母乳喂养系统化管理对住院早产儿实施母乳喂养效果的影响
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摘要
目的观察母乳喂养系统化管理对住院早产儿实施母乳喂养效果的影响。方法将2016年1～12月在河北省秦皇岛市妇幼保健院(以下简称"我院")产科生产的早产儿77例,采取常规母乳喂养与产后日常管理,设置为对照组;将2017年1～12月于我院生产的早产儿79例,采用母乳喂养系统化管理,设置为观察组。比较两组早产儿母乳喂养情况、并发症发生情况、生长发育情况,及产妇管理前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果观察组首次母乳喂养日龄明显少于对照组,1周时母乳喂养率高于对照组,1周时母乳量明显多于对照组,2周时母乳喂养率明显高于对照组,2周时母乳量明显多于对照组,住院期间纯母乳喂养率明显高于对照组,两组间比较差异均有统计学意义(P <0.05或P <0.01)。观察组住院期间早产儿并发症发生率明显低于对照组,差异有高度统计学意义(P <0.01)。观察组早产儿住院期间身长增长、体重增长、头围增长幅度明显高于对照组,差异均有高度统计学意义(P <0.01)。入院时,两组产妇SAS、SDS评分比较差异无统计学意义(P> 0.05)。出院前,两组产妇SAS、SDS评分明显低于入院时,且观察组产妇SAS、SDS评分明显低于对照组,差异有高度统计学意义(P <0.01)。结论在住院早产儿中,实施母乳喂养系统化管理,可明显提升纯母乳喂养率,增加产妇母乳量,降低早产儿住院期间并发症的发生率,提高早产儿生长发育速度,减少产妇产后发生焦虑、抑郁的不良心理状态,效果理想。
Objective To observe the effect of systematic management of breastfeeding on breast feeding in hospitalized preterm infants. Methods A total of 77 premature infants delivered in obstetrics department of Qinhuangdao Maternal and Child Health Hospital in Hebei Province( "our hospital" for short) from January to December 2016 was selected as control group, routine breastfeeding and postpartum routine management were used in control group, 79 premature infants delivered in our hospital from January to December 2017 were selected as observation group, systematic management of breastfeeding was used in observation group. The breastfeeding, complications, growth and development of premature infants were compared between two groups. The self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores before and after maternal management were compared between two groups. Results The first breastfeeding age of observation group was significantly less than that of control group, the breastfeeding rate at 1 week of observation group was higher than that of control group, the amount of breast milk at 1 week of observation group was significantly more than that of control group, the breastfeeding rate at 2 weeks of observation group was significantly higher than that of control group, the amount of breast milk at 2 weeks of observation group was significantly more than that of control group, and the rate of exclusive breastfeeding in observation group was significantly higher than that in control group during hospitalization. There were significant differences between two groups(P < 0.05 or P < 0.01). The incidence rate of complications of premature infants during hospitalization in observation group was significantly lower than that in control group, the difference was highly statistically significant(P < 0.01). The growth of length, weight and head circumference of preterm infants in observation group were significantly higher than those in control group during hospitalization, the differences were highly statistically significant(P < 0.01). At admission, there was no significant difference in SAS and SDS scores between two groups(P > 0.05). Before discharge, SAS and SDS scores of parturients in two groups were significantly lower than those at admission, the scores of SAS and SDS in observation group were significantly lower than those in control group, the differences were highly statistically significant(P < 0.01). Conclusion Systematic management of breastfeeding in hospitalized premature infants can significantly improve the rate of exclusive breastfeeding, increase the amount of breast milk, reduce the complications of premature infants during hospitalization, improve the growth and development of premature infants, and reduce the anxiety and depression of postpartum women.
