Impact of Delivery Mode on Morbidity in Preterm Infants with Very Low Birth Weights (<1500 Grams)

The mode of delivery and gestational age for very-low-birth-weight (VLBW) preterm infants are not yet well established and are constant topics of debate. Objective: To analyze the impact of delivery mode on morbidity in preterm infants weighing less than 1500 g. Results: Among 21,957 births, 81 were analyzed;53 were delivered vaginally, and 28 were delivered by cesarean section. The median maternal age, gestational age and body mass index among those delivered vaginally and by cesarean section were 20 years and 22.5 years, 27.6 weeks and 30.1 weeks, and 26.0 kg/m2 and 27.8 kg/m2, respectively. With respect to neonatal blood gas parameters, for those born vaginally and by cesarean section, the median pH was 7.32 and 7.24, the pCO2 was 41.5 mmHg and 51.1 mmHg, and the pO2 was 22.3 mmHg and 16 mmHg. The median fetal weight among those born by cesarean section and vaginally were 1180 g and 955 g, respectively. The median Apgar scores at the first and fifth minutes among those born by cesarean section and vaginally were 5.00 and 8.00 and 4.50 and 7.00, respectively. Conclusion: There was no significant difference between the results of vaginal and cesarean delivery for VLBW infants. Thus, further studies on this subject are needed.

Associated Factors to Immunization Timeliness and Completion in Preterm and Low Birth Weight Infants at Essos Hospital Center Yaounde

Introduction: Vaccination is very often delayed in premature and low birth weight infants. However, timely vaccination is even more important in this population because of their increased susceptibility to infection. Objective: To assess immunization practice and factors associated with vaccine promptness and completeness in former preterm and low-birth-weight infants. Methods: We conducted a retrospective analytical cross-sectional study (January 2017 to February 2019). Main Measurement: Promptness and completeness at each contact, Statistical analysis was performed using R software version 3.6.2, logistic regression was used to estimate the Odds Ratio (OR) and their 95% Confidence Interval (CI). Results: We recruited 310 children aged 12 to 36 months born before 37 weeks with low birth weight, 163 (52.6%) of whom were female. Two hundred and fifty-three had received the vaccines at the indicated age, with promptness rate of 81.6%, and 97.7% had completed routine immunization at 9 months. The mean age at vaccination initiation was 6 days ± 11 and the mean weight at vaccination initiation was 2233 g ± 494. High prematurity and very low birth weight were associated with a high rate of vaccine delay: 61.5% [OR: 15.56;(CI: 3.22 - 118.52;p = 0.002)] and 66.7% [OR: 19.19;(CI: 4.67 - 92.52;p < 0.001)] respectively. Distance > 5 km with EHC [OR: 3.48;(CI: 1.68 - 7.47;p = 0.001)] was associated with poor vaccination. Women in common-law unions had the lowest vaccine readiness rate (60.6%), (OR: 3.36;CI: 1.006 - 10.70;p = 0.038). The frequency of occurrence of post immunization adverse events was 24.5%, with fever type in 94.7%. Conclusion: Almost all premature and/or low-birth-weight children hospitalized at Essos Hospital Center had completed routine immunization at 9 months, and the majority had received the vaccines in a timely manner. Similar study is needed in rural area.

Neurally adjusted ventilator assist in very low birth weight infants:Current status

