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袋鼠式护理可以改善极早产儿的短期结局。

Kangaroo mother care can improve the short-term outcomes of very preterm infants.

机构信息

I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Université Toulouse III Paul-Sabatier, Toulouse, France.

出版信息

J Neonatal Perinatal Med. 2021;14(1):21-28. doi: 10.3233/NPM-200455.

Abstract

BACKGROUND

Kangaroo mother care (KMC) is a cornerstone of preterm infant management. The purpose of this study was to estimate the effectiveness of daily prolonged KMC in very preterm infants and its influence on neonatal morbidity and short-term outcomes, and breastfeeding optimization.

METHODS

Research included 52 very preterm infants. According to the KMC duration newborns were divided into two groups; Group1 of 22 infants (42.3%) - KMC lasted more than 3 hours/day, Group 2 of 30 infants (57.7%) - KMC lasted less than 3 hours/day.

RESULTS

Nosocomial sepsis occurred less frequently in Group 1 versus Group 2 (OR = 10.50; 95% CI 1.23-89.67, p = 0.012). Incidences of BPD, NEC, IVH I-II grades, the duration of parenteral nutrition, and growth parameters have not been different between groups (p > 0.05). Breastfeeding rates at discharge prevailed in Group 1 (OR = 3.70; 95% CI 1.16-11.86, p = 0.025). The most important factors for nosocomial sepsis: combination of parenteral nutrition duration and daily prolonged KMC, as a preventing factor (p = 0.002). Combination of the neonatal intensive care unit (NICU) treatment duration, type of enteral feeding, and mother's age add as factors that have important influence on breastfeeding prolongation (p = 0.009).

CONCLUSION

Nosocomial infection prevention and breastfeeding optimization are profitable outcomes of daily prolonged KMC in very preterm infants. No significant differences in the BPD, NEC, IVH I-II grades incidences, duration of parenteral nutrition, and growth parameters were found between studied groups. Combination of long-lasting KMC and short-term parenteral nutritionis a significant factor for nosocomial sepsis prophylaxis.

摘要

背景

袋鼠式护理(KMC)是早产儿管理的基石。本研究旨在评估对非常早产儿进行每日长时间 KMC 的效果及其对新生儿发病率和短期结局以及母乳喂养优化的影响。

方法

研究纳入 52 例非常早产儿。根据 KMC 持续时间,将新生儿分为两组;第 1 组 22 例婴儿(42.3%)-KMC 持续时间超过 3 小时/天,第 2 组 30 例婴儿(57.7%)-KMC 持续时间小于 3 小时/天。

结果

第 1 组院内败血症的发生率低于第 2 组(OR=10.50;95%CI 1.23-89.67,p=0.012)。BPD、NEC、IVH I-II 级、肠外营养持续时间和生长参数的发生率在两组间无差异(p>0.05)。第 1 组出院时母乳喂养率更高(OR=3.70;95%CI 1.16-11.86,p=0.025)。院内感染的最重要因素:肠外营养持续时间和每日长时间 KMC 的组合,作为预防因素(p=0.002)。新生儿重症监护病房(NICU)治疗持续时间、肠内喂养类型和母亲年龄的组合,作为对母乳喂养延长有重要影响的因素(p=0.009)。

结论

非常早产儿每日长时间 KMC 可预防院内感染和优化母乳喂养。两组间 BPD、NEC、IVH I-II 级发生率、肠外营养持续时间和生长参数无显著差异。长时间 KMC 与短期肠外营养的组合是预防院内感染的重要因素。

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