新生儿重症监护室开展家庭病房的实践与效果评价  

Evaluation of single family room effects on pretcrm infants in the neonatal intensive care unit

作　　者：李健[1] 华玲玲 李雪华[1] 娄未 莫丽 贾哲[2] Li Jian;Hua Lingling;Li Xuehua;Lou Wei;Mo Li;Jia Zhe(Department of Medical Administration Division,the General Hospital of Shenyang Military,Shenyang 110000,China)

机构地区：[1]沈阳军区总医院儿科,110000 [2]沈阳军区总医院医务部,110000 [3]江苏省无锡儿童医院儿科

出　　处：《中国实用护理杂志》2018年第33期2615-2619,共5页Chinese Journal of Practical Nursing

摘　　要：目的探索在新生儿重症监护室（NICU）内开展家庭病房对母亲焦虑、母乳喂养状况和早产儿行为神经发育的影响。方法将100例住NICU的早产儿按随机数字表法分为试验组48例和对照组52例，试验组新生儿在NICU住院期间保证父母每日至少4h与患儿在家庭病房中进行照护；对照组采用传统视频探视方法进行每日一次预约式探视。收集并记录2组患儿纯母乳喂养情况、院内感染发生率、母亲焦虑发生率和家长满意度及矫正胎龄足月后新生儿神经行为测定（NBNA）评分。结果试验组患儿在院期间及6月龄时纯母乳喂养率分别为82．50％（33／40）、42．50％（17／40），对照组分别为17．07％（7／41）、12．20％（5／41），2组比较差异有统计学意义（r：32．25、9．40，P〈0．01）；试验组患儿母亲焦虑评分33．00（31．00，41．75）分，对照组为43．00（34．50，46．00）分，差异有统计学意义（Z=-2．97，P=0．003）。试验组患儿矫正胎龄足月后NBNA评分为38．50（38．00，40．00）分，对照组为37．00（36．00，39．00）分，差异有统计学意义（Z=-2．86，P〈0．01）；2组患儿院内感染发生率、家长满意度比较差异均有统计学意义（P〈0．01）。结论家庭病房的开展有利于提高纯母乳喂养率，降低院内感染发生率，减轻母婴分离焦虑，提升家长满意度，对早产儿行为神经发育有一定的促进作用。Objective To explore the impact of family single room practices in NICU on maternal anxiety and breastfeeding status and neuropsychological development in preterm infants. Methods One-hundred NICU-born preterm infants were divided into the experimental group （n= 48） and the control group （n=52） according to random number table. Neonates in the experimental group were guaranteed parental care in the family ward for at least 4 hours a day during hospitalization in NICU, while the control group used a traditional video-based approach for daily scheduled visits. Finally, the results of exclusive breastfeeding, nosocomial infection, maternal anxiety, parental satisfaction, and full-term NBNA score after correction of gestational age were collected and recorded. Results The rates of exclusive breasffeeding were $2.50% （33/40）,42.50% （17/40）during hospitalization and six months old in the experimental group, and 17.07% （7/41）,12.20% （5/41）in the control group. The difference between the two groups was statistically significant during hospitalization and at 6 months of age （X^2=32.25, 9.40, P 〈0.01）. The score of maternal anxiety was 33.00（31.00, 41.75）in the experimental group, and 43.00（34.50, 46.00） in the control group. The difference between the two groups was statistically significant （Z=-2.97, P =0.003）.The NBNA score in the experimental group was 38.50 （38.00, 40.00）, and 37.00 （36.00, 39.00）in the control group. The difference between the two groups was statistically significant （Z=-2.86, P 〈0.01）. Conclusions The development of family ward is conducive to raising the rate of exclusive breasffeeding, reducing the incidence of nosocomial infection, relieving the anxiety of mother-infant separation and enhancing the satisfaction of parents, which can promote the behavioral and neuropsychological development of preterm infants.

关 键 词：婴儿 早产儿 家庭病房 母乳喂养 NBNA评分 

分 类 号：R473.72[医药卫生—护理学]