Continuous improvements in perinatal care have resultedin increased survival of premature infants.Their immature lungs are prone to injury with mechanical ventilation and this may develop into chronic lung disease(CLD) or bronchopulmonary dysplasia.Strategies to minimize the risk of lung injury have been developed and include improved antenatal management(education,regionalization,steroids,and antibiotics),exogenous surfactant administration and reduction of barotrauma by using exclusive or early noninvasive ventilatory support.The most frequently used mode of assisted ventilation is pressure support ventilation that may lead to patientventilator asynchrony that is associated with poor outcome.Ventilator-induced diaphragmatic dysfunction or disuse atrophy of diaphragm fibers may also occur.This has led to the development of new ventilation modes including neurally adjusted ventilatory assist(NAVA).This ventilation mode is controlled by electrodes embedded within a nasogastric catheter which detect the electrical diaphragmatic activity(Edi) and transmit it to trigger the ventilator in synchrony with the patient's own respiratory efforts.This permits the patient to control peak inspiratory pressure,mean airway pressure and tidal volume.Back up pressure control(PC) is provided when there is no Edi signal and no pneumatic trigger.Compared with standard conventional ventilation,NAVA improves blood gas regulation with lower peak inspiratory pressure and oxygen requirements in preterm infants.NAVA is safe mode of ventilation.The majority of studies have shown no significant adverse events in neonates ventilated with NAVA nor a difference in the rate of intraventricular hemorrhage,pneumothorax,or necrotizing enterocolitis when compared to conventional ventilation.Future large size randomized controlled trials should be established to compare NAVA with volume targeted and pressure controlled ventilation in newborns with mature respiratory drive.Most previous studies and trials were not sufficiently large and did not include longterm patient oriented outcomes.Multicenter,randomized,outcome trials are needed to determine whether NAVA is effective in avoiding intubation,facilitating extubation,decreasing time of ventilation,reducing the incidence ofCLD,decreasing length of stay,and improving long-term outcomes such as the duration of ventilation,length of hospital stay,rate of pneumothorax,CLD and other major complications of prematurity.In order to prevent barotrauma,next generations of NAVA equipment for neonatal use should enable automatic setting of ventilator parameters in the backup PC mode based on the values generated by NAVA.They should also include an upper limit to the inspiratory time as in conventional ventilation.The manufacturers of Edi catheters should produce smaller sizes available for extreme low birth weight infants.Newly developed ventilators should also include leak compensation and high frequency ventilation.A peripheral flow sensor is also essential to the proper delivery of all modes of conventional ventilation as well as NAVA.

出生缺陷与出生体重、胎龄的相关性

目的分析不同出生体重及胎龄围产儿的出生缺陷发生率,为进一步完善出生缺陷监测系统和降低出生缺陷发生率提供新的科学依据。方法对2003年10月1日至2015年9月30日西安市各级开设产科的医疗保健机构出生的孕28周~生后7 d所有围产儿进行出生缺陷监测并收集相关资料。结果2003至2015年共监测围产儿1236937例,其中出生缺陷儿10619例,出生缺陷发生率为8.59‰。2003至2015年西安市出生缺陷医院监测系统共收集出生体重<2500 g出生缺陷患儿3306例,出生孕周≥28周且<37周的出生缺陷患儿3473例,出生孕周≥42周的出生缺陷患儿共224例。2003至2015年低出生体重儿出生缺陷率显著高于正常体重儿(χ^(2)=37097.79,P<0.001)。2003至2015年早产儿(<37周)出生缺陷率显著高于正常产期儿(χ^(2)=24998.24,P<0.001),过期产儿出生缺陷率(≥42周)显著高于正常产期儿(χ^(2)=196.40,P<0.001)。低体重儿出生缺陷常见缺陷类型前5位依次是先天性脑积水、脊柱裂、先天性心脏病、无脑畸形、唇裂合并腭裂。正常体重儿出生缺陷出生结局以活产为主(占68.60%),而低体重儿出生缺陷出生结局以死胎为主(占54.72%),低体重儿出生缺陷与正常体重儿出生缺陷出生结局比较,差异有统计学意义(χ^(2)=647.59,P<0.001)。正常产期儿出生缺陷出生结局以活产为主(占77.38%),过期产儿出生缺陷出生结局以活产为主(占83.93%),而早产儿出生缺陷出生结局以死胎为主(占57.79%)。早产儿与正常产期儿出生缺陷出生结局比较,差异有统计学意义(χ^(2)=2025.08,P<0.001),早产儿与过期产儿出生缺陷出生结局比较,差异有统计学意义(χ^(2)=245.39,P<0.001),正常产期儿与过期产儿出生缺陷出生结局比较差异有统计学意义(χ^(2)=16.28,P=0.001)。结论早产儿、低出生体重儿及过期产儿出生缺陷发生率显著高于正常产期儿,低体重儿与正常体重儿、早产儿与正常产期儿、早产儿与过期产儿、正常产期儿与过期产儿出生缺陷出生结局比较,差异均有统计学意义。

