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題名 | 物理治療對新生兒加護病房中早產兒的早期介入治療--臺北榮民總醫院早期介入治療之病例報告 |
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作者 | 白偉男; | 書刊名 | 中華民國物理治療學會雜誌 |
卷期 | 16:1 1991.03[民80.03] |
頁次 | 頁80-89 |
分類號 | 417.5171 |
關鍵詞 | 早產兒; 早期介入治療; 物理治療; |
語文 | 中文(Chinese) |
中文摘要 | 近二十年來,早產兒照護之進步使其死亡率和罹病率都有明顯之下降。 目前早產兒死亡的主要原因是呼吸衰竭。而口腔動作和感覺動作協調不良也是常 見的問題。 物理治療師儘早在新生兒加護病房中介入治療的目的,便是在協助上述問題之處 理。早期介入治療的項目包含有胸腔物理治療,口腔動作和感覺動作之刺激。當 早產兒轉至新生兒病房後,上述之治療計劃仍繼續進行。出院前則必須對父母作 詳細之衛教。 胸腔物理治療的項目有:擺位、姿位引流、拍擊振動手法和呼吸運動,其目的是 緩解胸腔症狀,協助減少呼吸器協助而至獨立呼吸之過程,以及拔管前後之處理。 口腔動作之檢查包含了影響其控制能力的一些機制。如果有進食問題時,將教導 護士及家長,以正確的抱持姿勢,口腔週圍或內部之刺激手法,來改善餵食問題。 感覺動作之刺激包含了穩定的觸覺刺激,有規律的搖動,正確的擺位等,以增加 情緒行為的控制能力,進而加速感覺動作之發展。 筆者將介紹如何組成早期介入治療計劃的團隊,建立治療計劃之步驟,選取病患 之標準,初次治療的時機,治療的禁忌症和應特別注意的情況。詳細的治療手法, 則在一位有呼吸窘迫症候群的早產兒病例中討論。 最後,筆者提供讀者一些實際的建議,以利早期介入治療計劃的實施。 |
英文摘要 | The mortality and morbidity of the prematurely born infants have been significantly reduced within the past two decades due to theimprovement of neonatal care. Presently, theleading mortality cause of prematurlely borninfants is respiratory failure. Oral-motor, Sensory-motor dysfunctions are common problemsin the prematurely born population. The physical therapy intervention in theneonatoal intensive care unit intended to manage these dysfunctions as early as possible. Theearly intervention program includes chest physical therapy progrem, oral-motor stimulation andsensory-motor stimulation. The program shouldbe continued after the prematurely born infantis transferred to new-born room (NBR). Later,a detailed discharge plan should be given toparents. Chest physical therapy program incoporatespositioning, postural drainage, percusion, vibration and breathing exercises. The programis aimed to relieve acute pulmonary symptoms,and to assist weaning process, preextubalion,postextubation management. Oral-motor evaluation should examine theunderlying mechanism of sound oral-motor control. If difficulties present in oral-motorfunction, proper carrying posture for feeding,perioral, intraoral stimulation techniques aretaught. Sensory-motor program includes deep andfirm tactile stimulation, rhythmical rocking,proper positioning to promote state controlbehavior and to accelerate sensory-motor development. Discharge plan includes semierect positonto reduce respiratory distress. Flexed carryingposture and head position to provide properfeeding position and to reduce overactive extensor tone. Tactile, proprioceptive and vestibular stimulations are provided to facilitate sensory-motor development. The organization of the early interventionteam, procedures to set up this program, criteria for referral, timing to initiate treatment,contraindications and precautions for intervention are presented. Detailed treatment techniques are presented regarding a prematurelyborn infant with respiratory distress syndrome. Finally, some practical suggestions are provided for the readers to set up an early intervention program. (JPTA ROC 1990; 3: 80-89) |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。