集束化护理联合持续母乳喂养管理在提高极低和超低出生体质量儿母乳喂养率中的应用
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摘要
目的探讨新集束化护理联合持续母乳喂养管理在提高极低和超低出生体质量儿母乳喂养率中的应用价值。方法选取2013年1月—12月中山市博爱医院收治的极低和超低出生体质量儿66例为对照组,选取2017年1月—12月收治的极低和超低出生体质量儿82例作为观察组。对照组行常规护理及间断母乳喂养,观察组则采用集束化护理联合持续母乳喂养管理。记录2组低体质量新生儿母乳喂养情况、坏死性小肠结肠炎(NEC)发生率和出院后6个月婴儿生长发育情况。结果观察组新生儿喂养耐受率及持续母乳喂养率均高于对照组(P<0.01),NEC发生率明显低于对照组(P<0.05)。6个月后随访调查结果显示,观察组婴儿体质量、身高、头围等发育情况均优于对照组(P<0.05)。结论给予极低和超低出生体质量儿集束化护理联合持续母乳喂养,能提高新生儿母乳耐受性和母乳喂养率,对促进其生长发育具有积极作用。
Objective To investigate the application value of care bundles combined with continuous exclusive breastfeeding in improving the breastfeeding rate in very and extremely low birth weight(VLBW/ELBW) infants. Methods Totally 66 VLBW/ELBW infants were included as the control group between January and December 2013, another 66 VLBW/ELBW infants were included as the observation group between January and December 2017. Routine care and intermittent breastfeeding were adopted in the control group, and the care bundles combined with continuous exclusive breastfeeding were carried out in the observation group. The breastfeeding rate, incidence of necrotizing enterocolitis(NEC) and growth condition 6 months after discharge from hospital were compared between two groups. Results The rates of breastfeeding tolerance and successful breastfeeding in the observation group were higher than those in the control group(P<0.01). The incidence of NEC in the observation group was lower than that in the control group(P<0.05). After six-month follow-up, infants in the observation group had a better growth in bodyweight, height and head circumference compared with those in the control group(P<0.05). Conclusion The care bundles combined with continuous exclusive breastfeeding are effective to improve the breastfeeding tolerance and successful breastfeeding in VLBW/ELBW infants.
Objective To investigate the application value of care bundles combined with continuous exclusive breastfeeding in improving the breastfeeding rate in very and extremely low birth weight(VLBW/ELBW) infants. Methods Totally 66 VLBW/ELBW infants were included as the control group between January and December 2013, another 66 VLBW/ELBW infants were included as the observation group between January and December 2017. Routine care and intermittent breastfeeding were adopted in the control group, and the care bundles combined with continuous exclusive breastfeeding were carried out in the observation group. The breastfeeding rate, incidence of necrotizing enterocolitis(NEC) and growth condition 6 months after discharge from hospital were compared between two groups. Results The rates of breastfeeding tolerance and successful breastfeeding in the observation group were higher than those in the control group(P<0.01). The incidence of NEC in the observation group was lower than that in the control group(P<0.05). After six-month follow-up, infants in the observation group had a better growth in bodyweight, height and head circumference compared with those in the control group(P<0.05). Conclusion The care bundles combined with continuous exclusive breastfeeding are effective to improve the breastfeeding tolerance and successful breastfeeding in VLBW/ELBW infants.
引文
[1] 任素英, 于晔, 甘雨霞, 等. 住院早产儿母乳喂养集束化管理效果探讨[J]. 护理研究, 2018, 32(2): 283-285.
[2] YUAN SONG, YA LIU, YUN PAN, et al. The effect of long chain polyunsaturated fatty acid supplementation on intelligence in low birth weight infant during lactation: A meta-analysis[J]. PLoS One, 2018, 13(4): e0195662.
[3] 刘凤, 韩树萍, 余章斌, 等. 母乳喂养质量改进对极低和超低出生体重儿亲母母乳喂养率的影响[J]. 中国当代儿科杂志, 2016, 18(10): 937-942.
[4] 张翠凤, 武玲. 采集母乳在 NICU 中的实施及对极低出生体重儿的影响[J]. 护士进修杂志, 2016, 31(4): 304-306.
[5] 任素英, 于晔, 甘雨霞, 等. 住院早产儿母乳喂养集束化管理效果探讨[J]. 护理研究, 2018, 32(2): 283-285.
[6] 黄永文, 张枫, 刘燕, 等. 实用临床儿科学[M]. 天津: 天津科学技术出版社, 2011.
[7] 张李霞, 陈泳涛, 符茵, 等. 强化母乳喂养在预防极低出生体重儿感染中的作用[J]. 中国儿童保健杂志, 2017, 25(2): 161-164.
[8] 张方平. 微生态制剂联合母乳喂养治疗极低出生体重儿喂养不耐受的临床效果[J]. 中国妇幼保健, 2018, 33(11): 2472-2474.