The impact of anti-tobacco legislation on birth weight in Peru

Background:Tobacco exposure remains a significant issue for public health,especially for pregnant women.It increases the risk for premature labor,low birth weight and small for gestational age(SGA),among other effects.To reduce these risks,many countries have enacted public policies to curb tobacco exposure.Peru enacted anti-tobacco laws that forbid smoking in public places,require prevention text and images in products and publicity,along with restriction of sales to adults.We evaluated the effect of the implementation of this law on newborn outcomes:birth weight,prematurity and SGA.Methods:This was a quasi-experimental study that utilized data from the Peruvian Live Birth Registry.Children born to mothers from urban areas were the intervention group,while children born to mothers from rural areas were considered the control group.Only singletons with information on birth weight and gestational age,born to mothers aged 12 to 49 years were included in the study.In addition,newborns with birth weights greater than+4 standard deviations(SD)or less than−4 SD from the gestational age-specific mean were excluded.To measure the effect of legislation on birth weight we performed a difference in differences analysis.Results:A total of 2,029,975 births were included in the analysis.After adjusting for characteristics of the mother and the child,and contextual variables,the anti-tobacco law in Peru reduced the incidence of prematurity by 30 cases per 10,000 live births(95%CI:19 to 42).Conclusions:The reform had negligible effects on overall birth weights and on the incidence of SGA.This modest result suggests the need for a more aggressive fight against tobacco,prohibiting all types of advertising and promotion of tobacco products,among others measures.

低出生体重早产儿经外周静脉穿刺置入中心静脉导管异位的影响因素分析

目的:探讨低出生体重早产儿(LBW-PI)经外周静脉穿刺置入中心静脉导管(PICC)发生置管异位影响因素.方法:选取2020年1月至2023年7月本院拟行PICC置管的LBW-PI 96例为研究对象.根据是否发生置管异位,将其分别纳入研究组(n=24,PICC发生异位者)和对照组(n=72,PICC无异位者).收集患儿的临床资料,分析LBW-PI PICC异位发生的影响因素.结果:LBW-PI的PICC异位率为25.00%(24/96).多因素非条件Logistic回归分析结果显示,出生胎龄<32周、出生时体重<1500g、置管前机械通气、左上肢置管、置管时日龄1d、置管护士层级、贵要静脉置管、头静脉置管均为导致LBW-PI发生PICC异位的独立影响因素(OR>1,P<0.05).结论:LBW-PI的PICC异位率高,可能与早产儿出生胎龄、出生时体重、置管前机械通气、置管时日龄、左上肢置管、置管护士层级、头静脉和贵要静脉等有关.

早期母乳联合母乳强化剂对极低出生体重早产儿生长发育及喂养不耐受的影响

目的探讨早期母乳联合母乳强化剂对极低出生体重早产儿生长发育及喂养不耐受的影响。方法选择2021年8月—2022年9月青岛大学附属威海市立第二医院收治的82例极低出生体重早产儿为研究对象,采用随机数字表法将其分为对照组和观察组,各41例。对照组采取早期母乳喂养,观察组在对照组基础上联合母乳强化剂喂养。比较两组的生长发育指标、营养指标、喂养不耐受情况及并发症发生情况。结果出院1年后,观察组头围、身长均长于对照组,体重大于对照组,组间差异有统计学意义(P<0.05)。喂养3个月后,观察组前白蛋白、白蛋白、总蛋白水平均高于对照组,组间差异有统计学意义(P<0.05)。出院前,观察组喂养不耐受发生率、并发症发生率均低于对照组,组间差异有统计学意义(P<0.05)。结论早期母乳联合母乳强化剂对极低出生体重早产儿进行喂养可有效改善其喂养不耐受情况,可提高早产儿的机体营养状况,并促进生长发育,且可减少并发症的发生。

