Compliance of Blu-ray in the Treatment of Neonatal Hyperbilirubinemia

Author: Release time:2016-09-13 Browse6682Second

Neonatal hyperbilirubinemia is a common disease in the neonatal period, mainly in the blood bilirubin concentration increased so that cause skin and mucous membrane yellow dye. As indirect bilirubin has lipophilic, easy through the blood-brain barrier, causing nuclear jaundice, a series of nervous system damage. Therefore, the reduction of bilirubin is the key to the treatment of hyperbilirubinemia. Treatment of neonatal hyperbilirubinemia generally use blue light and drug therapy, and Blu-ray treatment is the most economical, safe and effective method. Parents of children in clinical practice is often difficult to accept, poor compliance, to bring some difficulties in treatment. We observed 60 cases of hyperbilirubinemia in children, found in the treatment of nurses in the blue health education and close cooperation with parents directly affect the therapeutic effect. The report is as follows:


1, clinical data


Sixty patients with hyperbilirubinemia requiring blue light irradiation, including 35 males and 25 females, aged from 2 to 20 days and weighing from 2.5 to 4.5 kg, were collected from April to December 2002.


Treatment: blue light and Yin Zhi Huang static point.


Blu-ray box for the Ningbo David Medical Devices Co., Ltd. production of double-sided blue box.


2, the results


Light exposure is generally required 24h, but the actual exposure time is often not reached, which is closely related to the parents of children with a direct impact on the prognosis of 60 cases of hyperbilirubinemia blue light compliance and irradiation time , The relationship between the number of days of hospitalization in Table 1.

Table 1 relationship between compliance, exposure time and the number of days of hospitalization.

/ Quatity

Average exposure time(h)


Average length of hospital stay(d)


compliance 35
23.8
3.9
uncompliance 25
10
7
add up 60
16.9
5.4

3 Discussion

3.1, blue light therapy to strengthen the intensity of nursing health education Blue light irradiation is the treatment of neonatal hyperbilirubinemia, the main method, the principle is: to light the skin, the fat-soluble unconjugated bilirubin, change the structure, decomposition Become non-toxic products of the brain - optical bilirubin, so soluble in water, can be quickly discharged from the bile or urine, and increased liver excretion of bilirubin. Because the newborn is the only child in a special group, more concerned about the disease in children, parents of children with hyperbilirubinemia lack of adequate knowledge, there are all kinds of concerns, especially nurses to see the naked children into blue Box, and my heart was afraid, fear, and some children hear the cry from the box immediately hold out, do not want to add, affecting the treatment, easy to produce nurse-patient conflicts. From the observation of 60 cases of hyperbilirubinemia in children can be seen in 25 cases of poor parental compliance, the performance can not meet, affecting the treatment, prolonging the number of hospital days. Analysis of the main reasons for the parents of children with disease knowledge, so the health education of nurses is particularly important in the light before the parents should be based on the education of children with disease knowledge and the role of light therapy, and personally taught to dispel the concerns of parents , Take the initiative to communicate with their parents. To avoid nurse-patient conflicts.

3.2, select the appropriate time into the box in children with blue box, due to change the original comfortable environment, the lack of mother caress, and wear eye goggles, often cause children crying, resulting in extravasation infusion, parents impatient, Reduce children crying, so that children in the blue light irradiation time, we summed up the experience in clinical practice: the box will be pre-warm box set at 30-32 ℃, humidity 50%, the children Feed, replace a good diaper, and then establish intravenous access, small pot into the phenobarbital sodium 5-8mg / kg, because phenobarbital sodium is both a liver enzyme inducer and sedative effect, immediately after the medicine into the box , Children can sleep quietly, so you can extend the exposure time, parents can rest, reduce fatigue, to avoid the occurrence of negative emotions.

3.3, the blue light irradiation process Note In order to ensure the effect of children with radiation, in addition to the front of the box for children wearing black goggles and diapers, to protect the eyes and the perineum, the children should be fully exposed to the blue light. Irradiation process, the nurses should take the initiative to visit, observe the reaction capacity of children, crying and jaundice subsided, pay attention to the temperature and humidity of the blue box, timely water into the tank, the body temperature every 2h test, and guide parents to wear sunglasses Children in the case of the box, to avoid goggles and diapers shift, asked to increase the number of water to supplement the non-dominant loss of water. Exposure to the process may appear temporary rash, diarrhea and green loose stools, urine color yellow, etc., should explain to the parents of children, so as not to panic, children crying more than when to help find out the reasons to eliminate parental anxiety, Easy to take the initiative to complete the treatment. Daily bilirubin levels were measured during phototherapy.