多维度护理模式对新生儿肺炎无创通气时长与鼻中隔皮肤压力性损伤的影响研究

doi:10.19983/j.issn.2096-8493.20250202

摘要/Abstract

摘要：

目的: 分析多维度护理模式对接受无创通气治疗的新生儿肺炎患儿缩短通气时长、降低鼻中隔皮肤压力性损伤发生率的临床效果。方法: 采用回顾性研究方法,参照入组标准选取2024年6—11月莆田市儿童医院收治的实施常规无创通气护理的61例新生儿肺炎患儿作为常规护理组,2024年12月至2025年7月收治的实施常规护理联合多维度护理模式的59例新生儿肺炎患儿作为多维度护理组。比较两组患儿的无创通气时长、鼻中隔皮肤压力性损伤发生率、住院时间、血气分析指标[包括动脉血氧分压(PaO₂)、氧合指数(PaO₂/FiO₂)、动脉血二氧化碳分压(PaCO₂)]的改善情况。结果: 护理干预后,多维度组的无创通气总时长[68.00(52.00, 89.50)h]和住院时间[(13.92±3.15)d]均明显短于常规组[分别为98.50(72.00, 124.30)h和(16.45±3.82)d],鼻中隔皮肤压力性损伤发生率[3.39%(2/59)]明显低于常规组[21.31%(13/61)],差异均有统计学意义(Z=-3.825,P<0.001;t=3.951,P<0.001;χ²=8.807,P=0.003)。多维度组的PaO₂和PaO₂/FiO₂水平[分别为(81.46±9.02)mmHg和(268.92±32.40)mmHg]均明显高于常规组[分别为(72.35±8.54)mmHg和(235.68±30.15)mmHg],PaCO₂水平[(40.05±4.87)mmHg]明显低于常规组[(45.18±5.23)mmHg],差异均有统计学意义(t=5.683、5.820、5.556,P值均<0.001)。结论: 对无创通气治疗的新生儿肺炎患儿实施多维度护理模式,能有效缩短通气时长和住院时间、显著降低鼻中隔皮肤压力性损伤的发生风险,并能更好地改善患儿氧合功能,是一种有效的临床护理策略。

关键词: 新生儿护理, 肺炎, 软组织损伤, 整体护理, 护理方法学研究

Abstract:

Objective: To analyze the clinical effects of multidimensional nursing mode on shortening ventilation duration and reducing the incidence of nasal septum pressure injuries in neonates with pneumonia receiving non-invasive ventilation (NIV). Methods: A retrospective study was conducted. Based on the inclusion criteria, 61 neonates with pneumonia who received routine NIV nursing at Putian Children’s Hospital from June to November 2024 were enrolled as the Routine Nursing Group, and another 59 neonates with pneumonia who received routine nursing combined with a multidimensional nursing mode from December 2024 to July 2025 were enrolled as the Multidimensional Nursing Group. The two groups were compared in terms of NIV duration, incidence of pressure injuries to the nasal septum skin, length of hospital stay, and improvements in blood gas analysis indicators (including arterial partial pressure of oxygen (PaO₂), oxygenation index (PaO₂/FiO₂), and arterial partial pressure of carbon dioxide (PaCO₂)). Results: After nursing intervention, the total NIV duration (68.00 (52.00, 89.50) h) and length of hospital stay ((13.92±3.15) d) in the Multidimensional Group was significantly shorter than those in the Routine Nursing Group (98.50 (72.00, 124.30) h and (16.45±3.82) d, respectively), and the incidence of nasal septum pressure injuries was significantly lower in the Multidimensional Group (3.39% (2/59) vs. 21.31% (13/61)), the differences were statistically significant (Z=-3.825, P<0.001; t=3.951, P<0.001; χ²=8.807, P=0.003). Furthermore, the levels of PaO₂ and PaO₂/FiO₂ in the Multidimensional Nursing Group ((81.46±9.02) mmHg and (268.92±32.40) mmHg, respectively) were significantly higher than those in the Routine Nursing Group ((72.35±8.54) mmHg and (235.68±30.15) mmHg), while the PaCO₂ level ((40.05±4.87) mmHg) was significantly lower than that in the Routine Nursing Group ((45.18±5.23) mmHg). All differences were statistically significant (t=5.683, 5.820, 5.556, respectively; all P<0.001). Conclusion: Implementing a multidimensional nursing mode in neonates with pneumonia undergoing NIV can effectively shorten ventilation duration, significantly reduce the risk of nasal septum pressure injuries, and better improve oxygenation function. Therefore, it is recommanded as an effective clinical nursing strategy.

Key words: Neonatal nursing, Pneumonia, Soft tissue injuries, Holistic nursing, Nursing methodology research

中图分类号:

R473.72

许晴, 马涵英, 邱悦. 多维度护理模式对新生儿肺炎无创通气时长与鼻中隔皮肤压力性损伤的影响研究[J]. 结核与肺部疾病杂志, 2026, 7(2): 239-243. doi: 10.19983/j.issn.2096-8493.20250202

Xu Qing, Ma Hanying, Qiu Yue. Impact of multidimensional nursing mode on ventilation duration and nasal septum pressure injury in neonates with pneumonia receiving non-invasive ventilation[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(2): 239-243. doi: 10.19983/j.issn.2096-8493.20250202

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参考文献 13

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组别	性别[例(构成比,%)]		胎龄 (周,$\overline{x}$±s)	出生体质量 (g,$\overline{x}$±s)	入院时出生日龄 (d,$\overline{x}$±s)	C-反应蛋白 (mg/L,$\overline{x}$±s)
组别	男婴	女婴	胎龄 (周,$\overline{x}$±s)	出生体质量 (g,$\overline{x}$±s)	入院时出生日龄 (d,$\overline{x}$±s)	C-反应蛋白 (mg/L,$\overline{x}$±s)
常规组(61例)	33(54.10)	28(45.90)	36.52±1.85	2856.45±512.33	5.82±3.15	12.61±5.32
多维度组(59例)	34(57.63)	25(42.37)	36.81±1.90	2910.20±498.76	5.51±2.94	11.95±4.84
统计检验值	χ²=0.151		t=0.847	t=0.581	t=0.557	t=0.710
P值	0.697		0.399	0.562	0.579	0.479

组别	无创通气总时长 [h,M(Q₁,Q₃)]	鼻中隔皮肤压力性损伤 [例(发生率,%)]	住院时间 (d,$\overline{x}$±s)
常规组(61例)	98.50(72.00,124.30)	13(21.31)	16.45±3.82
多维度组(59例)	68.00(52.00,89.50)	2(3.39)	13.92±3.15
统计检验值	Z=-3.825	χ²=8.807	t=3.951
P值	<0.001	0.003	<0.001

组别	PaO₂		PaO₂/FiO₂		PaCO₂
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
常规组(61例)	52.18±7.25	72.35±8.54	156.35±25.41	235.68±30.15	55.62±8.17	45.18±5.23
多维度组(59例)	53.02±6.88	81.46±9.02	159.80±23.96	268.92±32.40	54.33±7.85	40.05±4.87
t值	0.651	5.683	0.765	5.820	0.882	5.556
P值	0.517	<0.001	0.446	<0.001	0.380	<0.001

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