0~3岁早产/低出生体重儿养育问题调查:一项多中心横断面研究

目的了解我国城市地区0~3岁早产/低出生体重儿的家庭主要养育问题与需求,为我国儿童健康临床工作者针对性地开展高危儿家庭养育指导提供依据。方法采用我国14省15个城市的1989名0~3岁儿童及家长的家庭养育调查资料进行研究,比较分析早产/低出生体重儿家庭与正常儿童家庭面临的养育问题及其影响因素。结果接受调查的城市地区早产/低出生体重儿151名(7.6%),其中76.8%的早产/低出生体重儿的家长在过去3个月内遇到了≥3个家庭养育问题,高于正常组的66.8%,差异有统计学意义(χ^(2)=6.44,P=0.011)。早产/低出生体重儿的家庭养育问题主要集中在喂养或进餐(67.6%)、睡眠(66.2%)和行为(61.6%)三方面。多因素logistic回归发现,早产/低出生体重儿是婴幼儿家庭养育问题的风险因素(P<0.05);早产/低出生体重儿家庭养育问题的发生与儿童性别、儿童年龄、主要照养人、家庭结构等因素有关。结论早产/低出生体重儿的家长面临养育问题风险普遍较高,且不同年龄阶段存在具体问题差异,有必要及时发现养育风险因素,为该群体提供有针对性的养育照护咨询指导。

早期经验性抗生素延长暴露对早产儿住院结局的影响

目的回顾性分析胎龄<32周或出生体重<1500 g早产儿的临床资料,探讨早产儿早期经验性抗生素延长暴露对早产儿住院结局的影响,进一步指导早产儿抗生素的合理应用。方法收集青岛大学附属医院2018年1月1日到2020年12月31日收治的胎龄<32周或出生体重<1500 g的早产儿临床资料。按照生后早期经验性抗生素应用时间分为短期暴露组(≤5 d)和长期暴露组(>5 d),分析比较两组早产儿住院期间并发症。结果共291例,男166例,女125例。抗生素短期暴露组抗生素使用中位时间为3 d,长期暴露组抗生素使用中位时间为9 d。与短期暴露组相比,长期暴露组早产儿喂养不耐受(feeding intolerance,FI)发生率明显增加,达半量肠内喂养时间、达全肠内喂养时间及住院时间明显延长(P<0.05),长期暴露组早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)、晚发败血症(late-onset sepsis,LOS)的发生率明显升高(P<0.05)。单因素logistic回归分析显示,抗生素延长暴露与住院期间FI、BPD、LOS、复合不良结局发生率增加均相关。多因素logistic回归分析显示经验性抗生素延长暴露是FI、BPD的独立危险因素,多元线性回归分析显示抗生素暴露时间越长,住院时间及达全肠内喂养时间越长。结论经验性抗生素延长暴露可增加早产儿BPD风险,影响肠道喂养,导致住院时间延长。

早期肠道内营养对极低出生体重早产儿临床结局影响的Meta分析

目的系统评价早期肠道内营养对极低出生体重早产儿临床结局的影响。方法通过计算机检索有关极低出生体重早产儿应用早期肠道内营养后临床结局指标相关的文献,检索时间为建库起至2023年12月31日;数据提取后用RevMan5.4软件进行Meta分析。结果共筛选出323篇文献,最终纳入8篇,总样本量为3451例,Meta分析的结果显示,早期肠道内营养对极低出生体重早产儿住院时长[MD=-17.26,95%CI(-35.41,0.89),P=0.06]、NEC发病率[RR=0.98,95%CI(0.75,1.27),P=0.85]等无影响;但早期肠道内营养可以减少极低出生体重早产儿达全肠道内喂养时间[MD=-3.44,95%CI(-4.15,-2.73),P<0.00001]、静脉营养时间[MD=-5.90,95%CI(-10.42,-1.38),P=0.01]、喂养不耐受发生率[RR=0.70,95%CI(0.63,0.77),P<0.00001],感染发生率[RR=0.57,95%CI(0.42,0.76),P=0.0001]。结论早期肠道内营养能减少极低出生体重早产儿达全肠道营养时间、静脉营养时间、喂养不耐受发生率、感染发生率。

