家庭病房维持支气管肺发育不良早产儿最佳目标氧饱和度的单中心回顾性队列研究

Effect of family integrated ward on maintaining optimal oxygen saturation targets in premature infants with bronchopulmonary dysplasia:a single-center retrospective cohort study

目的探讨家庭病房在维持支气管肺发育不良(bronchopulmonary dysplasia,BPD)早产儿最佳目标脉搏氧饱和度(pulse oxygen saturation,SpO2)中的应用效果。方法采用回顾性队列研究,选择南京医科大学附属儿童医院新生儿重症监护室2019年6月至2022年1月收治的BPD早产儿为研究对象,按是否入住家庭病房实施家庭参与式护理分为家庭病房组和对照组,分析两组早产儿出院前24 h内最佳目标SpO2比例、家庭氧疗时间及出院后6个月内因呼吸系统疾病再入院率等情况。结果家庭病房组97例,对照组63例。家庭病房组与对照组相比,出院前24 h最佳目标SpO2比例提高(58.0%比24.0%),家庭氧疗时间缩短(7.0 d比12.0 d),出院6个月内因呼吸系统疾病再入院率降低(16.5%比30.2%),差异均有统计学意义(P<0.05)。进一步回归分析显示,家庭病房可显著减少家庭氧疗需求及家庭氧疗时间,但对6个月内因呼吸系统疾病再入院率无显著影响。结论家庭病房可有效提高BPD早产儿出院前24 h最佳目标SpO2比例,减少家庭氧疗需求并且缩短出院后家庭氧疗时间,有利于提高BPD早产儿生活质量。

Objective To study the application effect of family integrated ward in maintaining the optimal target pulse oxygen saturation(SpO2)in premature infants with bronchopulmonary dysplasia(BPD).Methods This was a retrospective cohort study.Premature infants with BPD admitted to the neonatal intensive care unit of Children's Hospital of Nanjing Medical University from June 2019 to January 2022 were enrolled.Based on whether to stay in family integrated ward and implement family integrated care(FICare),these premature infants were divided into the family ward group and the control group.The ratio of optimal target SpO2 within 24 h before discharge,the duration of home oxygen therapy,and ratio of readmission due to respiratory disease within 6 months after discharge were analyzed between the two groups.Results During the study period,a total of 167 premature infants with BPD were admitted,including 101 in the family ward group and 66 in the control group.Compared with the control group,the family ward group showed a higher proportion of achieving the optimal target SpO2 within 24 h before discharge(58.0%vs.24.0%),shorter duration for home oxygen therapy(7.0 d vs.12.0 d),and a lower readmission rate within 6 months after discharge(16.5%vs.30.2%),which had statistically significant difference(all P<0.05).Further regression analysis showed that participating in the family integrated ward significantly reduced the demand for home oxygen therapy and the duration of home oxygen therapy,but had no significant impact on the readmission rate within 6 months after discharge.Conclusions Family integrated ward can effectively increase the proportion of achieving the optimal target SpO2 for premature infants with BPD within 24 h before discharge,reduce the demand for home oxygen therapy,and shorten the time of home oxygen therapy after discharge,which is beneficial for improving the living quality of premature infants with BPD.