集束化护理联合持续母乳喂养管理在提高极低和超低出生体质量儿母乳喂养率中的应用

Application of care bundles combined with continuous exclusive breastfeeding in improving the breastfeeding rate in very and extremely low birth weight infants

目的探讨新集束化护理联合持续母乳喂养管理在提高极低和超低出生体质量儿母乳喂养率中的应用价值。方法选取2013年1月—12月中山市博爱医院收治的极低和超低出生体质量儿66例为对照组,选取2017年1月—12月收治的极低和超低出生体质量儿82例作为观察组。对照组行常规护理及间断母乳喂养,观察组则采用集束化护理联合持续母乳喂养管理。记录2组低体质量新生儿母乳喂养情况、坏死性小肠结肠炎(NEC)发生率和出院后6个月婴儿生长发育情况。结果观察组新生儿喂养耐受率及持续母乳喂养率均高于对照组(P<0.01),NEC发生率明显低于对照组(P<0.05)。6个月后随访调查结果显示,观察组婴儿体质量、身高、头围等发育情况均优于对照组(P<0.05)。结论给予极低和超低出生体质量儿集束化护理联合持续母乳喂养,能提高新生儿母乳耐受性和母乳喂养率,对促进其生长发育具有积极作用。

Objective To investigate the application value of care bundles combined with continuous exclusive breastfeeding in improving the breastfeeding rate in very and extremely low birth weight(VLBW/ELBW) infants. Methods Totally 66 VLBW/ELBW infants were included as the control group between January and December 2013, another 66 VLBW/ELBW infants were included as the observation group between January and December 2017. Routine care and intermittent breastfeeding were adopted in the control group, and the care bundles combined with continuous exclusive breastfeeding were carried out in the observation group. The breastfeeding rate, incidence of necrotizing enterocolitis(NEC) and growth condition 6 months after discharge from hospital were compared between two groups. Results The rates of breastfeeding tolerance and successful breastfeeding in the observation group were higher than those in the control group(P<0.01). The incidence of NEC in the observation group was lower than that in the control group(P<0.05). After six-month follow-up, infants in the observation group had a better growth in bodyweight, height and head circumference compared with those in the control group(P<0.05). Conclusion The care bundles combined with continuous exclusive breastfeeding are effective to improve the breastfeeding tolerance and successful breastfeeding in VLBW/ELBW infants.