consitituent ratio of critical index?? distribution of report time and clinical response and the impact on treatment were analyzed. Results There were 212 newborns with 369 items of time critical values?? and the rate of positive impact on management was 65.04%. Imaging tests??81 cases??22.0%????blood glucose??79 cases??21.4%?? and routine coagulation tests??77 cases??20.9%??were the most common critical values. Sample quality was the common cause of false positive critical values. Conclusion Periodically analyzing and summarizing critical values data could help to make a more reasonable critical value system and improve clinical work efficiency and quality.