初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响

目的探讨初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响。方法将128例极低出生体重儿随机分为干预组和对照组各64例。干预组采用2 mL/kg初乳灌肠;对照组采用1 mL/kg开塞露+1 mL/kg生理盐水1∶1稀释灌肠。灌肠自早产儿出生后24 h开始,至胎粪排尽时停止。结果干预组脱落10例,对照组脱落9例。干预组胎粪排尽时间和达到完全肠内营养时间显著短于对照组,体质量增长速度显著高于对照组(均P<0.05);干预组首次排出与排尽时的胎粪中的分泌型免疫球蛋A浓度、出生后第1次与第6天尿液中的分泌型免疫球蛋A浓度显著高于对照组(均P<0.05);干预组坏死性小肠结肠炎、喂养不耐受发生率显著低于对照组(均P<0.05)。结论初乳灌肠能促进极低出生体重儿胎粪排出,缩短达到完全肠内营养时间,提高体质量增长速度,提高早产儿免疫功能,降低相关并发症发生率。

妊娠剧吐患者的营养状况及妊娠结局分析

目的探讨妊娠剧吐(HG)患者的营养状况及其对妊娠结局的影响。方法以153例妊娠剧吐患者及其新生儿为观察组,350例健康产妇及其新生儿为对照组,比较2组孕妇特征和妊娠结局特点。妊娠剧吐患者新生儿中低出生体质量组7例、正常体质量组146例,分析2组孕妇快速反应蛋白、维生素和微量元素水平。结果与对照组比较,观察组新生儿平均出生体质量低,早产率、低出生体质量比例、女婴比例高(P<0.05)。观察组普遍存在微量营养素缺乏,其中维生素D、血清锰、锌缺乏尤为常见。与正常体质量组比较,低出生体质量组孕妇体质量减轻较多,孕期锌、铁、维生素C水平低(P<0.05)。结论HG患者应关注维生素D、锰和锌的补充,新生儿低出生体质量与孕妇孕期体质量下降水平偏高以及孕期锌、铁、维生素C水平偏低有关。

早期吞咽功能训练联合重力喂养护理在早产低体重儿中的应用效果

目的:观察早期吞咽功能训练联合重力喂养护理在早产低体重儿中的应用效果。方法:选取2020年6月至2022年6月该院收治的80例早产低体重儿进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各40例。两组均实施常规护理,在此基础上,对照组实施重力喂养护理,观察组在对照组基础上联合早期吞咽功能训练。比较两组喂养相关指标(恢复至出生体质量时间、达到全胃肠内喂养时间、开始经口喂养时间、住院时间)水平、护理前后生长发育指标(身长、体质量、头围)水平、早期神经发育[新生儿20项行为神经测定(NBNA)]评分,以及喂养不良反应发生率。结果:观察组恢复至出生体质量时间、达到全胃肠内喂养时间、开始经口喂养时间、住院时间均短于对照组,差异有统计学意义(P<0.05);护理后,观察组身长、体质量、头围水平均高于对照组,差异有统计学意义(P<0.05);观察组行为能力、被动肌张力、主动肌张力、原始反射、一般评估等NBNA各维度评分及总分均高于对照组,差异有统计学意义(P<0.05);观察组喂养不良反应发生率为17.50%(7/40),低于对照组的40.00%(16/40),差异有统计学意义(P<0.05)。结论:早期吞咽功能训练联合重力喂养护理应用于早产低体重儿可改善喂养相关指标水平,提高生长发育指标水平和早期神经发育评分,降低喂养不良反应发生率,效果优于单纯重力喂养护理。

早产/低出生体重儿特殊医学用途婴儿配方食品产品特点及注册现状

早产儿胃肠道功能发育不成熟,易发生喂养不耐受等问题,适用于早产/低出生体重儿的特殊医学用途配方食品包括母乳营养补充剂和早产/低出生体重婴儿配方。通过对早产儿相关共识、指南、文献等进行梳理,对申请注册的适用于早产/低出生体重儿特殊医学用途配方食品的产品情况进行分析,总结早产/低出生体重儿的营养需求特点、相应类别的产品配方特点等,并针对申请注册产品数量及种类有限、研发基础薄弱等问题提出建议,为该类产品的研究开发、注册管理及临床使用等提供参考。

