月嫂必知:早产儿的6大症状和6个护理关键，越早知道越好……
<div class="wx_rich_media_content" id="jsWxContainer"><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿是指出生时胎龄＜37周的新生儿。</span></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产宝宝没有等到日子就从妈妈的肚子里出来了，由于提前出生，组织器官还没有来得及发育成熟，所以我们要格外重视。</span></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">护理的重点是先根据早产儿的生理特点，观察孩子有无异常表现，及时发现发生的疾病，以做到及时处理。<br></span></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></p><p style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span class="wxart_image" wx-style="display:inline-block;width: 578px;height: auto !important;"></span></p><p style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></p><section data-mpa-template="t" mpa-from-tpl="t"><section style="padding: 10px;margin-left: 16px;margin-right: 16px;line-height: 1.75em;"><section style="display:flex;display:-webkit-flex;justify-content:center;-webkit-justify-content:center;" mpa-from-tpl="t"><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section><section style="padding-right: 15px; padding-left: 15px; border-bottom: 1px solid rgb(153, 153, 153); border-top: 1px solid rgb(153, 153, 153); height: 35px; line-height: 35px;" mpa-from-tpl="t"><span style="color: rgb(255, 0, 157);letter-spacing: 0.5px;"><strong>早产儿特点</strong></span></section><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section></section></section></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;color: rgb(255, 0, 157);"><strong>1．外表早产儿 </strong><br></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿体重大多在2500g以下，身长不到47cm。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">且哭声轻，颈肌软弱，四肢肌张力低下，皮肤红嫩，胎毛多，耳壳软，乳晕不清，足底纹少。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">男宝宝的睾丸未降或未全降，女宝宝则大阴唇不能盖住小阴唇。<br data-filtered="filtered"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);"><strong>2．呼吸早产儿 </strong></span></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿呼吸中枢相对不成熟，而且呼吸不规则；常发生呼吸暂停。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;"><strong>呼吸暂停：</strong>指呼吸停止时间达15～20秒，或虽不到15秒，但伴有心率减慢(＜100次／分)和出现紫绀。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿的肺发育不成熟，导致表面活性物质少，所以极易发生肺透明膜病。若有宫内窘迫史的早产儿，则很容易发生吸入性肺炎。<br data-filtered="filtered"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);"><strong>3．消化早产儿 </strong></span></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿吞咽反射弱，很容易呛乳而发生窒息或者是吸入性肺炎。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">所以早产儿最好以母乳喂养为宜。而早产儿易发生坏死性小肠炎，这时，我们就要注意乳汁的渗透压。<br data-filtered="filtered"><br data-filtered="filtered">因为早产儿的肝不成熟，所以生理性黄疸病情较重，且持续时间长，还容易引起核黄疸。而且早产儿肝功能不完善，极易发生出血症。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span class="wxart_image" wx-style="display:inline-block;width: 578px;height: auto !important;"></span></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;"><strong><span style="color: rgb(255, 0, 157);">4．神经 </span></strong><br></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">神经系统的功能和胎龄有密切关系，胎龄越小，反射越差。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿易发生缺氧，导致缺氧缺血性脑病。此外，由于早产儿脑室管膜下存在一些发达的胚胎生发层组织，所以，会导致颅内出血。<br data-filtered="filtered"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);"><strong>5．体温 </strong></span></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿的体温调节功能很差，而且基础代谢低，再加上体表面积相对大，皮下脂肪少，易散热，汗腺发育不成熟和缺乏寒冷发抖反应。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">因此，早产儿的体温易随环境温度变化而变化。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);letter-spacing: 0.5px;"><strong>6．其他 </strong></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿还易发生高血糖、贫血和严重感染。<br data-filtered="filtered"></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span class="wxart_image" wx-style="display:inline-block;width: 100%;height: auto !important;"></span></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section data-mpa-template="t" mpa-from-tpl="t"><section style="padding: 10px;margin-left: 16px;margin-right: 16px;line-height: 1.75em;"><section style="display:flex;display:-webkit-flex;justify-content:center;-webkit-justify-content:center;" mpa-from-tpl="t"><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section><section style="padding-right: 15px; padding-left: 15px; border-bottom: 1px solid rgb(153, 153, 153); border-top: 1px solid rgb(153, 153, 153); height: 35px; line-height: 35px;" mpa-from-tpl="t"><span style="color: rgb(255, 0, 157); letter-spacing: 0.5px;"><strong>常见护理诊断</strong></span></section><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section></section></section></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">1．体温过低与体温调节功能差，产热贮备力不足有关。<br data-filtered="filtered"><br data-filtered="filtered">2. 营养失调，低于机体需要量与摄入不足及消化吸收功能差有关。<br data-filtered="filtered"><br data-filtered="filtered">3．