袋鼠式护理在极低出生体重儿中的应用

鲁萍; 厉建英; 周迎春; 夏芳琴; 吕俊英; 王建平

doi:10.16766/j.cnki.issn.1674-4152.002392

袋鼠式护理在极低出生体重儿中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002392

温州医科大学附属第二医院育英儿童医院NICU，浙江温州 325027

基金项目:

浙江省医药卫生科技计划项目 2018KY524

温州市科技局课题 Y20180392

详细信息

通讯作者:
王建平，E-mail：vuc522868@163.com

中图分类号: R473.72 R722
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- 文章访问数: 156
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-16
- 网络出版日期: 2022-08-13

Application of kangaroo nursing in infants with very low birth weight

The Second Affiliated Hospital of Wenzhou Medical University, Yuying Children's Hospital, Wenzhou, Zhejiang 325027, China

摘要

摘要: 目的极低出生体重儿的临床护理与治疗始终是临床诊疗中的重点和难点，本文旨在研究袋鼠式护理在极低出生体重儿中的应用效果。方法选取温州医科大学附属第二医院新生儿科2018年1月—2019年12月接收的160例极低出生体重住院患儿作为研究对象，按随机数字表法分为干预组(80例)和对照组(80例)，对照组采用早产儿常规护理方法，干预组在对照组基础上采用袋鼠式护理干预。观察并记录2组住院时间、住院费用、患儿生长发育情况、住院期间纯母乳喂养率、住院期间并发症发生情况、母亲心理情绪状况、极低出生体重儿基础护理常识掌握程度、护理满意度，并进行组间比较分析。结果 2组住院时间、住院费用、体重增长值、身长增长值、头围增长值及住院期间纯母乳喂养率比较差异有统计意义(均P＜0.05)；干预组住院期间新生儿坏死性小肠结肠炎(0 vs.7.50%)、肺炎(8.75% vs. 22.50%)、败血症(6.25% vs. 18.75%)及喂养不耐受(28.75% vs. 53.75%)发生率明显低于对照组，差异有统计学意义(均P＜0.05)；2组母亲的焦虑自评量表评分[(33.77±1.15)分vs. (38.26±1.20)分]与抑郁自评量表评分[(31.34±1.33)分vs. (44.29±2.06)分]、护理满意度(96.25% vs. 78.75%)、基本护理常识得分[(90.55±2.30)分vs.(78.42±1.65)分]比较差异有统计学意义(均P＜0.05)。结论袋鼠式护理有助于促进极低出生体重儿生长发育，降低住院费用和时间，也有利于改善患儿母亲的心理情绪状态，提高护理满意度。
- 极低出生体重儿 /
- 袋鼠式护理 /
- 母乳喂养 /
- 并发症 /
- 心理情绪
Abstract: Objective Clinical nursing and treatment of infants with very low birth weight is always the focus and difficulty in clinical diagnosis and treatment. This article aims to study the application effect of kangaroo nursing in infants with very low birth weight. Methods A total of 160 patients with very low birth weight hospitalised in the Department of Neonatology, Yuying Children's Hospital, Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects and randomly divided into the intervention group (n=80) and the control group (n=80). The control group adopted routine care for premature infants, and the intervention group adopted kangaroo nursing intervention on the basis of the control group. The length of hospitalisation, hospitalisation expenses, growth and development of the children, the rate of exclusive breastfeeding during hospitalisation, the occurrence of complications during hospitalisation, the psychological and emotional status of the mother, the mastery of basic nursing knowledge for infants with very low birth weight and the satisfaction of nursing care were observed and recorded, and then a comparative analysis between groups was performed. Results Significant differences in hospitalisation time, hospitalisation expenses, weight gain, body length gain, head circumference gain and the rate of exclusive breastfeeding during hospitalisation were found between the two groups (all P < 0.05). During hospitalisation, the incidence rates of neonatal necrotising enterocolitis (0 vs. 7.50%), pneumonia (8.75% vs. 22.50%), sepsis (6.25% vs. 18.75%) and feeding intolerance (28.75% vs. 53.75%) were significantly lower in the intervention group than in the control group (P < 0.05). The Self-Rating Anxiety Scale [(33.77±1.15) points vs. (38.26±1.20) points], Self-Rating Depression Scale [(31.34±1.33) points vs. (44.29±2.06) points], satisfaction (96.25% vs. 78.75%) and basic nursing common sense score [(90.55±2.30) points vs. (78.42±1.65) points] showed significant statistical differences between groups (all P < 0.05). Conclusion Kangaroo nursing can help promote the growth and development of infants with very low birth weight, reduce hospitalisation costs and time, improve the psychological and emotional state of the mothers and increase the quality and satisfaction of diagnosis and treatment.
- Infants with very low birth weight /
- Kangaroo nursing /
- Breastfeeding /
- Complications /
- Psychological emotions

