手术分娩对产妇和新生儿血中T淋巴细胞的影响

目的 探讨手术分娩对产妇和新生儿T淋巴细胞亚群数量的影响.方法 足月分娩产妇60例,依据分娩方式及手术时机分为自然分娩(NL)组、择期剖宫产(PCS)组、急诊剖宫产(ECS)组各20例;分别采集分娩时的产妇外周血和新生儿脐血,应用流式细胞仪检测T细胞各亚群的百分比.结果 NL组、PCS组、ECS组产妇血中T淋巴细胞亚群CD3+(69.15±13.24)%、(73.50±4.86)%、(68.68±7.50)%;CD3+CD4+(32.03±9.44)%、(36.35±11.82)%、(34.88±7.54)%;CD3+CD8+(29.83±6.01)%、(30.59±7.30)%、(28.08±4.09)%;CD4+/CD8+1.09±0.37、1.33±0.65、1.25±0.27各组间差异均无统计学意义(P＞0.05);新生儿脐血:PCS组中由于CD4+的减少而呈现CD4+/CD8+的比值明显低于NL、ECS组,分别为2.71±0.86、3.52±1.50、3.30±1.03(P＜0.05).结论 产妇血中T淋巴细胞亚群数量不受手术分娩以及产程影响;PCS可能会加剧新生儿对某些病原体的易感性.     

新生儿肺透明膜病应用经鼻持续正压通气治疗的评价

目的检验经鼻持续正压通气对新生儿肺透明膜病(HMD)的治疗效果。方法选取2010年7月至2013年7月在湖北医药学院附属东风医院就诊的HMD患儿64例作为研究对象,男40例,女24例,所有患儿均在出生2h内转入湖北医药学院附属东风医院接受治疗。将64例患儿分为两组,每组32例。两组患儿均给予常规的基础治疗,通气组另采用小儿呼吸机进行经鼻的持续正压通气治疗,观察两组患儿治疗后住院时间、并发症发生率、肺部感染率、持续肺泡内正压参数变化、两组患儿吸入氧分数参数变化和血气分析参数。结果两组患儿的基本资料比较差异无统计学意义(P0.05)。两组患儿治愈例数、住院时间、持续肺泡内正压参数、吸入氧分数参数和血气分析参数比较差异有统计学意义(P0.05)。结论经鼻持续正压通气对HMD在常规治疗的基础上可以达到良好的治疗效果,但是容易出现肺部并发症。     

陕西省某医院2014—2017 年新生儿医院内感染分析

目的 探讨陕西省某医院新生儿科医院感染的流行特点,为预防和控制新生儿医院感染提供科学依据。方法 回顾性分析2014 年1 月—2017 年12 月入住陕西省人民医院新生儿科的患儿,收集在住院期间发生医院感染的患儿临床资料,对数据进行分析。结果 近4 年来共监测新生儿9 634 例,其中发生院内感染328 例,院内感染例次为332 例,2014—2017 年医院感染（NI）发生率比较,差异无统计学意义（P >0.05）。近4 年日感染率为5.51‰,发生导管相关血流感染率为6.00‰,2014—2017 年导管相关血流感染率比较,差异无统计学意义（P >0.05）。呼吸机使用时间为1 078 d,呼吸机相关肺炎发生率为19.48‰ ;2014—2017 年呼吸机相关肺炎感染率比较,差异无统计学意义（P >0.05）;医院感染部位以血液相关感染居首位,其次为呼吸道感染,2014—2017 年胃肠道感染、呼吸道感染及其他部位感染率比较,差异有统计学意义（P <0.05）。不同出生体重患儿NI 发生率比较,差异有统计学意义（P <0.05）。2014—2017 年每个季度的NI 发生率比较,差异无统计学意义（P <0.05）。结论 陕西省人民医院新生儿科医院感染控制效果尚可,但仍需加强院感监控;重点应预防极低出生体重组和血液相关感染,采取针对性的预防控制措施,减少医院内感染的发生。     

Intravenous morphine attenuates pain induced changes in skin blood flow in newborn infants

Abstract

In a previous study we found that pain and discomfort caused a marked increase in skin blood flow, in newborn infants, and that skin blood flow decreased after morphine. In this study we tested morphine effect on the skin blood flow response to pain more systematically. Skin blood flow was measured using a laser Doppler technique during 19 percutaneous central venous catheter placements in 18 infants, 10 of whom received intravenous morphine premedication. The mean ± SD baseline skin blood flow was similar between the two groups: 22.5±9.5 ml 100 g-7 m/n-7 in the morphine group, and 23.7± 8.0 ml TOO g~1 min~1 in the no-morphine group, respectively (p = n.s.). During PCVC placement in the morphine treated group, skin blood flow remained low with minimal variability. The mean value was 22.6 ±7.7 ml 100 g~1 min(p = n.s. compared to baseline). In 7/9 infants not treated with morphine skin blood flow increased dramatically during PCVC placement; while in two it did not. But the mean skin blood flow in this group of 9 infants during PCVC placement was 45.3 ±34 ml 100 g~1 min~ \ an overall change of 97% increase from the baseline. This was statistically significant compared with the baseline and the morphine group value during PCVC insertion (p< 0.04). During the 45 min time period after PCVC placement, skin blood flow values between groups again were similar. We conclude that morphine pretreatment for PCVC placement minimizes pain-associated increases in skin blood flow. The issue of whether skin blood flow changes could serve as measures of adequate analgesia needs to be evaluated with further studies. [Neurol Res 1996; 18: 440-444]     

The effect of massage,wipe bathing and tub bathing on physiological measurements of late premature newborns: A randomized controlled trial

ObjectiveThe aim of this randomized experimental study is to analyze the effect of massage, wipe bathing and tub bathing on physiological measurements of late premature newborns.Designand Methods: This randomized experimental study was conducted on 192 newborns at the gestational week of 34 or higher in the neonatal intensive care unit of a university hospital. The researchers applied massage (n: 48), tub bathing (n: 48), and wipe bathing (n: 48) to the newborns. The control group (n: 48) received no intervention except for the routine clinical practices. The newborns' physiological measurements before, immediately after and 30 min after the interventions were taken and recorded on the “Newborn Follow-up Form.” The newborns’ physiological measurements were assessed by independent evaluators who were blinded to the purpose of the study at different phases across the massage, wipe bathing and tub bathing protocols. The statistical analysis was performed using percentages, means, repeated analysis, variance analysis, Bonferroni analysis.ResultsNo difference was found in the massage, wipe bathing, tub bathing and control groups' mean physiological measurements (pulse, respiration, oxygen saturation, blood pressure, body temperature) (p > 0.05).