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间歇性袋鼠式护理在极低出生体重早产儿中的临床应用探讨

Discussion of the clinical application of intermittent Kangaroo mother care in very low birth weight preterm infants

  • 摘要: 目的 探讨实施间歇性袋鼠式护理对极低出生体重早产儿的安全性和有效性。方法 回顾性分析2015年1月-2016年12月在广东省妇幼保健院出生的极低出生体重早产儿临床资料,按是否接受过袋鼠式护理分为袋鼠式护理(KMC)组和对照组。比较两组患儿院内感染率(院感率)、抗生素使用时间、坏死性小肠结肠炎(NEC)、早产儿视网膜病(ROP)、颅内出血(IVH)、脑室周围白质软化(PVL)、支气管肺发育不良(BPD)的发生率、平均每日体重增长率、达到全量喂养日龄、总用氧时间、住院费用和天数的差异。另外,比较两组患儿出生14天后死亡率和放弃救治率的差异。结果 共纳入65名患儿。除去出生14天后死亡3例,放弃救治10例,KMC组25例,对照组27例。两组患儿院感率、抗生素使用天数、NEC、ROP、IVH、PVL、BPD的发生率,以及平均每日体重增长率比较差异均无统计学意义(P>0.05)。同时两组患儿达到全量喂养日龄、总用氧时间、住院费用和住院天数差异也均无统计学意义(P>0.05)。两组患儿在出生14天后的死亡率差异无统计学意义(P>0.05),但出生14天后对照组家属放弃救治率明显高于KMC组(P <0.05)。结论 实施间歇性袋鼠式护理对于极低出生体重早产儿是安全的,不会增加院感发生,且能降低患儿住院期间放弃救治率。间歇性袋鼠式护理是否对极低出生体重早产儿有更好的治疗效果还需研究验证。

     

    Abstract: Objective To discuss the safety and effectiveness of applying intermittent kangaroo mother care for very low birth weight preterm infants.Methods Clinical data of very low birth weight preterm infants born from January 2015 to December 2016 were analyzed retrospectively. Subjects were divided into Kangaroo Mother Care (KMC) group and control group based on whether accepting kangaroo mother care. Nosocomial infection, antibiotics therapy time, the incidence of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), daily weight gain, age of total oral feeding, oxygen therapy time, costs and days of hospitalization were compared between two groups. Mortality and abandon rate after 14 days of delivery were also compared between two groups. Result 65 subjects were enrolled in this study. Among them there were 3 cases of death and 10 cases of being abandoned by parents after 14 days of delivery. There were 25 cases in KMC group and 27 cases in control group finally. There were no statistical differences in nosocomial infection, antibiotics therapy time, the incidence of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), and daily weight gain between the two groups (P>0.05). There were also no statistical differences in age of total oral feeding, oxygen therapy time, costs and days of hospitalization between the two groups (P>0.05). Although there was no difference in mortality after 14 days of delivery (P>0.05), the abandon rate after 14 days of delivery of control group was significantly higher than KMC group (P<0.05).Conclusion Intermittent kangaroo mother care is safe. It will not increase the incidence of nosocomial infection. It can reduce the abandon rate for hospitalized of very low birth weight preterm infants. Whether the intermittent kangaroo mother care is effective to VLBW preterm infants remains to be verified by further studies.

     

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