初乳口腔免疫治疗对极低出生体重早产儿经口喂养能力及肠道菌群的影响

目的探讨初乳经口免疫疗法(C-OIT)在极低出生体重早产儿(VLBWI)支持治疗中的应用效果。方法选择2021年4月至2023年3月江苏省宿迁市第一人民医院儿科收治的VLBWI 123例,采用随机数字表法分为C-OIT组(n=62)、对照组(n=61)。C-OIT组给予初乳口腔免疫治疗,对照组给予生理盐水口腔免疫治疗。治疗7 d,比较两组早产儿经口喂养能力(PIOFRA)、肠道菌群、喂养效果、喂养并发症。结果C-OIT组喂养前早产儿状态、吸吮能力、吞咽能力、喂养过程中维持生理稳定的能力、PIOFRA总分高于对照组(P<0.05);乳酸杆菌、双歧杆菌高于对照组,大肠杆菌低于对照组(P<0.05);开始经口喂养时间、完全经口喂养时间、恢复出生体重时间短于对照组(P<0.05);喂养并发症22.58%低于对照组40.98%(χ^(2)=4.809,P<0.05)。结论C-OIT能够提高极低出生体重早产儿PIOFRA,调节肠道菌群,提高喂养效果,减少VLBWI喂养并发症的发生。

妊娠期龈炎前列腺素E2的表达及清热安胎膏干预作用初探

目的:构建SD大鼠妊娠期龈炎模型,观察清热安胎膏对妊娠期龈炎前列腺素E2(PGE2)表达的影响。方法:18只SPF级SD雌鼠随机分为空白组、模型组、中药组,每组各6只,分别记录3组大鼠体重,空白组:在10%水合氯醛腹腔注射麻醉下,但不做处理,常规受孕;对照组:在10%水合氯醛腹腔注射麻醉下使用结扎法+10%蔗糖水制备大鼠实验性牙龈炎。中药组:在10%水合氯醛腹腔注射麻醉下使用结扎法+10%蔗糖水制备大鼠实验性牙龈炎,受孕成功后应用清热安胎膏填塞龈沟。三组大鼠受孕后将孕鼠单独分笼,并使三组大鼠自然妊娠至分娩子代大鼠,记录每只新生仔鼠的数量及体重,使用ELISA法检测各阶段三组大鼠龈沟液PGE2水平,记录牙龈指数(gingival index,GI)及新生仔鼠体重、数目及窝重,比较清热安胎膏的治疗效果。结果:中药组使用清热安胎膏治疗后,与模型组比较,临床GI有所降低,龈沟液PGE2表达下调(P<0.05)。结论:使用清热安胎膏对妊娠期龈炎大鼠进行治疗,大鼠牙龈红肿状况明显缓解,GI评分降低,龈沟液PGE2表达下调,治疗效果显著。

基于微信支持的喂养指导对早产、低出生体质量儿出院后生长发育等各项指标的干预效果

目的探讨基于微信支持的喂养指导对早产、低出生体质量儿出院后生长发育等各项指标的干预效果。方法选取2022年2月至2023年1月广州市番禺区中心医院新生儿科收治的92例早产、低出生体质量儿作为研究对象,采用随机数表法分为对照组和观察组各46例。对照组新生儿在常规喂养指导下喂养,观察组新生儿在基于微信支持的喂养指导下喂养。两组均校正胎龄至40周,比较两组校正6个月龄、12个月龄的体格发育指标,再入院率,盖塞尔(Gesell)智能发育量表评分,血红蛋白(Hb),血钙(Ca),产时与校正6、12个月龄母亲喂养相关知识的掌握情况。结果校正6、12个月龄,观察组新生儿的体质量、身长、头围分别为(7.84±0.21)kg、(65.87±1.26)cm、(42.37±0.74)cm与(9.80±0.37)kg、(73.68±3.54)cm、(45.82±1.50)cm,均明显重于或长于对照组的(6.78±0.32)kg、(62.45±2.42)cm、(39.71±0.67)cm与(8.59±0.53)kg、(70.59±3.75)cm、(44.05±1.42)cm,差异均有统计学意义(P<0.05);校正6、12个月龄,观察组新生儿再入院率分别为6.52%、15.22%,明显低于对照组的21.74%、34.78%,差异均有统计学意义(P<0.05);校正6、12个月龄,观察组新生儿的粗大运动、精细运动、适应、语言、个人-社会性行为评分分别为(90.35±9.25)分、(89.79±8.42)分、(87.28±7.15)分、(91.83±9.05)分、(92.15±8.56)分与(90.32±9.30)分、(89.65±8.59)分、(88.39±7.40)分、(92.41±9.22)分、(93.20±7.71)分,均明显高于对照组的(77.94±8.01)分、(78.26±8.25)分、(73.46±6.21)分、(80.37±8.47)分、(81.33±8.02)分与(78.87±7.35)分、(78.43±8.31)分、(75.76±6.32)分、(82.87±8.64)分、(82.32±8.51)分,差异均有统计学意义(P<0.05);校正6、12个月龄,两组新生儿的Hb、Ca水平比较差异均无统计学意义(P>0.05);校正6、12个月龄,观察组新生儿的母亲早产儿喂养相关知识的掌握得分为(81.46±4.58)分、(96.34±3.19)分,明显高于对照组的(73.26±6.35)分、(82.38±5.16)分,差异均有统计学意义(P<0.05)。结论基于微信支持的喂养指导有利于早产、低出生体质量儿生长发育,可降低再入院率及促进智能发育,同时还可提高其母亲喂养知识掌握度,值得推广应用。

