袋鼠式护理可提高极早产儿纯母乳喂养率，并缩短需要无创辅助通气的极早产儿实现完全肠内喂养的时间。
Kangaroo mother care enhances exclusive breastmilk feeding and shortens time to achieve full enteral feeding in extremely preterm infants requiring non-invasive assisted ventilation.
作者信息
Li Jiaxin, Wang Huiyan, Yang Jiaming, Chen Xueyu, Cao Aifen, Yang Chuanzhong, Xiong Xiaoyun
机构信息
College of Nursing, Shanxi University of Chinese medicine, Jinzhong, 030619, China.
Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, 518028, China.
出版信息
Int Breastfeed J. 2024 Jul 31;19(1):52. doi: 10.1186/s13006-024-00662-9.
BACKGROUND
Extremely preterm infants (EPIs) frequently encounter challenges in feeding due to their underdeveloped digestive systems. Attaining full enteral feeding at the earliest possible stage can facilitate the removal of vascular catheters and decrease catheter-related complications.
METHODS
We performed a retrospective cohort study comprising 145 extremely preterm infants with a gestational age < 28 weeks who underwent non-invasive mechanical ventilation at Shenzhen Maternity & Child Healthcare Hospital between January 2019 and June 2020. The KMC group received standard nursing care along with KMC, while the control group received standard nursing care without KMC. KMC initiation took place three weeks after admission and continued for a period of two weeks or more while maintaining stable vital signs. We evaluated the rate of exclusive breastmilk feeding within 24 h prior to discharge and the time to full enteral feeding throughout hospitalization. Additionally, we conducted a multiple linear regression analysis to identify the independent factors associated with exclusive breastmilk feeding rates and the time to full enteral feeding.
RESULTS
The KMC group exhibited a significantly higher rate of exclusive breastmilk feeding in the 24 h before discharge in comparison to the Non-KMC group (52.8% vs. 31.5%, OR 2.43; 95% CI 1.24, 4.78). Moreover, the KMC group achieved full enteral feeding in a shorter duration than the Non-KMC group (43.1 ± 9.6 days vs. 48.7 ± 6.9 days, p < 0.001). Multiple linear regression analysis revealed that KMC was an independent protective factor associated with improved exclusive breastmilk feeding rates (OR 2.43; 95% CI 1.24, 4.78) and a reduction in the time to full enteral feeding (β -5.35, p < 0.001) in extremely preterm infants.
CONCLUSION
Kangaroo Mother Care (KMC) can expedite the achievement of full enteral feeding and enhance exclusive breastmilk feeding rates in extremely preterm infants receiving non-invasive assisted ventilation. These findings highlight the beneficial effects of KMC on the feeding outcomes of this vulnerable population, underscoring the importance of implementing KMC as a part of comprehensive care for extremely preterm infants.
背景
极早产儿（EPIs）由于消化系统发育不全，在喂养方面经常面临挑战。尽早实现完全肠内喂养有助于拔除血管导管并减少与导管相关的并发症。
方法
我们进行了一项回顾性队列研究，纳入了2019年1月至2020年6月期间在深圳市妇幼保健院接受无创机械通气的145例孕周<28周的极早产儿。袋鼠式护理（KMC）组在接受标准护理的同时接受KMC，而对照组仅接受标准护理，不进行KMC。KMC在入院三周后开始，持续两周或更长时间，同时维持生命体征稳定。我们评估了出院前24小时内纯母乳喂养率以及住院期间完全肠内喂养的时间。此外，我们进行了多元线性回归分析，以确定与纯母乳喂养率和完全肠内喂养时间相关的独立因素。
结果
与非KMC组相比，KMC组出院前24小时内的纯母乳喂养率显著更高（52.8%对31.5%，OR 2.43；95%CI 1.24，4.78）。此外，KMC组实现完全肠内喂养的时间比非KMC组短（43.1±9.6天对48.7±6.9天，p<0.001）。多元线性回归分析显示，KMC是与极早产儿纯母乳喂养率提高（OR 2.43；95%CI 1.24，4.78）和完全肠内喂养时间缩短相关的独立保护因素（β -5.35，p<0.001）。
结论
袋鼠式护理（KMC）可加快极早产儿在接受无创辅助通气时实现完全肠内喂养的进程，并提高纯母乳喂养率。这些发现凸显了KMC对这一脆弱群体喂养结局的有益影响，强调了将KMC作为极早产儿综合护理一部分实施的重要性。
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