Novorojenček z nekrotizirajočim enterokolitisom : diplomsko delo

Tomšič, Taja (author), Bizjak, Martina (mentor), Kamenšek, Tina (co-mentor), Vettorazzi, Renata (reviewer)

Uvod: Nekrotizirajoči enterokolitis je kritično zdravstveno stanje, ki se v večini primerov pojavi pri nedonošenčkih. Je najpogostejša in najbolj smrtonosna bolezen gastrointestinalnega trakta pri nedonošenčkih. Razdelimo ga v pet faz s pomočjo modificirane Bellove lestvice. Simptomi in znaki zajemajo napet trebuh, krvavo blato, neprenašanje hrane, bradikardijo, apnejo, termolabilnost, ileus in prost zrak v želodcu in črevesju. Namen: V diplomskem delu želimo predstaviti nekrotizirajoči enterokolitis, opisati specifiko obravnave novorojenčkov z nekrotizirajočim enterokolitisom, predstaviti znanje, ki ga medicinska sestra potrebuje za optimalno zdravstveno nego novorojenčka z nekrotizirajočim enterokolitisom in predstaviti ugotovitve publikacij, ki so raziskovale preventivne ukrepe in dejavnike tveganja za nekrotizirajoči enterokolitis. Metode dela: Uporabljen je bil deskriptivni raziskovalni pristop s pregledom domače in tuje literature v slovenščini in v angleščini. Literatura je bila iskana v podatkovnih bazah Medline, Cinahl, DiKul, Pubmed in v spletnih portalih Google učenjak v času od februarja 2021 do novembra 2021. Uporabili smo 20 enot literature, na spletu dostopne članom Univerze v Ljubljani. Rezultati: Medicinske sestre morajo biti seznanjene z gastrointestinalnimi in sistemskimi znaki, preventivnim ukrepanjem in dejavniki tveganja za nekrotizirajoči enterokolitis. Večina raziskovalcev priznava nedonošenost in hranjenje z mlečno formulo kot dejavnike tveganja in preventivne strategije, kot so hranjenje izključno z materinim mlekom in uporabo standardiziranih načinov hranjenja. Nasprotujoča mnenja prevladujejo v povezavi z uporabo probiotikov in antibiotikov in aplikacijo transfuzije eritrocitov. Razprava in zaključek: Med preventivne ukrepe proti nekrotizirajočemu enterokolitisu uvrščamo hranjenje z materinim mlekom in uporabo standardiziranih režimov hranjenja, dejavniki tveganja pa predstavljajo nedonošenost, hranjenje z mlečno formulo. Nasprotujoča mnenja raziskovalcev se pojavijo na obeh področjih. Nekateri poudarijo tudi pomen komunikacije v interdisciplinarnem timu za zgodnje odkrivanje in zdravljenje nekrotizirajočega enterokolitisa. Nove raziskave potekajo na področju uporabe probiotikov, antenatalnih steroidov, imunoglobulinov in rastnih dejavnikov. Nekateri raziskovalci se osredotočajo tudi na posodobitev Bellove lestvice.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, nekrotizirajoči enterokolitis, vloga medicinske sestre, dejavniki tveganja, preventivno ukrepanje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Tomšič]
• Year: 2022
• Number of pages: 45 str.
• PID: 20.500.12556/RUL-135407
• UDC: 616-083
• COBISS.SI-ID: 100675843
• Publication date in RUL: 11.03.2022

Secondary language

• Language: English
• Title: Newborn infant with necrotizing enterocolitis : diploma work

Abstract

Introduction: Necrotizing enterocolitis is a critical health status, which mostly occurs in premature infants. It is recognized as the most common and deadly gastrointestinal disease in preterm infants. Necrotizing enterocolitis can be divided in five stages of the disease according to modified Bell staging criteria. Symptoms and signs include abdominal distention, bloody stool, food intolerance, bradycardia, apnea, temperature instability, signs of ileus and free gas in the abdomen and intestine. Purpose: The purpose is to present necrotizing enterocolitis and its treatment, to present knowledge, necessary for nurses taking care for newborns with necrotizing enterocolitis and to present findings of published articles, researching reventive strategies and risk factors of necrotizing enterocolitis. Methods: A descriptive research approach was used to review literature written in Slovene and English. Literature was searched by Medline, Cinahl, Dikul, Pubmed and Google Schoolar from February 2021 to November 2021. We used 20 units of literature, fully available online to members of University Ljubljana. Results: Nurses need to be aware of gastrointestinal and systemic signs, preventive strategies and risk factors regarding necrotising enterocolitis. Most researchers consider immaturity and formula feeding as risk factors and breast milk feeding and use of standardized feeding regimens as preventice strategies. However researchers dissagree on some risk factors and preventive strategies such as use of probiotics, antibiotics and red blood cell transfusion. Discussion and conclusion: Preventive strategies against necrotizing enterocolitis include breast milk feeding and implementation of standardised feeding regimens, however scientist have different opinions regarding use of probiotics. Risk factors include prematurity and formula feeding. Scientist have yet again contradictive views about red blood cell transfusion, maternal smoking, advancment of enteral feeding and congenital heart diseases. Some also emphasize the meaning of communication in interdisciplinary team for early recognition and treatment of necrotizing enterocolitis. New studies are centred towards the use of probiotics, antenetal steroids, immunoglobulin and growth factors as preventive strategies. Some also give consideration to modifying Bell staging criteria or even replacing it.

• Keywords: diploma theses, nursing care, necrotizing enterocolitis, nursing role, risk factors, prevention