基于最佳证据的早产儿喂养护理实践

Practice of feeding strategies for preterm infants based on the best evidence

目的基于最佳证据建立早产儿喂养护理方案,探讨其临床应用效果。方法遵循JBI循证卫生保健模式,获得早产儿喂养的最佳证据。将2019年1~3月住院早产儿96例列入对照组,2019年5~7月住院早产儿129例列入观察组。对照组按常规喂养护理;观察组实施基于最佳证据的早产儿喂养护理方案。统计住院期间母乳喂养率、早产儿喂养不耐受发生率、开始经口喂养时间、达到全胃肠喂养时间、住院时间。结果观察组母乳喂养率显著高于对照组,早产儿喂养不耐受发生率显著低于对照组,住院时间显著短于对照组(P<0.05,P<0.01);两组早产儿开始经口喂养时间、达到全胃肠喂养时间比较,差异无统计学意义(均P>0.05)。结论对早产儿实施基于最佳证据的早产儿喂养护理方案,可规范护士喂养行为,提高母乳喂养率,降低早产儿喂养不耐受发生率,提升早产儿护理质量。

Objective To establish a feeding program for preterm infants based on the best evidence,and to explore its clinical application effect.Methods According to the standard procedures of JBI Model of Evidence Based Healthcare,the best evidence of feeding strategies for preterm infants was obtained.Then the 96 preterm infants admitted to hospital from January to March 2019 were taken as a control group,and the 129 preterm infants admitted to hospital from May to July 2019 were regarded as an intervention group.The control group received routine feeding care,while the intervention group received the feeding strategies for preterm infants based on the best evidence.The rate of breast-feeding during hospitalization,the incidence of feeding intolerance,the time of starting oral feeding,the time of full enteral feeding and the length of hospitalization were observed.Results The rate of breast-feeding in the intervention group was significantly higher than that of the control group,incidence of feeding intolerance was significantly lower than that of the control group,and length of hospitalization was significantly shorter than that of the control group(P<0.05,P<0.01).There were no significant differences in the time of starting oral feeding and reaching full enteral feeding between the two groups(P>0.05 for both).Conclusion Practice of feeding strategies for preterm infants based on the best evidence,could standardize nurses′feeding behavior,increase the rate of breast-feeding,and reduce the incidence of feeding intolerance,then improve the nursing quality for preterm infants.