发育支持性护理对极低出生体重早产儿生长发育的影响

目的分析发育支持性护理对极低出生体重早产儿生长发育的影响。方法本次试验样本选取新生儿重症监护室收入的极低出生体重早产儿(出生体重低于1500 g),样本录入时间为2022年11月至2023年12月,抽检样本共有72例,应用随机数字表法划分为2个独立小组,观察组、对照组各有36例。对照组实施常规护理,观察组予发育支持性护理,观察两组患儿肠道功能、体格发育及神经行为发育情况。结果统计两组患儿恢复出生体重时间、静脉营养时间,观察组时间均短于对照组(P<0.05)。矫正胎龄40周,以对照组为参照,观察组体重、头围测定数值偏高(P<0.05)。矫正胎龄40周时,采用新生儿神经行为量表评估患儿神经行为方面的发育情况,观察组测定数值处于正常范围的患儿多于对照组(P<0.05)。结论对极低出生体重早产儿实施发育支持性护理具有改善其喂养状况以及促进肠道发育的效果,有利于促进体格以及神经行为发育。

1例极低出生体重儿桡动脉置管后肢体动脉血栓的护理

文章总结1例极低出生体重儿桡动脉置管后导致穿刺侧肢体动脉血栓形成的护理经验。主要包括早期识别血管痉挛和血栓形成,给予硝酸甘油局部湿热敷患肢扩张血管,低分子肝素钠抗凝、尿激酶溶栓,配合氧气吹拂患肢局部、硫酸镁湿敷等多项综合护理措施。通过针对性的治疗和精细化护理,患儿血液循环恢复,患肢手指颜色、手指活动恢复正常,33 d后康复出院。

探讨极低出生体重儿的血25(OH)D水平对促进患儿生长发育所发挥的作用

目的探讨极低出生体重儿的血25(OH)D水平对促进患儿生长发育所发挥的作用。方法选取广东省深圳市中西医结合医院新生儿科2020年7月—2023年5月收治的80例极低出生体重儿(Very Low Birth Weight,VLBW)早产儿作为研究对象,依据随机数表法将患儿分为对照组(n=40)和研究组(n=40),对照组口服维生素D3900 IU/D,研究组口服维生素D31300 IU/D。对比两组的骨代谢指标、生长发育指标、并发症情况。结果研究组治疗21 d、35 d的血25(OH)D、血钙、血磷水平均高于对照组,血碱性磷酸酶、甲状旁腺激素水平均低于对照组,差异有统计学意义(P均<0.05);研究组并发症发生率为12.50%,低于对照组的22.50%,差异无统计学意义(χ^(2)=2.813,P>0.05)。结论补充维生素D31300 IU/D能有效提高VLBW早产儿血25(OH)D水平,调节钙磷代谢,促进患儿生长发育,降低早产儿代谢性骨病等并发症风险。