赵小荣 陈利玲 束君艳

【摘要】 目的：分析抚触护理对高胆红素血症新生儿睡眠质量及心理运动功能的影响。方法：将2018年3-10月在笔者所在医院医院产科出生的70例高胆红素血症新生儿，根据护理方法不同分为抚触组（n=40）、对照组（n=30），均给予常规对症支持治疗配合基础护理，前者另给予抚触护理，评价护理效果。结果：抚触组治疗依從性优于对照组（P<0.05）。两组干预第1天胆红素、睡眠时间比较差异无统计学意义（P>0.05），第3、6天均显著改善，但抚触组第3、6天胆红素低于对照组，每日睡眠时间长于对照组（P<0.05）。两组干预前Gesell婴儿发育诊断量表评估结果差异无统计学意义（P>0.05），干预后两组心理适应性、大运动、精细运动、语言、社会行为评分均明显升高，但抚触组显著高于对照组（P<0.05）。结论：抚触护理可提高高胆红素血症新生儿治疗依从性，有效降低胆红素水平，并改善睡眠质量及心理运动功能。

【关键词】 抚触护理; 高胆红素血症; 新生儿; 睡眠质量; 心理运动功能

doi：10.14033/j.cnki.cfmr.2019.18.032 文献标识码 B 文章编号 1674-6805（2019）18-00-03

【Abstract】 Objective：To analyze the effect of touch nursing on sleep quality and psychomotor function of neonates with hyperbilirubinemia.Method：A total of 70 neonates with hyperbilirubinemia who were born in obstetrics department of the hospital from March to October 2018 were divided into the touch group （n=40） and the control group（n=30） according to different nursing methods.All of them were given routine symptomatic supportive treatment and basic nursing.The former was additionally given touch nursing.Nursing effect was evaluated.Result：The treatment compliance of the touch group was significantly better than that of the control group（P<0.05）.There was no significant difference in bilirubin or sleep time between the two groups at the 1st day of intervention（P>0.05），but they were significantly improved at the 3rd and 6th day.Bilirubin in the touch group was significantly lower than that in the control group at the 3rd and 6th day，and the sleep time was significantly longer than the control group（P<0.05）.There was no significant difference in the evaluation results of Gesell infant development diagnosis scale between the two groups before intervention（P>0.05）.The psychological adaptability，gross motor，fine motor，language and social behavior scores were significantly increased after intervention，and the scores of touch group were significantly higher than those of the control group（P<0.05）.Conclusion：Touch nursing can improve the treatment compliance of neonates with hyperbilirubinemia，effectively decrease the bilirubin level，and improve sleep quality and psychomotor function.

【Key words】 Touch nursing; Hyperbilirubinemia; Neonate; Sleep quality; Psychomotor function

First-authors address：Xiantao First Peoples Hospital，Xiantao 433000，China

新生儿疾病以高胆红素血症最为多见，由血清胆红素异常升高所致，发病机制尚未完全明确，但高浓度的未结合胆红素进入血脑屏障对新生儿生长发育的不利影响已得到证实，尤其是胆红素脑损伤，严重时可遗留新生儿神经系统后遗症，如听视力障碍、脑性瘫痪、椎体外系运动障碍及神经行为异常等[1]。蓝光照射简单、安全，是高胆红素血症的常用疗法，但实际临床中治疗效果常受到新生儿的不适应、哭闹、睡眠质量等影响[2]。基于此，笔者所在医院参考现代临床经验，对新生儿实施抚触护理，发现效果满意，现报道如下。