Charpak Nathalie, Ruiz Juan Gabriel, Zupan Jelka, Cattaneo Adriano, Figueroa Zita, Tessier Rejean, Cristo Martha, Anderson Gene, Ludington Susan, Mendoza Socorro, Mokhachane Mantoa, Worku Bogale
Kangaroo Foundation, Bogota, Colombia.
Acta Paediatr. 2005 May;94(5):514-22. doi: 10.1111/j.1651-2227.2005.tb01930.x.
The components of the Kangaroo Mother Care (KMC) intervention, their rational bases, and their current uses in low-, middle-, and high-income countries are described. KMC was started in 1978 in Bogotá (Colombia) in response to overcrowding and insufficient resources in neonatal intensive care units associated with high morbidity and mortality among low-birthweight infants. The intervention consists of continuous skin-to-skin contact between the mother and the infant, exclusive breastfeeding, and early home discharge in the kangaroo position. In studies of the physiological effects of KMC, the results for most variables were within clinically acceptable ranges or the same as those for premature infants under other forms of care. Body temperature and weight gain are significantly increased, and a meta-analysis showed that the kangaroo position increases the uptake and duration of breastfeeding. Investigations of the behavioral effects of KMC show rapid quiescence. The psychosocial effects of KMC include reduced stress, enhancement of mother-infant bonding, and positive effects on the family environment and the infant's cognitive development.
Past and current research has clarified some of the rational bases of KMC and has provided evidence for its effectiveness and safety, although more research is needed to clearly define the effectiveness of the various components of the intervention in different settings and for different therapeutic goals.
本文描述了袋鼠式护理(KMC)干预措施的组成部分、其理论基础以及目前在低收入、中等收入和高收入国家的应用情况。KMC于1978年在哥伦比亚波哥大启动,以应对新生儿重症监护病房过度拥挤和资源不足的问题,这些问题与低体重婴儿的高发病率和高死亡率相关。该干预措施包括母亲与婴儿持续的皮肤接触、纯母乳喂养以及以袋鼠式姿势早期出院回家。在对KMC生理效应的研究中,大多数变量的结果在临床可接受范围内,或与其他护理形式下的早产儿结果相同。体温和体重增加显著,一项荟萃分析表明,袋鼠式姿势可增加母乳喂养的摄入量和持续时间。对KMC行为效应的研究显示婴儿能迅速安静下来。KMC的社会心理效应包括减轻压力、增强母婴联结,以及对家庭环境和婴儿认知发展产生积极影响。
过去和当前的研究已阐明了KMC的一些理论基础,并为其有效性和安全性提供了证据,尽管还需要更多研究来明确该干预措施各组成部分在不同环境和不同治疗目标下的有效性。