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Clinical analysis of 40 cases of premature infants_2702

By Phillip Hughes,2014-10-30 11:11
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Clinical analysis of 40 cases of premature infants_2702

Clinical analysis of 40 cases of premature infants

     Abstract Objective To analyze the common treatment measures in preterm infants. Methods in January 2002 -2,007-year pediatric hospital in

    December of 40 cases of premature infants admitted to the clinical data

    were analyzed retrospectively. Results 40 cases were treated 36 cases of children discharged with a cure rate up to 90%. Conclusion attention to monitoring, warmth, and respiratory support, prevention of infection, bleeding, treatment of jaundice in premature infants to treat the success of effective measures.

     Key words Preterm infants; clinical analysis of

     Abstract Objective To analyze the common treatments of premature infants. Methods The clinical data of 40 cases of premature infants

    accepted in paediatric department from January 2002 to December 2007 were reviewed. Results Among the 40 patients, 36 recovered and were discharged. The cure rate was 90%. Conclusion Intensive care and warming, respiratory support, prevention of infation, bleeding and jaundice treatment are effective measures for treating premature infants.

     Key words premature infants; clinical analysis

     Premature infants is 28 ~ 37 weeks pregnant live births, birth weight <2 500 g. in particular, gestational age "33 weeks preterm infants, the phylogeny is more mature, survival function is very low, complicated by hyaline membrane disease , sepsis, Scleroderma, pathologic jaundice, pulmonary hemorrhage, apnea, etc., and the high mortality rate. Now I

    pediatric hospital in January 2002 ~ December 2007 during the period of the 40 cases of premature infants treated were analyzed retrospectively.

     1 Data and methods

     1.1 General Information

     All patients were transferred to my hospital obstetrics. 40 cases of

    premature infants, the male 22 cases, female 18 cases, 31 ~ 32 weeks in 1 case, 32 ~ 33 weeks in 3 cases, 33 ~ 34 weeks in 9 cases, 34 ~ 36 weeks 27. Weight <1 500 g 1 Li, 1 500 ~ 2 000 g 16 Li, 2 000 ~ 2 500 g 23 Li. Mode of delivery: cesarean section in 23 cases, 17 cases of vaginal delivery. After birth, 2 cases of severe asphyxia, cyanosis asphyxia in 13 cases, 25 cases without asphyxia. Twin 8 cases, pregnancy-induced

    hypertension in 4 cases, 3 cases of premature rupture of membranes,

    placenta previa in 7 cases, intrahepatic cholestasis of pregnancy in 12 cases, other 6 cases.

     1.2 Prevalence

     Scleroderma 10 cases, pneumonia in 9 cases, hyperbilirubinemia eight cases, three cases of hypocalcemia, hypoglycemia in 2 cases,

    gastrointestinal bleeding in 1 case, hypoxic-ischemic encephalopathy in 7

    cases, were mild .

     1.3 Treatment

     1.3.1 close monitoring of vital signs measured every 4 h temperature 1 times, every 2 h observation of looking, measuring heart rate,

    breathing, abnormal situation if timely reporting of a doctor at any time to adjust, and pay attention to eyes, navel, buttocks, etc. care.

     1.3.2 Thermal Control Scleroderma in children in this group the time of admission body temperature below 36 ? in 6 patients, mild and

    accompanied by a hard swelling after admission were placed in warm boxes, according to the weight adjustment of box temperature and relative humidity in the 50% ~ 60%. So that children remain at moderate temperature, tank temperature dropped to 30 ? ~ 29 ? when the

    temperature can be maintained in the normal range can a warm box. Treatment of Scleroderma, using partial erasure of vitamin E massage, infrared therapy, 2 / d, while using intravenous infusion of low molecular weight dextran, 5 ml / kg * d, or compound Danshen injection 2 ml / d.

     1.3.3 respiratory support under the complexion, and decide whether or oxygen breathing, there is cyanosis and respiratory difficulty were given oxygen, the general nasal catheter oxygen (intermittent) 2 ~ 3 days, the

    concentration of 30% to 40% is appropriate. If apnea while giving intravenous aminophylline loading dose 4 ~ 6 mg / kg * d, adding 10% glucose solution 20ml slow infusion, according to the amount of medication to maintain breathing 3 ~ 5 d.

     1.3.4 feeding of sucking a strong person, both by direct breast feeding or bottle-fed premature infant formula, if the sucking is weak and swallowing function is good, can be used teaspoon or dropper-feeding. In

    order to prevent low blood sugar, most people admitted to hospital have begun after the intravenous infusion of 10% glucose solution. Within 1 week after birth, the total liquid volume of 60 ~ 80 ml / kg * d, 1 week after the 80 ~ 100 ml / kg * d.