Objective To observe the effect of systematic management of breastfeeding on breast feeding in hospitalized preterm infants. Methods A total of 77 premature infants delivered in obstetrics department of Qinhuangdao Maternal and Child Health Hospital in Hebei Province( "our hospital" for short) from January to December 2016 was selected as control group, routine breastfeeding and postpartum routine management were used in control group, 79 premature infants delivered in our hospital from January to December 2017 were selected as observation group, systematic management of breastfeeding was used in observation group. The breastfeeding, complications, growth and development of premature infants were compared between two groups. The self-rating anxiety scale(SAS) and self-rating depression scale(SDS) scores before and after maternal management were compared between two groups. Results The first breastfeeding age of observation group was significantly less than that of control group, the breastfeeding rate at 1 week of observation group was higher than that of control group, the amount of breast milk at 1 week of observation group was significantly more than that of control group, the breastfeeding rate at 2 weeks of observation group was significantly higher than that of control group, the amount of breast milk at 2 weeks of observation group was significantly more than that of control group, and the rate of exclusive breastfeeding in observation group was significantly higher than that in control group during hospitalization. There were significant differences between two groups(P < 0.05 or P < 0.01). The incidence rate of complications of premature infants during hospitalization in observation group was significantly lower than that in control group, the difference was highly statistically significant(P < 0.01). The growth of length, weight and head circumference of preterm infants in observation group were significantly higher than those in control group during hospitalization, the differences were highly statistically significant(P < 0.01). At admission, there was no significant difference in SAS and SDS scores between two groups(P > 0.05). Before discharge, SAS and SDS scores of parturients in two groups were significantly lower than those at admission, the scores of SAS and SDS in observation group were significantly lower than those in control group, the differences were highly statistically significant(P < 0.01). Conclusion Systematic management of breastfeeding in hospitalized premature infants can significantly improve the rate of exclusive breastfeeding, increase the amount of breast milk, reduce the complications of premature infants during hospitalization, improve the growth and development of premature infants, and reduce the anxiety and depression of postpartum women.
引文
[1]郑锦霞,王勤,赵敏慧,等.闭环式管理模式对提高住院早产儿母乳喂养率效果研究[J].护理学报,2016,23(5):32-34.
[2]蒲蓉,罗健蓉,赵铀,等.临床护理路径在个性化母乳喂养管理中的应用效果观察[J].中国计划生育和妇产科,2015(6):53-56.
[3]杨倩,王依琼.母婴分离新生儿母乳喂养的规范化管理[J].解放军护理杂志,2015,32(23):55-57.
[4]赵迎娟,卢淑亚,白利颖.产科儿科合作护理对ICU早产儿母乳喂养效果的影响[J].中华现代护理杂志,2016,22(27):3964-3967.
[5]谭小琴,侯志蓉,涂正燕,等.应用PDCA管理方法提高新生儿在院期间纯母乳喂养率[J].湖南中医药大学学报,2016(A02):1228-1229.
[6]冯淑菊,景亚琳,陈杭健,等.住院早产儿母乳喂养系统化管理的临床应用效果[J].协和医学杂志,2014,5(4):399-404.
[7]张谦慎.新生儿重症监护病房母乳收集、保存和处理[J].中华围产医学杂志,2013,16(7):385-387.
[8] Hassiotou F,Geddes DT,Hartmann PE. Cells in human milk:state of the science[J]. J Hum Lactx,2013,29(2):171-182.
[9]季福婷,张玉侠,胡晓静,等.初乳口腔滴注对极低出生体重儿喂养状况的效果研究[J].中华护理杂志,2016,51(10):1157-1160.
[10] Han Shuping. Benefits of breastfeeding for premature infants in neonatal intensive care unit[J]. Chin J Neonatol,2015,30(3):161-163.
[11]中国医师协会新生儿科医师分会营养专业委员会,中国医师协会儿童健康专业委员会母乳库学组,《中华儿科杂志》编辑委员会.新生儿重症监护病房推行早产儿母乳喂养的建议[J].中华儿科杂志,2016,54(1):13-16.
[12]钟小秋.系统化护理干预对改善母乳喂养的效果分析[J].实用临床护理学电子杂志,2017,2(35):86,104.
[13]许芳玲,叶丽珍.系统化护理对母乳喂养方式干预效果分析[J].中国公共卫生管理,2016,32(2):276-277.
