住院足月新生儿按需喂养模式的构建及初步应用  

Construction and preliminary implementation of demand-based feeding mode for hospitalized full-term newborns

作　　者：杨童玲[1] 李丽玲 王丽 吕天婵 胡晓静 Yang Tongling;Li Liling;Wang Li;LüTianchan;Hu Xiaojing(Newborn Ward,Children′s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院新生儿病房,上海201102 [2]复旦大学附属儿科医院新生儿重症监护病房,上海201102 [3]复旦大学附属儿科医院护理部,上海201102

出　　处：《护理学杂志》2023年第15期56-60,75,共6页Journal of Nursing Science

基　　金：国家重点研发计划项目(2021YFC2701004);上海市科委长三角科技创新共同体领域项目(21002411900)。

摘　　要：目的构建无陪护病房的住院足月新生儿适宜的按需喂养模式,进行临床初步应用,为我国新生儿病房开展按需喂养提供参考。方法检索国内外数据库获取来自临床实践指南、最佳实践、证据总结、系统评价、专家共识的证据,采用德尔菲法构建无陪护病房的住院足月新生儿适宜的按需喂养模式。纳入住院足月新生儿19例,采用随机数字表法将其分为观察组10例和对照组9例,观察组采用按需喂养模式,对照组采用传统的按时按量喂养模式。结果构建新生儿按需喂养模式包含喂养开始的指征,新生儿吃饱的指征,安全按需喂养评估3个维度共25条目,并绘制按需喂养流程图。观察组实施新生儿按需喂养模式后,平均每天心率大于160次/min的时间显著低于对照组,新生儿体质量增长显著高于对照组(均P<0.05)。结论构建的住院足月新生儿按需喂养模式,有利于维持新生儿生理指标稳定,促进体质量增长。Objective To create an appropriate demand-based feeding mode for full-term newborns hospitalized in unaccompanied ward,to preliminarily put the feeding mode into practice,and to provide evidence for carrying out demand-based feeding in neonatal units.Methods We searched domestic and foreign databases to obtain evidence from clinical practice guidelines,best practices,evidence summaries,systematic reviews and expert consensus.Then a demand-based feeding mode for full-term newborns hospita-lized in unaccompanied ward was drafted and subjected to Delphi expert consultation.Nineteen full term hospitalized newborns were included and randomly divided into an experimental group of 10 cases and a control group of 9 cases.The experimental group was subjected to demand-based feeding mode,while the control group was fed on schedule with fixed volume of milk.Results The demand-based feeding mode for full term newborns included such 3 dimensions as cues to start feeding,cues of infant satiety,and safe demand-based feeding,totaling 25 items.A flow chart of demand-based feeding was drawn.The experimental group had shorter period of average daily heart rate>160 beats/min,and higher weight gain,than the control group(both P<0.05).Conclusion The demand-based feeding mode for full term newborns is beneficial for maintaining stable physiological indicators and promoting weight gain in newborns.

关 键 词：新生儿 按需喂养 喂养指征 喂养评估 体质量 生长发育 新生儿护理 循证护理 

分 类 号：R473.72[医药卫生—护理学] R459.3[医药卫生—临床医学]