新生儿科病房捐赠人乳使用现状分析  

Analysis of the current situation of the use of donated human milk in Neonatal Ward

作　　者：王敏 徐巧 李丹 龚小慧[2] 范巧玲 张婷[1] WANG Min;XU Qiao;LI Dan;GONG Xiaohui;FAN Qiaoling;ZHANG Ting(Department of Gastroenterology,Shanghai Children’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200062,China;Department of Neonatology,Shanghai Children’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200062,China)

机构地区：[1]上海市儿童医院/上海交通大学医学院附属儿童医院消化科,上海200062 [2]上海市儿童医院/上海交通大学医学院附属儿童医院新生儿科,上海200062

出　　处：《上海医药》2025年第3期10-14,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:在没有生母乳汁的情况下,捐赠人乳是一种安全的替代品。本文分析上海市儿童医院新生儿科病房捐赠人乳的使用现状。方法:采用回顾性队列研究方法,收集2017—2021年出生后24 h内入住上海市儿童医院新生儿科病房的早产儿的病历资料,分析他们住院期间捐赠人乳的使用情况,包括捐赠人乳喂养率及其喂养时间、喂养占比。结果:新生儿科病房5年中共收治符合纳入标准的早产儿2831例,其中1080例(38.1%)接受过捐赠人乳喂养。在接受过捐赠人乳喂养的早产儿中,半数以上早产儿(591例,54.7%)的胎龄≤32周。胎龄≤32周和>32~37周早产儿中分别有591和489例接受过捐赠人乳喂养,捐赠人乳喂养率分别为71.7%(591/824)和24.4%(489/2007)。在接受过捐赠人乳喂养的早产儿中,高达80.6%(870/1080)的早产儿在出生后3 d内开始使用捐赠人乳喂养,其中70.9%的胎龄≤32周早产儿使用捐赠人乳开奶,使用捐赠人乳喂养的持续时间中位数为23 d(13 d,38 d);20.1%的胎龄>32~37周早产儿使用捐赠人乳开奶,使用捐赠人乳喂养的持续时间中位数为12 d(7 d,21 d)。捐赠人乳喂养的主要适用指征是早产儿,其他适用指征包括先天性肠道畸形、先天性心脏畸形和新生儿坏死性小肠结肠炎后的再喂养等。结论:在上海市儿童医院,早产儿在住院期间主要使用捐赠人乳喂养。人乳库的建立极大程度地改变了新生儿科病房早产儿的喂养方式。Objective:Donated human milk(DHM)is a safe alternative in the absence of mother’s own milk.The aim of this study was to investigate the current situation of donor breastfeeding in the Neonatal Ward of Shanghai Children’s Hospital.Methods:A retrospective cohort study was conducted to collect the medical records of preterm infants admitted to our hospital within 24 hours after birth from 2017 to 2021 and to analyze the feed of DHM during their hospitalization,including donor breastfeeding rates,duration of feeding,and percentage of feeding.Results:A total of 2831 preterm babies who met the inclusion criteria were admitted over the 5-year period,of whom 1080(38.1%)had received DHM feeding.The majority of DHM-fed preterm infants(54.7%)were born at gestational age(GA)≤32 weeks.DHM-fed preterm infants with GA≤32 weeks and>32-37 weeks were 591 and 489,and the rates of DHM feeding were 71.7%(591/824)and 24.4%(489/2007),respectively.Up to 80.6%(870/1080)of preterm infants started feeding with DHM within 3 days of birth.Seventy-point nine percent of premature infants with GA≤32 weeks used DHM as their first milk,with a feeding duration of 23 days(13,38);20.1%of GA>32-37 weeks premature infants were fed with DHM as their first milk for 12 days(7,21).The primary indication for DHM feeding was prematurity;other indications included congenital intestinal malformations and cardiac malformations,and neonatal necrotizing enterocolitis refeeding,etc.Conclusion:DHM is mainly used in preterm neonates in our hospital.The advent of breast milk banking has dramatically changed breastfeeding practices in the Neonatal Ward.

关 键 词：母乳喂养 捐赠人乳 人乳库 早产儿 

分 类 号：R174.4[医药卫生—妇幼卫生保健] R722[医药卫生—公共卫生与预防医学]