长三角地区极/超低出生体重儿不同乳品种类搭配喂养现状的调查研究

doi:10.3761/j.issn.0254-1769.2022.16.006

摘要/Abstract

摘要： 目的分析长三角地区各医疗机构的极/超低出生体重儿不同乳品种类搭配喂养的现状，为临床中该类群体喂养方式的选择提供依据。方法 2019年1月—12月，采用NICU极/超低出生体重儿喂养情况调查表，回顾性收集长三角地区5所三级甲等医院NICU胎龄≤35周且出生后24 h内入院的极/超低出生体重儿的临床资料，获得不同乳品种类搭配喂养的情况，同时比较纯母乳喂养组和亲母母乳不足时使用配方奶补足组患儿喂养的相关临床指标。结果共收治极/超低出生体重儿830例，最终纳入667例。其中仅接受亲母母乳喂养82例（12.3%），仅接受捐赠母乳喂养5例（0.8%），接受亲母母乳+捐赠母乳喂养65例（9.8%），以上3种方式统称为纯母乳喂养，共计152例（22.9%）。接受捐赠母乳+配方奶喂养34例（5.1%），仅接受配方奶喂养75例（11.2%），接受亲母母乳+配方奶喂养333例（49.9%），接受亲母母乳+捐赠母乳+配方奶喂养73例（10.9%）。使用纯母乳喂养组肠外营养天数少于配方奶补足组，坏死性小肠结肠炎和迟发性败血症的发生率更低，差异均具有统计学意义（P<0.05）。结论长三角地区各医疗机构的极/超低出生体重儿纯母乳喂养情况不容乐观，亲母母乳不足时以配方奶进行补足喂养仍然不如纯母乳喂养效果好。

关键词: 极低出生体重儿, 超低出生体重儿, 母乳喂养, 捐赠母乳, 配方奶, 儿科护理学

Abstract:

Objective To analyze the application status of different dairy products for very and extremely low birth weight infants in Yangtze River Delta，so as to provide evidence for making better feeding choices in clinic Practice. Methods From January 2019 to December 2019，the self-made “form of feeding situation in very low birth weight infants（VLBW） in neonatal intensive care unit（NICU）” was used to collect data and uploaded to the database，and the clinical data of VLBW infants with gestational age ≤35 weeks and admitted to the NICU within 24 hours after birth in 5 tertiary hospitals in the Yangtze River Delta were retrospectively analyzed，and the composition ratio of different dairy types was obtained. At the same time，the clinical outcomes related to feeding in the exclusive breastfeeding group and the formula supplement group were compared. Results 830 cases of VLBW infants were admitted to the NICUs of 5 hospitals，among which 667 cases met the inclusion criteria. Among them，82（12.3%） received exclusive maternal breast milk;5（0.8%） received exclusive donated breast milk;65（9.8%） received both maternal and donated breast milk，the above three feeding types were collectively referred to as exclusive breastfeeding, a total of 152（22.9%） cases. 34（5.1%） received both donated breast milk and formula;75（11.2%） received exclusive formula;333（49.9%） received both maternal breast milk and formula;73（10.9%） received formula，maternal and donated breast milk. The number of days of parenteral nutrition in the donor breast milk supplement group was less than that in the formula supplement group，and the incidence of necrotizing enterocolitis and septicemia was lower than that in the formula supplement group，with statistical significance（P<0.05）. Conclusion The exclusive breastfeeding rate of VLBW infants in various institutions in the Yangtze River Delta region is not optimistic. When the mother’s breast milk is insufficient，formula supplement feeding is still not as effective as exclusive breastfeeding.

Key words: Very Low Birth Weight Infants, Extremely Low Birth Weight Infants, Breastfeeding, Donor Human Milk, Formula Milk, Pediatric Nursing

王丽, 吕天婵, 李丽玲, 金玉梅, 王燕, 唐云飞, 马月兰, 窦亚兰, 刘婵, 曹云, 宦夏, 张莉, 曹素珍, 黄国英, 胡晓静. 长三角地区极/超低出生体重儿不同乳品种类搭配喂养现状的调查研究[J]. 中华护理杂志, 2022, 57(16): 1956-1961.

WANG Li, LÜ Tianchan, LI Liling, JIN Yumei, WANG Yan, TANG Yunfei, MA Yuelan, DOU Yalan, LIU Chan, CAO Yun, HUAN Xia, ZHANG Li, CAO Suzhen, HUANG Guoying, HU Xiaojing. Multicenter survey on feeding of very low birth weight infants with different types of dairy products in the Yangtze River Delta[J]. Chinese Journal of Nursing, 2022, 57(16): 1956-1961.

图/表 4

表1 极/超低出生体重儿一般资料及乳品种类搭配情况（n=667）

Table 1 Characteristics of V/ELBWIs and the collocation of dairy products （n=667）

表2 纯母乳喂养组和亲母母乳不足时使用配方奶补足组患儿的一般资料比较

Table 2 Comparison of general data between the exclusive breastfeeding group and the formula milk supplement group

表3 纯母喂养组和亲母母乳不足时使用配方奶补足组患儿的喂养相关指标比较

Table 3 Comparison of feeding related indicators between the exclusive breast-feeding group and the formula milk supplement group when the mother’s breast milk is insufficient

表4 纯母乳喂养组和亲母母乳不足时使用配方奶补足组患儿并发症情况比较

Table 4 Comparison of complications between the exclusive breastfeeding group and the formula milk supplement group when the mother’s breast milk is insufficient

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