ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (6): 540-543.doi: 10.3969/j.issn.1674-3865.2018.06.025

• 临床护理 • 上一篇    下一篇

袋鼠式护理对出生体质量低于2 000 g早产儿住院期间生长发育和临床疗效指标的影响

甘桂芬，蔡园   

  1. 414000 湖南 岳阳，岳阳市二人民医院新生儿科
  • 出版日期:2018-12-25 发布日期:2019-03-25
  • 通讯作者: 甘桂芬，E-mail：ggfoyyf@163.com
  • 作者简介:甘桂芬(1975-)，女，副主任医师。研究方向：新生儿疾病的诊治

Effect of Kangaroo mother care on the growth and development of preterm infants less than 2 000 grams and clinical efficacy during hospitalization

GAN Guifen，CAI Yuan   

  1. Yueyang Second People's Hospital，Yueyang 414000，China
  • Online:2018-12-25 Published:2019-03-25

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摘要：
目的
研究袋鼠式护理(KMC)对出生体质量低于2 000 g早产儿住院期间生长发育和临床疗效的影响。
方法
2016年1月至2017年6月在岳阳市二人民医院产科分娩并入住新生儿科的出生体质量<2 000 g的早产儿136例，随机分为KMC组和对照组各68例。KMC组经评估后尽早实施KMC护理，对照组给予常规护理，直至出院。比较两组早产儿出院时生长发育情况、新生儿行为神经测定评分和临床疗效指标之间的差异。
结果
KMC组出院体质量、出院头围、住院期间平均体质量增长显著高于对照组，差异有统计学意义(P<0.05)。两组出院身长和宫外发育迟缓发生率比较，差异无统计学意义(P>0.05)。KMC组早产儿住院期间新生儿行为神经测定评分为(35.37±0.96)分，高于对照组(35.00±0.86)分，差异有统计学意义(P<0.05)。KMC组早产儿住院期间呼吸暂停和支气管肺发育不良发生率显著低于对照组，差异有统计学意义(P<0.05)，两组动脉导管未闭、颅内出血、喂养不耐受、消化道出血、坏死性小肠结肠炎和院内感染发生率比较差异无统计学意义(P>0.05)。营养支持方面，KMC组早产儿禁食时间、肠外营养时间、达全肠内营养时间显著少于对照组，平均加奶速度快于对照组，差异有统计学意义(P<0.05)。KMC组早产儿氧疗时间、机械通气时间和住院时间均显著短于对照组，差异有统计学意义(P<0.05)。
结论
KMC可促进早产儿生长和神经行为发育，可降低早产相关并发症的发生，促进营养方案的顺利实施，有利于早产儿呼吸稳定和提早出院，具有良好的临床疗效。

关键词: 低出生体质量, 早产儿, 袋鼠式护理

Abstract:
Objective
To study the effect of Kangaroo mother care (KMC) on the growth and development of preterm infants with birth weight less than 2 000 g and clinical efficacy during hospitalization.
Methods
A total of 136 preterm infants with birth weight less than 2 000 g from January 2016 to June 2017 in Yueyang Second People's Hospital were randomly divided into KMC group(68 cases) and control group(68 cases). The KMC group was given kangaroo mother care as early as possible, while the control group was given routine care until discharge. The growth and development condition and NBNA scores were recorded. The clinical efficacy of the two groups was evaluated.
Results
The weight and head circumference at discharge, average weight gain in hospital in KMC group were significantly higher than those in the control group(P<0.05). There was no significant difference between the two groups in body length at discharge or the incidence of extrauterine growth retardation(P>0.05). The NBNA score in KMC group (35.37±0.96) was higher than that in control group (35.00±0.86). The incidence of apnea and bronchopulmonary dysplasia in KMC group was significantly lower than that in the control group(P<0.05). There was no significant difference in the incidence of patent ductus arteriosus, intracranial hemorrhage, feeding intolerance, gastrointestinal bleeding, necrotizing enterocolitis or nosocomial infection between the two groups (P>0.05). Compared with the control group, the KMC group had shorter duration of fasting and parenteral nutrition, earlier total enteral nutrition and faster rate of adding milk(P<0.05). Moreover, the duration of oxygen therapy, mechanical ventilation and hospitalization in the KMC group were significantly shorter than those in the control group(P<0.05).
ConclusionKangaroo mother care can promote the growth and neurobehavioral development of preterm infants, reduce the incidence of complications related to premature birth, and promote the implementation of the nutritional support. KMC is beneficial to respiratory stability and early discharge and has good clinical effect on preterm infants.

Key words: Low birth weight, Preterm infants, Kangaroo mother care