[14]张丽莉.系统化护理干预对改善产妇母乳喂养自信心和纯母乳喂养率的效果观察[J].临床医药文献电子杂志,2015,2(29):6105-6106.
[15]赵力立,曹明英,姚朱华,等.协同护理模式对急性心肌梗死患者心功能及心理状态的影响[J].护士进修杂志,2014,29(16):1463-1465.
[16]冉梅,熊英.自由度评估护理对急性心肌梗死患者早期康复效果的影响[J].内科,2014,9(4):453-455.
[17]张静,周彬.早期康复护理干预应用于老年急性心肌梗死患者的临床价值探讨[J].吉林医学,2013,34(17):3478-3479.
[18]杨海丽.前瞻性护理对急性心肌梗死患者便秘和生活质量的影响[J].齐鲁护理杂志,2013,19(7):33-34.
[19]赵云英.老年急性心肌梗死合并心力衰竭200例临床护理[J].齐鲁护理杂志,2013,19(7):76-77.
[2]蒲蓉,罗健蓉,赵铀,等.临床护理路径在个性化母乳喂养管理中的应用效果观察[J].中国计划生育和妇产科,2015(6):53-56.
[3]杨倩,王依琼.母婴分离新生儿母乳喂养的规范化管理[J].解放军护理杂志,2015,32(23):55-57.
[4]赵迎娟,卢淑亚,白利颖.产科儿科合作护理对ICU早产儿母乳喂养效果的影响[J].中华现代护理杂志,2016,22(27):3964-3967.
[5]谭小琴,侯志蓉,涂正燕,等.应用PDCA管理方法提高新生儿在院期间纯母乳喂养率[J].湖南中医药大学学报,2016(A02):1228-1229.
[6]冯淑菊,景亚琳,陈杭健,等.住院早产儿母乳喂养系统化管理的临床应用效果[J].协和医学杂志,2014,5(4):399-404.
[7]张谦慎.新生儿重症监护病房母乳收集、保存和处理[J].中华围产医学杂志,2013,16(7):385-387.
[8] Hassiotou F,Geddes DT,Hartmann PE. Cells in human milk:state of the science[J]. J Hum Lactx,2013,29(2):171-182.
[9]季福婷,张玉侠,胡晓静,等.初乳口腔滴注对极低出生体重儿喂养状况的效果研究[J].中华护理杂志,2016,51(10):1157-1160.
[10] Han Shuping. Benefits of breastfeeding for premature infants in neonatal intensive care unit[J]. Chin J Neonatol,2015,30(3):161-163.
[11]中国医师协会新生儿科医师分会营养专业委员会,中国医师协会儿童健康专业委员会母乳库学组,《中华儿科杂志》编辑委员会.新生儿重症监护病房推行早产儿母乳喂养的建议[J].中华儿科杂志,2016,54(1):13-16.
[12]钟小秋.系统化护理干预对改善母乳喂养的效果分析[J].实用临床护理学电子杂志,2017,2(35):86,104.
[13]许芳玲,叶丽珍.系统化护理对母乳喂养方式干预效果分析[J].中国公共卫生管理,2016,32(2):276-277.
[14]张丽莉.系统化护理干预对改善产妇母乳喂养自信心和纯母乳喂养率的效果观察[J].临床医药文献电子杂志,2015,2(29):6105-6106.
[15]赵力立,曹明英,姚朱华,等.协同护理模式对急性心肌梗死患者心功能及心理状态的影响[J].护士进修杂志,2014,29(16):1463-1465.
[16]冉梅,熊英.自由度评估护理对急性心肌梗死患者早期康复效果的影响[J].内科,2014,9(4):453-455.
[17]张静,周彬.早期康复护理干预应用于老年急性心肌梗死患者的临床价值探讨[J].吉林医学,2013,34(17):3478-3479.
[18]杨海丽.前瞻性护理对急性心肌梗死患者便秘和生活质量的影响[J].齐鲁护理杂志,2013,19(7):33-34.
[19]赵云英.老年急性心肌梗死合并心力衰竭200例临床护理[J].齐鲁护理杂志,2013,19(7):76-77.
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