间歇性袋鼠式护理对26~33+6周早产儿纯母乳喂养的影响

Effect of intermittent kangaroo mother care on exclusively breast feeding of premature infants with a gestational age of 26-33+6 weeks(Department of Neonatology,Peking University International Hospital,Beijing 102206,China)

目的调查新生儿重症监护室(neonatal intensive care unit,NICU)26~33+6周早产儿间歇性袋鼠式护理(kangaroo mother care,KMC)与纯母乳喂养率之间的关系。方法回顾性分析2016年1月+6至2023年8月北京大学国际医院新生儿科收治的胎龄26~33周的119例早产儿及其母亲的临床资料,根据是否进行间歇性KMC分为KMC组(n=60)与常规护理组(n=59)。比较两组早产儿出院时、矫正胎龄40周、矫正4月龄、矫正6月龄的纯母乳喂养率及早产儿结局。统计学方法采用t检验、非参数检验、χ^(2)检验。结果2组早产儿纯母乳喂养率比较,出院时KMC组为95.00%(57/60),常规护理组为74.58%(44/59),差异有统计学意义(t=9.666,P=0.002);矫正40周KMC组为53.33%(32/60),常规护理组为30.51%(18/59),差异有统计学意义(t=6.361,P=0.012);矫正4月龄KMC组为48.33%(29/60),常规护理组为25.42%(15/59),差异有统计学意义(t=6.700,P=0.010);矫正6月龄KMC组为41.67%(25/60),常规护理组为20.34%(12/59),差异有统计学意义(t=6.316,P=0.012)。各时期KMC组纯母乳喂养率均高于常规护理组。两组早产儿在院内感染发生率(t=0.001,P=0.973)、宫外生长发育迟缓(extrauterine growth retardation,EUGR)发生率(t=0.425,P=0.515)、出院胎龄(t=-0.500,P=0.617)、出院体质量(t=-0.439,P=0.661)、喂养不耐受发生率(t=0.067,P=0.795)方面比较,差异均无统计学意义。结论间歇性KMC+6可促进26~33周早产儿矫正6月龄内的纯母乳喂养率,应更好地在NICU中积极推广。

Objective To investigate the relationship between intermittent kangaroo mother care(KMC)+6 and the rate of exclusively breast feeding for premature infants with a gestational age of 26-33 weeks in neonatal intensive care unit(NICU).Method The clinical data of 119 premature infants with a gestational+6 age of 26-33 weeks and their mothers admitted to Department of Neonatology,Peking University International Hospital from January 2016 to August 2023 were retrospectively analyzed.According to whether intermittent KMC was performed or not,they were divided into KMC group(n=60)and routine care group(n=59).The rates of exclusively breast feeding at discharge,corrected gestational age of 40 weeks,corrected age of 4 months,corrected age of 6 months,and the outcome of premature infants were compared between the two groups.Statistical methods performed by t-test,non-parametric test andχ^(2) test.Result The rates of exclusively breast feeding was 95.00%(57/60)in the KMC group and 74.58%(44/59)in the routine care group at discharge,the difference was statistically significant(t=9.666,P=0.002);53.33%(32/60)in the KMC group and 30.51%(18/59)in the routine care group at the corrected gestational age of 40 weeks,the difference was statistically significant(t=6.361,P=0.012);48.33%(29/60)in the KMC group and 25.42%(15/59)in the routine care group at the corrected age of 4 months,the difference was statistically significant(t=6.700,P=0.010);41.67%(25/60)in the KMC group and 20.34%(12/59)in the routine care group at the corrected age of 6 months,the difference was statistically significant(t=6.316,P=0.012).The rates of exclusively breast feeding of the KMC group were significantly higher than that of the routine care group in each period.There was no significant difference between the two groups in the incidence of nosocomial infection(t=0.001,P=0.973),extrauterine growth retardation(EUGR,t=0.425,P=0.515),gestational age(t=-0.500,P=0.617)or weight(t=-0.439,P=0.661)at discharge,feeding intolerance(t=0.067,P=0.795).Conclusion Intermittent+6 KMC promotes exclusively breast feeding rate of premature infants with a gestational age of 26-33 weeks within corrected age of 6 months and should be better promoted actively in NICU.