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袋鼠式护理对低体重和早产儿出生后28天内临床结局的疗效:一项随机临床试验的荟萃分析。

The efficacy of Kangaroo-Mother care to the clinical outcomes of LBW and premature infants in the first 28 days: A meta-analysis of randomized clinical trials.

作者信息

Zhu Zhen, Wang Xinchen, Chen Wenzeng, Pei Shuping, Wang Qingmin, Guan Hailian, Zhu Guang

机构信息

Department of Obstetrics, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Department of Gynaecology, Tongde Hospital of Zhejiang Province, Hangzhou, China.

出版信息

Front Pediatr. 2023 Feb 27;11:1067183. doi: 10.3389/fped.2023.1067183. eCollection 2023.

Abstract

OBJECTIVE

The objective of this study was to systematically determine the benefits of Kangaroo-Mother Care (KMC) on the clinical outcomes of low birthweight (LBW) and preterm infants.

METHODS

For this study, the following databases were retrieved for articles published until November 2021: PubMed, Web of Science, EBSCO, and the Cochrane library. The primary clinical outcome was mortality between enrollment and 28 days. The secondary clinical outcomes were the mean duration of hospital stay, hypothermia, sepsis, exclusive breastfeeding at the end of the neonatal period, and exclusive breastfeeding at discharge.

RESULTS

We conducted a meta-analysis, which included 17 RCTs, involving overall 17,668 participants. The results of this meta-analysis showed that KMC could reduce the primary clinical outcome of mortality between enrollment and 28 days (RR: 0.80, 95% Cl: 0.71-0.91, < 0.01). For the secondary clinical outcomes, KMC had a varying degree of benefits on the mean duration of hospital stay (SMD: -0.96, 95% Cl: -1.02-0.90, < 0.001), hypothermia (RR: 0.45, 95% Cl: 0.27-0.75, < 0.01), and sepsis (RR: 0.79, 95% Cl: 0.70-0.89, < 0.001). The exclusive breastfeeding at the end of the neonatal period and exclusive breastfeeding at discharge of KMC had benefits, which was not statistically different though (OR: 2.16, 95% Cl: 0.55-8.41, = 0.27; OR: 1.16, 95% Cl: 0.82-1.64, = 0.39, respectively).

CONCLUSIONS

KMC was decreased mortality in LBW and premature infants between enrollment and 28 days. In addition, KMC also had a favorable effectiveness on the secondary clinical outcomes, such as mean duration of hospital stay, hypothermia, sepsis. Moreover, KMC also had a slight effectiveness on exclusive breastfeeding at the end of the neonatal period and exclusive breastfeeding at discharge.

摘要

目的

本研究的目的是系统地确定袋鼠式护理(KMC)对低出生体重(LBW)和早产儿临床结局的益处。

方法

在本研究中,检索了以下数据库中截至2021年11月发表的文章:PubMed、科学网、EBSCO和考克兰图书馆。主要临床结局是入组至28天之间的死亡率。次要临床结局是平均住院时间、体温过低、败血症、新生儿期末纯母乳喂养以及出院时纯母乳喂养。

结果

我们进行了一项荟萃分析,纳入了17项随机对照试验,共涉及17668名参与者。该荟萃分析结果显示,KMC可降低入组至28天之间死亡率这一主要临床结局(风险比:0.80,95%置信区间:0.71 - 0.91,<0.01)。对于次要临床结局,KMC对平均住院时间(标准化均数差:-0.96,95%置信区间:-1.02 - 0.90,<0.001)、体温过低(风险比:0.45,95%置信区间:0.27 - 0.75,<0.01)和败血症(风险比:0.79,95%置信区间:0.70 - 0.89,<0.001)有不同程度的益处。KMC在新生儿期末纯母乳喂养和出院时纯母乳喂养方面有好处,不过差异无统计学意义(比值比分别为:2.16,95%置信区间:0.55 - 8.41,=0.27;1.16,95%置信区间:0.82 - 1.64,=0.39)。

结论

KMC降低了LBW和早产儿入组至28天之间的死亡率。此外,KMC对次要临床结局,如平均住院时间、体温过低、败血症也有良好效果。而且,KMC对新生儿期末纯母乳喂养和出院时纯母乳喂养也有轻微效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b6/10008937/dd624c5c1e98/fped-11-1067183-g001.jpg

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