基于移动医疗APP营养管理干预策略对早产儿出院后营养状况及体格发育的作用

Role of nutrition intervention strategy based on mobile medical APP on nutritional status and physical development of premature infants after discharge from hospital

目的探讨基于移动医疗APP营养管理干预策略对早产儿出院后营养状况及体格发育的作用。方法选取2018年1月至2020年12月,南宁市第二人民医院与广州医科大学附属深圳沙井医院新生儿病房收治的60例早产儿为研究对象。采用随机数字表法,将其分为研究组(n=30)与对照组(n=30)。对2组早产儿,分别采用基于移动医疗APP、常规电话随访策略进行出院后营养管理干预,并随访6个月。采用成组t检验、χ^(2)检验,对2组早产儿生长发育指标、《小儿智能发育检查表》评分、生化指标、疾病发生率进行统计学比较。2组早产儿性别构成比、出生胎龄、出生体重等一般临床资料比较,差异均无统计学意义(P>0.05)。本研究遵循的程序经过南宁市第二人民医院医学伦理委员会批准(审批文号:20180108),与纳入研究早产儿监护人均签署临床研究知情同意书。结果①干预后研究组早产儿身高、头围、体重分别为(66.7±6.4)cm、(7.7±2.2)kg、(42.0±3.4)cm,均显著优于对照组的(60.3±5.3)cm、(7.0±1.5)kg、(39.2±2.5)cm,并且差异均有统计学意义(t=4.187、P<0.001,t=2.291、P=0.029,t=3.575、P<0.001)。②干预后,研究组早产儿《智能量表》与《运动量表》评分分别为(91.1±10.4)分、(48.6±5.2)分,均显著高于对照组的(78.2±8.2)分、(42.3±4.1)分,并且差异均有统计学意义(t=5.287、5.235,P<0.001)。③干预后,研究组早产儿血清前白蛋白(PA)、视黄醇结合蛋白(RBP)水平分别为(136.1±8.5)mg/L、(140.7±16.9)mg/L,均显著高于对照组的(120.3±7.0)mg/L、(126.6±14.3)mg/L,并且差异均有统计学意义(t=7.808、3.498,P<0.001)。④研究组早产儿疾病发生率为10.0%(3/30),显著低于对照组的36.7%(11/30),并且差异有统计学意义(χ^(2)=5.583、P=0.016)。结论对早产儿采取基于移动医疗APP营养管理干预策略,可显著提高早产儿出院后营养状况,促进其生长发育,减少早产儿疾病发生,进而提高其生存质量。

Objective To investigate the role of nutrition intervention strategies based on mobile medical APP on nutritional status and physical development of premature infants after discharge from hospital.Methods A total of 60 premature infants in neonatal ward of Second Nanning People′s Hospital and Shenzhen Shajing Hospital Affiliated to Guangzhou Medical University from January 2018 to December 2020 were selected as research subjects.They were divided into study group(n=30)and control group(n=30)by random digits table method.Premature infants in study group received nutrition intervention strategy by mobile medical APP for 6 months,while premature infants in control group received routine follow-up by phone call for 6 months.The growth and development indicators of premature infants,score of Children′s Developmental Checklist,biochemical indicators,and incidence of neonatal diseases were compared between two groups by independent-samples t test and chi-square test.There were no statistically significant differences between two groups in general clinical data such as gender composition ratio,gestational age at birth,and birth weight(P>0.05).This study was approved by the Medical Ethics Committee of Second Nanning People′s Hospital(approval No.20180108),and each guardian of premature infants signed an informed consent form for clinical research.Results①After intervention,body length,head circumference and body weight of premature infants in study group were(66.7±6.4)cm,(7.7±2.2)kg,(42.0±3.4)cm respectively,which were all better than those(60.3±5.3)cm in control group,(7.0±1.5)kg,(39.2±2.5)cm in control group,and all differences were statistically significant(t=4.187,P<0.001;t=2.291,P=0.029;t=3.575,P<0.001).②After intervention,scores of Intelligence Scale and Exercise Scale in study group were(91.1±10.4)scores and(48.6±5.2)scores,which were higher than those(78.2±8.2)scores,(42.3±4.1)scores in control group,and both differences were statistically significant(t=5.287,5.235;P<0.001).③After intervention,levels of serum pre-albumin(PA)and retinol-binding proteins(RBP)in study group were(136.1±8.5)mg/L,(140.7±16.9)mg/L respectively,which were significantly higher than those(120.3±7.0)mg/L,(126.6±14.3)mg/L in control group,and both differences were statistically significant(t=7.808,3.498;P<0.001).④The incidence of disease in study group was 10.0%(3/30),which was significantly lower than that 36.7%(11/30)in control group,and the difference was statistically significant(χ^(2)=5.583,P=0.016).Conclusions Nutrition intervention strategy based on mobile medical APP can significantly improve nutritional status of premature infants after discharge from hospital,promote their growth and development,reduce incidence of neonatal diseases,and improve their quality of life.