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新生儿重症监护病房以家庭为中心的护理:对早产儿结局的荟萃分析和系统评价

Family-centered care in the neonatal intensive care unit: a meta-analysis and systematic review of outcomes for preterm infants.

作者信息

Chen Shuang, Shen Hong, Jin Qiuhong, Zhou Liangping, Feng Lin

机构信息

Department of Neonates, People's Hospital of Suzhou High-tech Zone, Suzhou, China.

Department of Neonates, The Affiliated Suzhou Hospital of Nanjing University Medical School, Suzhou, China.

出版信息

Transl Pediatr. 2025 Jan 24;14(1):14-24. doi: 10.21037/tp-24-373. Epub 2025 Jan 21.

Abstract

BACKGROUND

The efficacy of family integrated care for preterm infants is not well established. This meta-analysis aims to assess the impact of family-integrated care on preterm infants to inform neonatal clinical practices.

METHODS

We conducted a literature search in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Weipu, and Wanfang databases up to August 25, 2024. Two researchers independently screened articles, applying predefined inclusion and exclusion criteria, and performed quality assessments and data extraction. Meta-analysis was conducted using RevMan 5.3 software.

RESULTS

Thirteen randomized controlled trials (RCTs) were included, encompassing 3,005 preterm infants, of which 1,390 received family-integrated care. Family-integrated care significantly improved breastfeeding rates [odds ratio (OR) =5.92, 95% confidence interval (CI): 2.37 to 14.82, P<0.001], weight gain [mean difference (MD) =3.16, 95% CI: 2.51 to 3.80, P<0.001], and sleep duration (MD =3.25, 95% CI: 2.05 to 4.44, P<0.001) in preterm infants and reduced the one-month readmission rate (OR =0.37, 95% CI: 0.22 to 0.61, P<0.001). Egger's regression test indicated no publication bias among the outcomes (all P>0.05).

CONCLUSIONS

Family-integrated care markedly improves breastfeeding rates, promotes weight gain, and extends sleep duration in preterm infants, while concurrently reducing the likelihood of hospital readmission. This approach offers substantial benefits to both the preterm infants and their families, highlighting its potential for wider implementation in neonatal nursing practice.

摘要

背景

家庭综合护理对早产儿的疗效尚未明确确立。本荟萃分析旨在评估家庭综合护理对早产儿的影响,为新生儿临床实践提供参考。

方法

截至2024年8月25日,我们在PubMed、Cochrane图书馆、Embase、Web of Science、中国知网(CNKI)、维普和万方数据库中进行了文献检索。两名研究人员独立筛选文章,应用预先定义的纳入和排除标准,并进行质量评估和数据提取。使用RevMan 5.3软件进行荟萃分析。

结果

纳入了13项随机对照试验(RCT),涉及3005名早产儿,其中1390名接受了家庭综合护理。家庭综合护理显著提高了早产儿的母乳喂养率[优势比(OR)=5.92,95%置信区间(CI):2.37至14.82,P<0.001]、体重增加[平均差(MD)=3.16,95%CI:2.51至3.80,P<0.001]和睡眠时间(MD =3.25,95%CI:2.05至4.44,P<0.001),并降低了1个月再入院率(OR =0.37,95%CI:0.22至0.61,P<0.001)。Egger回归检验表明各结局不存在发表偏倚(所有P>0.05)。

结论

家庭综合护理显著提高了早产儿的母乳喂养率,促进了体重增加,延长了睡眠时间,同时降低了再次入院的可能性。这种方法对早产儿及其家庭都有很大益处,凸显了其在新生儿护理实践中更广泛实施的潜力。

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