有感染危险 与免疫功能不足有关。<br data-filtered="filtered"><br data-filtered="filtered">4．不能维持自主呼吸与呼吸器官发育不成熟有关。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br data-filtered="filtered"><span class="wxart_image" wx-style="display:inline-block;text-align: center;white-space: normal;width: 578px;height: auto !important;"></span><br mpa-from-tpl="t"></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section data-mpa-template="t" mpa-from-tpl="t"><section style="padding: 10px;margin-left: 16px;margin-right: 16px;line-height: 1.75em;"><section style="display:flex;display:-webkit-flex;justify-content:center;-webkit-justify-content:center;" mpa-from-tpl="t"><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section><section style="padding-right: 15px; padding-left: 15px; border-bottom: 1px solid rgb(153, 153, 153); border-top: 1px solid rgb(153, 153, 153); height: 35px; line-height: 35px;" mpa-from-tpl="t"><span style="color: rgb(255, 0, 157);letter-spacing: 0.5px;"><strong><span style="font-size: 17px;">早产儿护理措施</span></strong></span></section><section style="width:14.4px;" mpa-from-tpl="t"><span class="wxart_image" wx-style="display:inline-block;width: 100%;display: block;height: auto !important;"></span></section></section></section></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;"><span style="color: rgb(255, 0, 157);"><strong>1．早产儿室</strong></span><strong> </strong><br></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">除了足月宝宝的所有配备下，还应建议家长配备婴儿培养箱、远红外保暖床、微量输液泵、吸引器和复苏囊等设备。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">还要加强早产儿的护理管理，最好开展系统化整体护理。<br data-filtered="filtered"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);"><strong>2．维持体温稳定 </strong></span></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿体温中枢发育不完善，所以体温不稳定，但大多数为体温低下。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">因此，早产儿室的温度应保持在24℃～26℃，晨间护理时提高到27℃～28℃，相对湿度55％～65％。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">还应该根据早产儿的体重、成熟度及病情，给予不同的保暖措施，加强体温监测，每日2～4次。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">一般早产儿体重小于2000g者，我们应尽提前给婴儿培养箱保暖。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">若体重大于2000g，我们可以在箱外保暖者，还可以给宝宝戴绒布帽，以降低耗氧量和散热量。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">如有其他必要操作时，我们可以在远红外辐射床保暖下进行，没有条件的家庭，则因地制宜，采取简易保暖方法，并尽量缩短操作时间。<br data-filtered="filtered"></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span class="wxart_image" wx-style="display:inline-block;width: 578px;height: auto !important;"></span></section><section style="text-align: center; margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;color: rgb(255, 0, 157);"><strong>3．合理喂养 </strong><br></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿各种消化酶不足，所以导致消化吸收能力差，但生长发育所需营养物质多。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">因此，早产儿最好母乳喂养，若宝妈无法母乳喂养，我们应该采用早产儿配方乳。喂乳量也要根据早产儿耐受力而定。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">如果宝宝吸吮能力不强，我们可以采用滴管、胃管喂养和补充静脉高营养液。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">我们还要每天详细记录出入量、准确磅体重，以便让医生分析及时调整补充营养。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿易缺乏维生素K，所以出生后应补充维生素 K1，预防出血症。除此之外，还应补充维生素A、C．D、E和铁剂等物质。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);letter-spacing: 0.5px;"><strong>4. 预防感染 </strong></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿的抵抗力比足月儿更低，所以对于消毒隔离的要求更高。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">因此，我们更应加强口腔、皮肤及脐部的护理，发现微小病灶都应及时处理。经常更换体位，以防发生肺炎。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">严禁多人看望宝宝，而且再事后还要及时进行空气及有关用品消毒，确保空气及仪器物品洁净，防止交叉感染。<br data-filtered="filtered"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);"><strong>5．维持有效呼吸 </strong></span></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">早产儿易发生缺氧和呼吸暂停。如果缺氧要及时通知医生。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br data-filtered="filtered"><span style="color: rgb(255, 0, 157);letter-spacing: 0.5px;"><strong>6．密切观察病情 </strong></span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">由于早产儿各系统器官发育不成熟，其功能不完善，我们要具备高度的责任感与娴熟的业务技能，加强巡视，密切观察病情变化。</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><br></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">如发现以下情况，应及时报告医师，并协助查找原因，迅速处理：</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">①体温不正常；</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">②呼吸不规则或呻吟；</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">③面部或全身青紫(或苍白)；</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">④烦躁不安或反应低下；</span></section><section style="margin-left: 16px; margin-right: 16px; line-height: 1.75em;"><span style="letter-spacing: 0.5px;">⑤惊厥；早期或重度黄值；食欲差、呕吐、腹泻、腹胀、出生3天后仍有黑便；硬肿症；出血症状；24小时仍无大小便。</span></section></div><p></p> {:6_306:} 点赞 {:4_141:} 不错
页:
[1]