     1.3.5 Infection prevention and control due to prematurity, low birth weight resistance is poor, prone to cross-infection, so a daily UV

    disinfection a meeting room, warm boxes, stethoscope, a daily disinfectant wipe one time, medical staff access to children before the flow of water,

    wash hands with soap, but also with children as appropriate use of antibiotics.

     1.3.6 treatment of jaundice in light of oral Bacillus subtilis and Enterococcus faecium two together viable multi-dimensional particles and

    montmorillonite powder, jaundice, severe cases, Blu-ray exposure time 1 ~

    3 d.

     1.3.7 Control hemorrhage in preterm infants prone to cerebral hemorrhage, gastrointestinal hemorrhage, pulmonary hemorrhage, admitted to hospital for routine vitamin K1 1 ~ 3 mg, 1 / d, used in conjunction 3

    days.

     2 Results

     40 cases of children in the 36 patients discharged after treatment, the cure rate was 90%, 3 cases were automatically discharged from economically disadvantaged families accounted for 7.5%, 1 patient died

    2.5%, all patients survived an average of 6.5 days hospitalization days for up to 10 days, the shortest 3 days. Reposted elsewhere in the paper for free download http://

     3 Discussion

     Preterm infants, especially very low birth weight infants because of

    developmental immaturity of organs after birth prone to various diseases and high mortality rate. Along with the development of medical science in recent years, neonatal intensive care unit of the establishment and the use of parenteral nutrition, and the use of bedside care and other

    comprehensive treatment and care manual, so that premature and low birth weight infants was significantly higher survival rate, by children in this group The treatment, summed up the following experience.

     3.1 Guardianship

     To send an experienced and love their jobs, strong sense of responsibility nurses hand care, close observation of vital signs and looking, the reaction conditions, and early detection of problems, timely treatment, and to maintain lateral position to prevent vomiting caused by suffocation.

     3.2 Temperature Management

     Prevention of Scleroderma, warmth must start from the delivery room at room temperature maintained at 24 ? ~ 26 ?, and then clean up after

    the birth of the first parcel respiratory tract, umbilical cord ligation, etc., and immediately set warm inside, so that the baby body temperature maintained at 36 ? ~ 37 ? [1]. Due to low birth weight infants,

    especially very low birth weight infants body is small, relatively large

    body surface area, the skin is thin, evaporative cooling and more brown fat, less heat less, relying on its own it is difficult to maintain normal body temperature, on the environment require a higher , the temperature is too low prone to cause cold injury, there metabolic acidosis,

    hypoglycemia, microcirculation, blood viscosity increased, coagulation disorders, subcutaneous tissue pathophysiological changes such as a hard swelling, severe pulmonary hemorrhage occurred, while the warmth over , moisture can also lead to dehydration and loss of increased hypernatremia [2]. Hence, throughout the course of treatment, temperature management is very important.

     3.3 Respiratory Management

     Promptly clean up after birth, respiratory secretions, maintain

    airway patency, the general should not continue to oxygen, oxygen concentration of 30% ~ 40% is appropriate given the high concentration of oxygen causing the eye lens posterior fibrous tissue hyperplasia, the risk of visual impairment [3], pairs of primary apnea can back or irritate the foot care or the use of aminophylline [1].

     3.4 feed

     Conditions allow those who try to breast-feeding, because breast milk

    is convenient, but also economic, health, and breast milk contains a wealth of anti-infective substances, milk protein, fat, sugar, an appropriate ratio of calcium and phosphorus ratio appropriate, in line with the growth and development needs of premature infants , in the absence of breast-milk can be used in preterm infants fed formula, a small

    amount several times, gradually increase in order to prevent vomiting

    caused by excessive feeding and gastrointestinal bleeding caused by suffocation, early complement proteins, sugar, vitamins and trace elements.

     3.5 Prevention of bleeding

     After birth, routine use of vitamin K1 1 ~ 3 mg, once a day qd for 3 days.

     3.6 review after discharge from hospital on a regular basis, follow-

    up

     On proper feeding methods, time to add food supplements to prevent iron deficiency, calcium, zinc, etc. to help parents learn to newborn massage, on time vaccination, identify problems, timely correction of hypoxic-ischemic encephalopathy while giving the neurotrophic drugs, early exercise, mental exercise.

     References

     1 Xin Ying, Ke-Lun Wei. The very low birth weight infants a few questions [J]. Pediatric Emergency Medicine, 2002, (1): 63.

     2 ZHAO Shi-min, SUN Jian-wei. Very low birth weight infant's body

    temperature management [J]. Pediatric Emergency Medicine, 2002, (1): 2.

     3 Rong-Hua Chen, Shu-Bao Chen, Zhu Guoqi capacity. Pediatric rounds Manual [M]. Nanjing: Jiangsu Science and Technology Press, 1999,68 reposted elsewhere in the paper for free download http://

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