袋鼠式护理联合穴位按摩在防治早产儿胃肠外营养相关性胆汁淤积的可行性研究  

Study on feasibility of kangaroo mother care combined with acupoint massage in prevention and treatment of premature infants with parenteral nutrition associated cholestasis

作　　者：李正中 林梅[1] 黄芝蓉[1] 马妮妮[1] 李玉娟 梁崔 陆华湘 黄柳凤 LI Zhengzhong;LIN Mei;HUANG Zhirong;MA Nini;LI Yujuan;LIANG Cui;LU Huaxiang;HUANG Liufeng(Neonatology Department of Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Graduate School,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院新生儿科,广西百色533000 [2]右江民族医学院研究生学院,广西百色533000

出　　处：《右江医学》2020年第9期674-679,共6页Chinese Youjiang Medical Journal

基　　金：广西肝胆疾病临床医学研究中心课题(桂科AD17129025)。

摘　　要：目的探讨袋鼠式护理(KMC)联合穴位按摩对防治早产儿胃肠外营养(PN)相关性胆汁淤积(PNAC)的影响。方法根据纳入标准,选取2018年7月至2019年8月新生儿监护病房(NICU)住院治疗的早产儿120例,按入院顺序进行编号,采用随机数字表进行分组,对照组和观察组各60例。两组均按照我国新生儿重症监护室早产儿营养指南给予PN支持疗法及抗感染等对症治疗。对照组给予常规护理,观察组在对照组基础上给予袋鼠式护理及穴位按摩,记录并比较两组早产儿入院时,入院后第5天、第10天、第15天的肝功能指标[血清DBIL、TBIL、总胆汁酸(TBA)、ALT、AST]、静脉营养持续时间、恢复到出生体重的天数、平均体重增长速度、新生儿神经行为评分(纠正胎龄至40周)以及患儿母亲的焦虑、抑郁程度。结果入院时两组早产儿一般资料及各项生化指标比较,差异均无统计学意义(P>0.05);动态监测生化指标,观察组血清DBIL、TBIL、ALT、AST均低于对照组,差异有统计学意义(P<0.05);此外,观察组PN的持续时间、恢复至出生体重的时间以及平均体重增长速度均优于对照组,差异有统计学意义(P<0.05)。结论袋鼠式护理联合穴位按摩的方法在预防和减少早产儿PNAC的发生、提高早产儿胃肠道的功能、促进其生长发育等方面具有积极作用。Objective To explore the influence of kangaroo mother care(KMC)combined with acupoint massage on prevention and treatment of premature infants with parenteral nutrition associated cholestasis(PNAC).Methods 120 premature infants hospitalized in neonatal intensive care unit(NICU)from July 2018 to August 2019 were selected according to inclusion criteria.They were numbered according to the order of admission and divided into control group and observation group according to random number table,with 60 cases in each group.Both groups were given PN support therapy and anti-infection symptomatic treatment according to the nutritional guidelines of premature infants in NICU.In addition,the control group were given routine nursing,and the observation group were given KMC combined with acupoint massage on the basis of the control group.The liver function indexes(serum DBIL,TBIL,TBA,ALT,AST)on admission,5 days,10 days and 15 days after admission as well as duration of intravenous nutrition,days of recovery to birth weight,average rate of weight gain,neonatal behavioral neurological assessment(corrected gestational age was 40 weeks)and the degree of anxiety and depression of the mother were recorded and compared between the two groups.Results At the time of admission,there was no statistically significant difference in general data and biochemical indexes between the two groups(P>0.05).Dynamic monitoring of biochemical indicators showed that serum DBIL,TBIL,TBA,ALT and AST of the observation group were lower than those of the control group,difference was statistically significant(P<0.05).Moreover,the observation group gained an advantage over the control group in the duration of PN,time of recovery to birth weight and average rate of weight gain,difference was statistically significant(P<0.05).Conclusion KMC combined with acupoint massage has a positive effect on preventing and reducing the occurrence of premature infants with PNAC,improving the function of gastrointestinal tract and promoting the growth and development of t

关 键 词：早产儿 袋鼠式护理 穴位按摩 胃肠外营养 胆汁淤积 

分 类 号：R722.6[医药卫生—儿科]