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表 1 2组极低出生体重儿一般临床资料比较

Table 1. Comparison of general clinical data of ultra-low birth weight infants between the two groups

组别	例数	性别[例(%)]		胎龄(x±s，周)	出生体重(x±s，g)	出生身长(x±s，cm)	出生头围(x±s，cm)	分娩方式[例(%)]		Apgar评分(x±s，分)
组别	例数	男	女	胎龄(x±s，周)	出生体重(x±s，g)	出生身长(x±s，cm)	出生头围(x±s，cm)	顺产	剖宫产	Apgar评分(x±s，分)
干预组	80	51(63.75)	29(36.25)	30.48±4.67	1 298.94±120.07	37.75±3.82	27.64±2.33	57(71.25)	23(28.75)	8.09±0.80
对照组	80	49(61.25)	31(38.75)	30.18±3.94	1 300.65±129.38	38.01±2.88	26.94±2.73	55(68.75)	25(31.25)	8.11±0.60
统计量		0.107^a		0.439^b	0.087^b	0.486^b	1.744^b	0.119^a		0.179^b
P值		0.744		0.661	0.931	0.628	0.083	0.730		0.859
注：^a为χ²值，^b为t值, ^c为Z值。

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表 2 2组极低出生体重儿母亲及家庭一般资料比较

Table 2. Comparison of general data of mothers and families of ultra-low birth weight infants in the two groups

组别	例数	母亲年龄(x±s，岁)	母亲学历[例(%)]			是否有医保[例(%)]		家庭年收入[例(%)]			母亲SAS评分(x±s，分)	母亲SDS评分(x±s，分)	母亲护理知识得分(x±s，分)
组别	例数	母亲年龄(x±s，岁)	大专及以下	本科	硕士及以上	是	否	＜5.0万元	5.0~10.0万元	＞10.0万元	母亲SAS评分(x±s，分)	母亲SDS评分(x±s，分)	母亲护理知识得分(x±s，分)
干预组	80	27.79±5.87	17(21.25)	42(52.50)	21(26.25)	58(72.50)	22(27.50)	7(8.75)	39(48.75)	34(42.50)	41.55±4.95	42.75±5.30	36.88±4.70
对照组	80	28.21±6.53	15(18.75)	45(56.25)	20(25.00)	61(76.25)	19(23.75)	5(6.25)	38(47.50)	37(46.25)	42.81±4.37	44.12±4.58	35.69±5.21
统计量		0.428^a	0.253^b			0.295^c		0.473^b			1.707^a	1.749^a	1.517^a
P值		0.669	0.881			0.587		0.789			0.090	0.082	0.131
注：^a为t值，^b为Z值, ^c为χ²值。

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表 3 2组极低出生体重儿住院时间、费用、生长发育及纯母乳喂养比较

Table 3. Comparison of hospital stay time, cost, growth and exclusive breastfeeding of ultra-low birth weight infants in two groups

组别	例数	住院费用(x±s，万元)	住院时间(x±s，d)	身长增长值(x±s，cm/周)	体重增长值(x±s，g/d)	头围增长值(x±s，cm/周)	纯母乳喂养[例(%)]
干预组	80	6.74±1.25	12.37±1.33	1.12±0.26	4.17±0.30	1.25±0.17	63(78.75)
对照组	80	8.29±2.33	16.44±4.29	0.86±0.15	3.74±0.10	0.99±0.10	33(41.25)
统计量		5.271^a	8.105^a	7.747^a	12.162^a	11.791^a	23.438^b
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：^a为t值，^b为χ²值。

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表 4 2组极低出生体重儿住院期间并发症发生情况比较[例(%)]

Table 4. Comparison of complications in the two groups of ultra-low birth weight infants during hospitalization[cases (%)]

组别	例数	新生儿坏死性小肠结肠炎	肺炎	败血症	喂养耐受差
干预组	80	0	7(8.75)	5(6.25)	23(28.75)
对照组	80	6(7.50)	18(22.50)	15(18.75)	43(53.75)
χ²值		4.329	5.736	5.714	10.316
P值		0.038	0.017	0.017	0.001

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表 5 2组极低出生体重儿母亲心理情绪、护理常识掌握评分及满意度比较v

Table 5. Comparison of ultra-low birth weight infants ' mothers ' psychological emotions, nursing knowledge mastery scores and satisfaction of the two groups

组别	例数	SAS评分(x±s，分)	SDS评分(x±s，分)	护理知识得分(x±s，分)	护理满意度[例(%)]
干预组	80	33.77±1.15	31.34±1.33	90.55±2.30	77(96.25)
对照组	80	38.26±1.20	44.29±2.06	78.42±1.65	63(78.75)
统计量		24.162^a	47.238^a	38.329^a	11.200^b
P值		＜0.001	＜0.001	＜0.001	0.001
注：^a为t值，^b为χ²值。

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