基于儿童早期预警评分的护理干预对新生儿呼吸窘迫综合征血气指标、康复进程及预后的影响

doi:10.19983/j.issn.2096-8493.20260138

摘要/Abstract

摘要：

目的: 探讨在新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome, NRDS)患儿中采取基于儿童早期预警评分(pediatric early warning score, PEWS)护理的干预效果,旨在为NRDS患儿护理干预提供新的参考和借鉴。方法: 回顾性分析2023年10月至2025年10月莆田学院附属医院收治的98例NRDS患儿,依据护理方式不同将其分为两组,对照组49例患儿采取常规护理干预,观察组49例患儿采取基于PEWS的护理,两组均持续护理2周。对两组患儿的血气指标水平、康复进程、并发症发生率,以及家属对护理服务的满意度展开评估与比较。结果: 护理后观察组动脉血二氧化碳分压(PaCO₂)为(40.28±3.20)mmHg(1mmHg=0.133kPa),低于对照组的(44.76±3.23)mmHg;动脉血氧分压(PaO₂)和动脉血氧饱和度(SaO₂)分别为(83.39±5.90)mmHg和(95.14±3.56)%,均高于对照组的(75.54±5.88)mmHg和(92.29±3.31)%,差异均有统计学意义(t值分别为6.897、6.597、4.104,P值均<0.001)。观察组机械通气时间和住院时间分别为(125.19±10.10)h和(8.93±1.79)d,均短于对照组的(160.06±10.13)h和(11.69±1.85)d,差异均有统计学意义(t值分别为17.064、7.505,P值均<0.001)。观察组并发症总发生率为8.2%(4/49),低于对照组的28.6%(14/49);观察组患儿家属满意度为95.9%(47/49),高于对照组的83.7%(41/49),差异均有统计学意义(χ²=6.806,P=0.009;χ²=4.009,P=0.045)。结论: NRDS患儿经基于PEWS的护理干预后,可促进血气指标水平改善,加快患儿康复进程,还可降低并发症发生,有利于改善患儿预后,提升家属满意度。

关键词: 呼吸窘迫综合征, 新生儿, 新生儿护理, 血气分析, 康复, 预后

Abstract:

Objective: To investigate the effect of nursing intervention guided by the pediatric early warning score (PEWS) in neonates with neonatal respiratory distress syndrome (NRDS), and to provide new evidence for the clinical nursing of NRDS. Methods: A retrospective analysis was conducted on 98 children with NRDS admitted to Putian University Affiliated Hospital from October 2023 to October 2025. According to different nursing methods, they were divided into two groups: a control group of 49 children received routine nursing intervention, and an observation group of 49 children received PEWS based nursing. Both groups received continuous nursing for 2 weeks. Evaluate and compare the levels of various blood gas indicators, rehabilitation process, incidence of complications, and family satisfaction with nursing services between two groups of pediatric patients. Results: After nursing, the arterial partial pressure of carbon dioxide (PaCO₂) in the observation group was (40.28±3.20) mmHg (1 mmHg=0.133 kPa), which was lower than that in the control group (44.76±3.23) mmHg; The arterial partial pressure of oxygen (PaO₂) and arterial oxygen saturation (SaO₂) were (83.39±5.90) mmHg and (95.14±3.56) %, respectively, both higher than the control group’s (75.54±5.88) mmHg and (92.29±3.31) %, the differences were statistically significant (t=6.897, 6.597, 4.104, all P values <0.001); The mechanical ventilation time and hospitalization time of the observation group were (125.19±10.10) hours and (8.93±1.79) days, respectively, which were shorter than those of the control group (160.06±10.13) hours and (11.69±1.85) days, the differences were statistically significant (t=17.064, 7.505, P values <0.001); The total incidence of complications in the observation group was 8.2% (4/49), which was lower than that in the control group (28.6%, 14/49), the differences were statistically significant (χ²=6.806, P=0.009); The satisfaction rate of the family members of the observation group was 95.9% (47/49), which was higher than that in the control group (83.7%, 41/49), the differences were statistically significant (χ²=4.009, P=0.045). Conclusion: PEWS-based nursing intervention can effectively improve blood gas parameters, accelerate rehabilitation, reduce the incidence of complications such as pneumonia and hypoxic-ischemic encephalopathy, and improve the prognosis of neonates with NRDS, thereby increasing their families’ satisfaction with nursing care.

Key words: Respiratory distress syndrome, newborn, Neonatal nursing, Blood gas analysis, Rehabilitation, Prognosis

中图分类号:

R473.72

王琳琳, 李虹, 张燕. 基于儿童早期预警评分的护理干预对新生儿呼吸窘迫综合征血气指标、康复进程及预后的影响[J]. 结核与肺部疾病杂志,2026, 7(5): 630-634. doi: 10.19983/j.issn.2096-8493.20260138

Wang Linlin, Li Hong, Zhang Yan. Effect of pediatric early warning score-based nursing intervention on blood gas parameters, rehabilitation progress, and prognosis in neonates with respiratory distress syndrome[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(5): 630-634. doi: 10.19983/j.issn.2096-8493.20260138

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组别	例数	性别[例(构成比,%)]		胎龄 (周,$\bar{x}±s$)	年龄 (d,$\bar{x}±s$)	体质量 (g,$\bar{x}±s$)
组别	例数	男性	女性	胎龄 (周,$\bar{x}±s$)	年龄 (d,$\bar{x}±s$)	体质量 (g,$\bar{x}±s$)
对照组	49	28(57.1)	21(42.9)	34.56±1.01	5.56±1.01	1425.83±10.07
观察组	49	25(51.0)	24(49.0)	34.59±1.03	5.59±1.04	1425.89±10.10
统计检验值		χ²=0.370		t=0.146	t=0.145	t=0.029
P值		0.543		0.885	0.885	0.977

组别	例数	PaCO₂(mmHg)		t值	P值	PaO₂(mmHg)		t值	P值	SaO₂(%)		t值	P值
组别	例数	护理前	护理后	t值	P值	护理前	护理后	t值	P值	护理前	护理后	t值	P值
对照组	49	61.18± 3.57	44.76± 3.23	23.875	<0.001	56.29± 5.71	75.54± 5.88	16.440	<0.001	82.09± 5.51	92.29± 3.31	11.108	<0.001
观察组	49	61.10± 3.49	40.28± 3.20	30.779	<0.001	56.34± 5.79	83.39± 5.90	22.906	<0.001	82.14± 5.73	95.14± 3.56	13.499	<0.001
t值		0.112	6.897			0.043	6.597			0.044	4.104
P值		0.911	<0.001			0.966	<0.001			0.965	<0.001

组别	例数	气胸	肺炎	肺出血	缺氧缺血性脑病	合计
对照组	49	4(8.2)	4(8.2)	3(6.1)	3(6.1)	14(28.6)
观察组	49	1(2.0)	1(2.0)	1(2.0)	1(2.0)	4(8.2)
χ²值		0.843	0.843	0.261	0.261	6.806
P值		0.168	0.168	0.307	0.307	0.009

组别	例数	非常满意	满意	不满意	总满意度
对照组	49	23(46.9)	18(36.8)	8(16.3)	41(83.7)
观察组	49	37(75.5)	10(20.4)	2(4.1)	47(95.9)
χ²值					4.009
P值					0.045

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