足月新生儿发生高胆红素血症的影响因素及护理对策

目的:分析导致足月新生儿发生高胆红素血症的影响因素,制定护理对策。方法:选取2018年1月至2019年1月在泰安市中心医院产科进行分娩的260例产妇及其新生儿作为研究对象。观察记录产妇围产期资料、分娩情况、新生儿情况,同时监测新生儿胆红素值,并通过多因素Logistic回归分析足月新生儿发生高胆红素血症的影响因素及制定护理对策的关系。结果:本次研究足月新生儿发生高胆红素血症的总发生率为33.85%,单因素分析结果显示,产妇围产期情况中分娩方式及胎儿窘迫均为足月新生儿发生高胆红素血症的相关影响因素(均P<0.05);新生儿情况中头颅血肿、开奶时间、母乳喂养频率、排尿次数、血型不合及胎便排出时间均为足月新生儿发生高胆红素血症的相关影响因素(均P<0.05);多因素分析结果显示,胎儿窘迫、开奶时间、胎便排出时间及血型不合均为影响足月新生儿是否发生高胆红素血症的独立影响因素(OR>1,均P<0.05)。结论:该院足月新生儿高胆红素血症的发生率偏高,还有很大的降低空间。导致新生儿发生高胆红素血症的相关因素较多,其中,减少开奶时间、减少胎儿胎便排除时间、预防性诊断血型不合并及时治疗及加强围产期综合护理是降低新生儿发生高胆红素血症的有效途径。

Analysis of influencing factors and nursing countermeasures of hyperbilirubinemia in full-term neonates

Objective To analyze the influencing factors leading to hyperbilirubinemia in full-term neonates and develop nursing countermeasures.Methods A total of 260 women and their newborns who delivered in the obstetrics department of Central Hospital of Taian City from January 2018 to January 2019 were selected as the research subjects.Perinatal data,delivery conditions and neonatal conditions were observed and recorded,and neonatal bilirubinemia was monitored at the same time.Multivariate Logistic regression was used to analyze the influencing factors of hyperbilirubinemia in full-term neonates and the relationship between nursing strategies.Results In this study,the total incidence of hyperbilirubinemia in full-term neonates was 33.85%.Univariate analysis results showed that delivery mode and fetal distress in perinatal conditions were related influencing factors for hyperbilirubinemia in full-term neonates(P<0.05).In neonatal conditions,cranial hematoma,time to open milk,frequency of breast-feeding,frequency of urination,blood group incompatibility and time to fecal discharge were all related influencing factors for hyperbilirubinemia in full-term neonates(P<0.05).Multivariate analysis showed that fetal distress,lactation time,fecal expulsion time and blood group incompatibility were the independent influencing factors for hyperbilirubinemia in full-term neonates(OR>1,P<0.05).Conclusions The incidence of hyperbilirubinemia in full-term neonates in this hospital is high and there is still a great room for reduction.There are many related factors leading to the occurrence of neonatal hyperbilirubinemia,among which,reducing the time of opening milk,reducing the time of fetal fecal elimination,preventive diagnosis of blood type without timely treatment and strengthening the perinatal comprehensive nursing are effective ways to reduce the occurrence of neonatal hyperbilirubinemia.