输液泵控制换血术治疗50例新生儿重症黄疸的护理

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1、·1O2·实用临床医学2009年第l0卷第5期PracticalClinicalMedicine，2009，Vol10，No5输液泵控制换血术治疗50例新生儿重症黄疸的护理汪金秀，涂满梅，聂娇(江西省儿童医院NlCU，南昌330O06)摘要：目的总结输液泵控制换血治疗新生儿重症黄疸的护理经验。方法应用输液泵控制换血疗法，对50例重症黄疽新生儿实施换血。术前予患儿必要的镇静、血液适度加温，行外周动、静脉留置针穿刺，形成封闭的换血回路；术中由输液泵控制出、入血量的速度，密切观察生命体征和出入血量的变化，动态监测血pH值、血糖、血生化、血清总胆红素浓

2、度等；术后继续监测生命体征，加强兰光治疗的护理。结果5O例换血过程顺利，平均换血时间(154．2±20．78)min；血清总胆红素浓度换血前为(478．36±59．25)／~mol／L，换血后为(237．75±43．42)t~mol／L，总胆红素换出率为5O．3O。结论输液泵控制换血治疗新生儿重症黄疸安全实用、操作简便、疗效显著。精心、细致、周到的护理是换血成功的保证。关键词：输液泵；换血术；护理；高胆红素血症，新生儿中图分类号：R473．72；R722．17文献标识码：A文章编号：1009-8194(2009)05-0102-04Nursin

3、gCarefor50CasesofNeonateHyperbilirubinemiaTreatedwithPumpControlledExchangeTransfusionWANGJin-xiu．TUMan-mei，NIEJiao(DepartmentofNICU，JiangxiChildren’SHospital，Nanchang330006，China)ABSTRACT：ObjectiveTosumuptheexperiencesofnursingcareforhyperbilirubinemianeo—natestreatedwithpu

4、mpcontrolledexchangetransfusion．MethodsPumpcontrolledexchangetransfusionwasadministeredto50casesofneonatehyperbilirubinemia．Beforetheoperation，nec—essarysedationshouldbeconductedandthebloodbagshouldbeproperlyheatedandloopoftransfusionwouldbeformedviapunctureoftheperipheralar

5、teryandvein；Inthecourseoftheoperation，thespeedwascontrolledbythepump，thevitalsignsandthechangeofbloodvolumewerecloselyobserved，thepHvalueofblood，bloodsugar，bloodbiochemistryandtheconcentra—tionofserumtotalbilirubinhadbeendynamicallymonitored；Aftertheoperation，vitalsignswerec

6、ontinuouslymonitoredandthenursingcareforphototherapywasenforced．Results50casesoftransfusionwereallsuccessfu1．Theaveragetimeoftransfusionwas(154．2±2O．78)minutes．Be—forethetransfusionthelevelofserumtotalbilirubinwas(478．36±59．25)~mol／Lwhichdroppedto(237．75±43．42)umol／Lafterthe

7、transfusion．Theexchangerateofserumtotalbilirubinwas5O．30．ConclusionThetreatmentofpumpcontrolledexchangetransfusionhasaremarkableefficacyontheneonateswithhyperbilirubinemia，andelaborateanddelicatenursingisessentialforitsSUccess．KEYWORDS：pump；exchangetransfusion；nursingcare；hy

8、perbilirubinemia，neonatal收稿日期：2009—03—19作者简介：汪金秀(1971一)，女，本科，主管护师，主要从事新生儿重症