朱翡翡　　裴金霞

[摘要] 目的 观察基于延续护理探讨经络穴位按摩联合抚触对新生儿高胆红素血症的预防效果。 方法 选取2017年1～8月我院妇产科分娩的192例新生儿黄疸患儿为受试对象，随机分为四组，即抚触联合穴位按摩组（A组）、抚触组（B组）、穴位按摩组（C组）、对照组（D组），每组48例。自纳入日起，每组采取相应措施，持续干预10 d。比较四组患儿高胆红素血症、重症高胆红素血症发生率、胎便转黄时间和黄疸消退时间及纯母乳喂养率。结果 干预后，A組患儿高胆红素血症发生率明显低于B组、C组、D组，差异有统计学意义（P<0.05），A组患儿重症高胆红素血症发生率低于B组、C组、D组，差异无明显统计学意义（P>0.05）。A组患儿胎便转黄时间和黄疸消退时间均早于B组、C组、D组，差异有统计学意义（P<0.05）；A 组纯母乳喂养率均高于B组、C组、D组，差异有统计学意义（P<0.05）。 结论 基于延续护理对新生儿进行经络穴位按摩联合抚触，可减少新生儿高胆红素血症发生的风险，缩短胎便转黄时间和黄疸消退时间，提高母乳喂养率，有利于新生儿的生长发育。

[关键词] 延续护理；经络穴位按摩；抚触；预防；新生儿高胆红素血症

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2018）17-0150-04

The preventive effect of touch combined with meridian and point massage on neonatal hyperbilirubinemia based on continued nursing

ZHU Feifei PEI Jinxia

Department of Obstetrics and Gynecology， Hangzhou Hospital of Traditional Chinese Medicine， Hangzhou 310006， China

[Abstract] Objective To observe the preventive effect of touch combined with meridian and point massage on neonatal hyperbilirubinemia based on continued nursing. Methods 192 newborns with hyperbilirubinemia who were born in Obstetrics and Gynecology Department in our hospital from January to August 2017 were selected and randomly divided into four groups including touch combined with meridian and point massage group（group A）， touch group（group B）， meridian and point massage group（group C）， control group（group D）. Each group had 48 cases and was continuously treated with corresponding measure over 10 days since entrance.The incidence of hyperbilirubinemia and severe hyperbilirubinemia and the time of yellowing of meconium and the time when neonatal jaundice disappeared of four groups were compared. Results After intervention， the incidence of neonatal hyperbilirubinemia of group A was significantly lower than those of group B， group C and group D and the differences were significant（P<0.05）. The incidence of severe hyperbilirubinemia of group A was lower than those of group B， group C and group D， but the differences were not significant（P>0.05）. The time of yellowing of meconium and the time when neonatal jaundice disappeared of group A were earlier than those of group B， group C and group D and the differences were significant（P<0.05）. The exclusive breastfeeding rate of group A was higher than those of group B， group C and group D， and the difference was significant（P<0.05）. Conclusion Touch combined with meridian and point massage based on continued nursing can reduce the incidence of neonatal hyperbilirubinemia， shorten the time of yellowing of meconium and the time when neonatal jaundice disappeared and increase the exclusive breastfeeding rate， which are beneficial for the growth and development of newborns.

[Key words] Continued nursing； Meridian and point massage； Touch； Prevention； Neonatal hyperbilirubinemia

新生儿黄疸是新生儿常见症状，我国新生儿黄疸发病率高达60%～80%。该病多发生于新生儿出生后1周内，有自愈性，预后较好[1-2]，但仍有10%～50%少数新生儿在发病过程中合并产生的并发症，如缺氧、感染或酸中毒等会损害新生儿中枢神经系统，导致高胆红素血症，且预后不良[3-4]。有研究显示，高胆红素血症可引起神经毒性，造成新生儿脑损伤，若出现核黄疸，则会对患儿产生严重影响，表现出睡眠质量差、哭闹等症状[5]。寻找有效预防新生儿高胆红素血症和胆红素脑病发生的方法，一直是国内外重要研究课题之一[6]。有相关报道显示，经络抚触可以有效减少新生儿血清胆红素的浓度，增加胆红素的排出，可以有效辅助治疗新生儿高胆红素血症[7-8]。……