局部母乳法对新生儿脐部护理效果比较的Meta分析  

The effect of local breast milk and natural drying on neonatal umbilical care:A Meta analysis

作　　者：唐帆[1] 李亚玲 李均凤 沈锋 韩樱 姚丽 Tang Fan;Li Yaling;Li Junfeng;Shen Feng;Hang Ying;Yao Li(School of Nursing of Guizhou Medical University,Guiyang,Guizhou 550025;Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004)

机构地区：[1]贵州医科大学,贵州贵阳550025 [2]贵州医科大学附属医院,贵州贵阳550004

出　　处：《护士进修杂志》2021年第18期1638-1644,共7页Journal of Nurses Training

基　　金：贵州医科大学护理学科教学与科学研究专项课题(编号:YJ20093)。

摘　　要：目的评价局部母乳法与自然干燥法对新生儿脐部护理的干预效果。方法计算机检索Pub Med、Embase、Web of Science、Cochrane Library、CINAHL Complete、中国知网(CNKI)、万方数据库(Wan fang Data)、维普数据库(VIP)和中国生物医学文献数据库(CBM)等公开发表的关于局部母乳法与自然干燥法在新生儿脐部中应用效果的相关文献,检索时间为建库至2020年12月31日。仅限于随机对照试验,对照组采取自然干燥法,观察组采取局部母乳法。结局指标为脐带脱落时间、脐炎发生率、脐部出血时间等变化。由2名研究者独立提取文献资料,根据Cochrane评分对纳入文献进行质量评价,并采用Revman 5.3软件进行系统分析;采用敏感性分析检验Meta分析结果的稳定性。结果共纳入8篇随机对照研究,其中6篇英文、2篇中文,共1362例患者,自然干燥组679例,母乳组683例。Meta分析结果显示:局部应用母乳进行脐部护理会缩短脐带脱落时间[MD=-1.10,95%CI(-1.35,-0.84),P<0.01]、脐带出血时间[MD=-1.76,95%CI(-2.32,-1.20),P<0.01],差异有统计学意义(P<0.05);观察组的脐炎发生率[RR=0.71,95%CI(0.49,1.03),P=0.07],与对照组比较,差异无统计学意义(P>0.05)。结论局部应用母乳护理脐部可有效缩短脐带脱落时间、减少脐带出血时间,且同时不增加脐部感染的风险。局部母乳法简捷、经济、无创,且具有母乳特有的免疫因子等优势,可降低医疗成本,优化医疗资源,对提高新生儿脐部护理质量有重要的指导意义。Objective To explore the intervention effect of local breast milk and natural drying on neonatal umbilical cord nursing.Methods Researches onthe effect of local breast milk and natural drying application in the umbilical cord of neonates were retrieved from the Pub Med,Embase,Web of Science,Cochrane Library,CINAHL Complete,CNKI,Wanfang Data,VIP and CBM for randomized controlled trials.The retrieval period was from the establishment of the database to 31 December,2020.By two researchers independently extracted the literature,according to the Cochrane score of the quality evaluation of the included literature,Meta-analysis was performed by using RevMan 5.3 statistical software.sensitivity analysis was used to test the stability of Meta analysisresults.Results A total of 8 randomized controlled studies were included,including 6 English and 2 Chinese,with a total of 1362 patients,Natural drying group 679 cases,breast milk group 683 cases.Results of Meta analysis showed that the clinical application of breast milk in umbilical cord can shorten the umbilical cord abscission time of neonates[MD=-1.10,95%CI(-1.35,-0.84),P<0.01],theumbilical cord bleeding days[MD=-1.76,95%CI(-2.32,-1.20),P<0.01].The difference was statistically significant(P<0.05);Compared with the control group,there was no significant difference incidence in the neonatal omphalitis[RR=0.71,95%CI(0.49,1.03),P=0.07].Conclusions The nursing of umbilical cord with breast milk can effectively shorten the umbilical cord separation time of neonates,reduce the days of umbilical cord bleeding while dose not increase the risk of umbilical cord infection.The local breast milk method is simple,economical and non-invasive,and has the advantages of special immune factors,which can reduce the medical cost,optimize the medical resources,and have important guiding significance for improving the nursing quality of newborn umbilical cord.

关 键 词：新生儿 局部母乳法 脐部护理 脐带脱落时间 脐带出血时间 脐炎 循证护理 

分 类 号：R473.72[医药卫生—护理学] R722.1[医药卫生—临床医学]