新生儿硬肿症死亡原因分析与护理体会

目的探讨致新生儿硬肿症死亡的原因及护理措施,以提高治愈率及护理疗效。方法通过回顾性总结2009年8月～201年8月我科收治的新生儿硬肿症203例的临床资料。结果治愈148例,死亡55例,病死率占37.2%。死亡组直接死亡疾病:DIC并肺出血、消化道出血32例,呼吸衰竭5例,肾功能衰竭5例,严重心力衰竭3例,上呼吸机合并严重肺部感染3例,败血症并中毒性脑病2例,低钠脑病1例,放弃治疗4例。结论新生儿硬肿症病死率与胎龄、体重、硬肿程度、发病季节、并发症等有关系,窒息、感染、早产、低体重、低温、护理方式等是影响新生儿硬肿症预后的重要因素,应加强围产期保健、提倡住院分娩、注意新生儿体温护理、预防感染、加强病情观察等,以减少新生儿硬肿症的发生及死亡。

THE DEATH REASON ANALYSIS AND NURSING EXPERIENCES OF NEONATALSCLERE- DEMA

Objective To explore the death reason of neonatal scleredema and the nursing measures in order to improve the cure rate and the nursing effect. Methods Retrospectively analyze the clinical data of 203 cases of neonatal scleredema in our department from August 2008 to August 2011. Results Among the 203 cases, 148 were cured and 55（37.2% ） were dead. The main causes of death related to pulmonary hemorrhage in DIC, gastrointestinal bleeding （ 32 ）, respiratory failure（ 5 ）, renal failure （ 5 ）, severe heart failure （ 3 ）, severe ventilator associated pneumonia（3 ）, toxic eneephalopathy in septicemia（2）, hyponatremic encephalopathy （1）, and 4 eases gave up treatment. Conclusion The mortality rate of neonatal seleredema is closely related to gestational age, weight, severity, season, complications etc. Asphyxia is an important factor affecting the prognosis of this disease, as well as infections, premature delivery, low birth weight, low temperature, nursing cares, and so on. Effective and strong measures should be carried out to reduce the morbidity and mortality, including providing good prenatal care, advocating hospital delivery, improved neonatal care of body temperature, preventing infections, strengthening the observation etc.