[9] 陈小慧, 余章斌, 韩树萍. 捐献母乳与配方奶喂养对极低、超低出生体质量儿的影响[J]. 中华实用儿科临床杂志, 2016, 31(19): 1464-1467.
[10] 郑华蓉, 蔡燕, 周红, 等. 应用程序化护理干预提高早产与极低出生体质量儿母乳喂养率的研究[J]. 中国护理管理, 2018, 18(2): 264-267.
[11] 尹燕, 黄兴楚, 谢化胜, 等. 母乳喂养预防极低出生体重儿坏死性小肠结肠炎作用分析[J]. 解放军医药杂志, 2017, 29(9): 103-105.
[12] LEMAS D J, YEE S, CACHO N, et al. Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity[J]. Semin Fetal Neonatal Med, 2016, 21(6): 406-409.
[13] Kate Jolly, Jenny Ingram, Joanne Clarke, et al. Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA)[J]. BMJ Open, 2018, 8(1): e019142.
[14] 蒋秋静, 肖年, 杨莉, 等. 重庆市贫困地区6～24月龄儿童营养及喂养现状调查[J]. 中国儿童保健杂志, 2017, 25(1): 97-99.
[15] GINOVART G, GICH I, GUTI RREZ A, et al. A Fortified Donor Milk Policy is Associated With Improved In-Hospital Head Growth and Weight Gain in Very Low-Birth-Weight Infants[J]. Adv Neonatal Care, 2017, 17(4): 250-257.
[16] 张琼, 高喜容, 庄严, 等. 不同喂养方式对极低出生体重儿临床预后的影响及其随访观察[J]. 中国医师杂志, 2016, 18(7): 1050-1053.
[2] YUAN SONG, YA LIU, YUN PAN, et al. The effect of long chain polyunsaturated fatty acid supplementation on intelligence in low birth weight infant during lactation: A meta-analysis[J]. PLoS One, 2018, 13(4): e0195662.
[3] 刘凤, 韩树萍, 余章斌, 等. 母乳喂养质量改进对极低和超低出生体重儿亲母母乳喂养率的影响[J]. 中国当代儿科杂志, 2016, 18(10): 937-942.
[4] 张翠凤, 武玲. 采集母乳在 NICU 中的实施及对极低出生体重儿的影响[J]. 护士进修杂志, 2016, 31(4): 304-306.
[5] 任素英, 于晔, 甘雨霞, 等. 住院早产儿母乳喂养集束化管理效果探讨[J]. 护理研究, 2018, 32(2): 283-285.
[6] 黄永文, 张枫, 刘燕, 等. 实用临床儿科学[M]. 天津: 天津科学技术出版社, 2011.
[7] 张李霞, 陈泳涛, 符茵, 等. 强化母乳喂养在预防极低出生体重儿感染中的作用[J]. 中国儿童保健杂志, 2017, 25(2): 161-164.
[8] 张方平. 微生态制剂联合母乳喂养治疗极低出生体重儿喂养不耐受的临床效果[J]. 中国妇幼保健, 2018, 33(11): 2472-2474.
[9] 陈小慧, 余章斌, 韩树萍. 捐献母乳与配方奶喂养对极低、超低出生体质量儿的影响[J]. 中华实用儿科临床杂志, 2016, 31(19): 1464-1467.
[10] 郑华蓉, 蔡燕, 周红, 等. 应用程序化护理干预提高早产与极低出生体质量儿母乳喂养率的研究[J]. 中国护理管理, 2018, 18(2): 264-267.
[11] 尹燕, 黄兴楚, 谢化胜, 等. 母乳喂养预防极低出生体重儿坏死性小肠结肠炎作用分析[J]. 解放军医药杂志, 2017, 29(9): 103-105.
[12] LEMAS D J, YEE S, CACHO N, et al. Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity[J]. Semin Fetal Neonatal Med, 2016, 21(6): 406-409.
[13] Kate Jolly, Jenny Ingram, Joanne Clarke, et al. Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA)[J]. BMJ Open, 2018, 8(1): e019142.
[14] 蒋秋静, 肖年, 杨莉, 等. 重庆市贫困地区6～24月龄儿童营养及喂养现状调查[J]. 中国儿童保健杂志, 2017, 25(1): 97-99.
[15] GINOVART G, GICH I, GUTI RREZ A, et al. A Fortified Donor Milk Policy is Associated With Improved In-Hospital Head Growth and Weight Gain in Very Low-Birth-Weight Infants[J]. Adv Neonatal Care, 2017, 17(4): 250-257.
[16] 张琼, 高喜容, 庄严, 等. 不同喂养方式对极低出生体重儿临床预后的影响及其随访观察[J]. 中国医师杂志, 2016, 18(7): 1050-1053.
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