母乳喂养质量改进在NICU极低出生体重儿中的应用

Application of breastfeeding quality improvement in very low birth weight infants in NICU

目的 探讨母乳喂养质量改进对新生儿重症监护室(NICU)极低出生体重儿的影响。方法 选取2021年1月1日—2021年12月31日南京市妇幼保健院NICU收治的70例极低出生体重儿(VLBWI)作为研究对象,按组间基线资料均衡可比的原则分为观察组和对照组,每组35例。对照组采取常规母乳喂养管理和宣教方式,观察组在常规母乳喂养管理的基础上通过增设人力资源、完善管理制度、加强医务人员培训、加大产妇及家属的宣教力度及加强院感监测共五个方面进行母乳喂养质量改进,比较两组VLBWI住院期间母乳喂养情况、生长发育情况、静脉营养时长、住院时长及并发症发生情况。结果 两组一般资料比较差异无统计学意义(P>0.05),观察组首次亲母母乳喂养时间、恢复出生体质量时间较对照组提前,住院期间纯母乳喂养率、体质量增长速率较对照组有所提升,静脉营养持续时间及总住院时长较对照组有所缩短,喂养不耐受、坏死性小肠结肠炎(NEC)、支气管肺发育不良(BPD)及视网膜病变(ROP)并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论 母乳喂养质量改进措施可提升NICU住院VLBWI纯母乳喂养率,促进其体质量的增长,缩短静脉营养持续时间及总住院时长,减少相关并发症的发生率。

Objective To investigate the effect of breastfeeding quality improvement on very low birth weight infants(VLBWI)in neonatal intensive care unit(NICU).Methods To select 70 cases of VLBWI admitted to the NICU of Nanjing Maternal and Child Health Hospital from January 1,2021 to December 31,2021 as the research subjects,they were divided into an observation group and a control group according to the principle of balanced and comparable baseline data between groups,with 35 patients in each group.The control group adopted routine breastfeeding management and education.On the basis of routine breastfeeding management,the observation group adopted additional human resources,improved management systems,strengthens training of medical staff,increased education for mothers and their families,and strengthened hospital infection monitoring.The quality of breastfeeding was improved in all aspects,and the breastfeeding status,growth and development,intravenous nutrition duration,hospitalization duration,and complications during VLBWI hospitalization were compared between the two groups.Results There was no statistically significant difference in the general information between the two groups(P>0.05).The observation group's first breastfeeding time and birth weight recovery time were earlier than those in the control group,the exclusive breastfeeding rate and body weight growth rate during hospitalization were higher than those in the control group,the duration of intravenous nutrition and total hospitalization time were shorter than those in the control group,the overall incidence rate of feeding intolerance,neonatal necrotizing enterocolitis(NEC),bronchopulmonary dysplasia(BPD)and retinopathy of prematurity(ROP)complications was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion Breastfeeding quality improvement measures can increase the exclusive breastfeeding rate of VLBWI patients hospitalized in NICU,promote their weight growth,shorten the duration of intravenous nutrition and total hospitalization time,and reduce the incidence of related complications.