目的 比较母乳喂养质量改进干预期和稳定干预期对NICU极低出生体重儿母亲泌乳量的不同影响,以期提高母乳喂养率。方法 回顾性收集了2015年8月-2016年1月质量改进干预期组(quality improvement group,QI组) NICU极低出生体重儿母婴分室的早产儿母亲的泌乳和亲母母乳喂养情况以及2016年2月—2016年7月质量改进稳定干预期组(stable quality improvement group,SQI组)的资料。对两组母亲的每日泌乳情况(挤奶次数、挤奶量、挤奶量达到350 ml/d的时间、7 d内挤奶量≥350 ml/d的人数)和亲母母乳喂养情况(亲母母乳喂养率、亲母母乳喂养量)进行比较。结果 对两组患儿母亲每日挤奶次数及挤奶量、亲母母乳喂养率和亲母母乳喂养量进行比较,结果表明SQI组较QI组母亲每日挤奶次数及挤奶量、亲母母乳喂养率和喂养量均明显增加(P<0.05);SQI组患儿母亲挤奶量达到350 ml/d的时间较QI组明显减少(P<0.05);SQI组患儿母亲7 d内挤奶量≥350 ml/d的人数较QI组明显增加(P<0.05)。结论 母乳喂养质量改进措施的稳定实施可提高NICU中极低出生体重儿母亲泌乳量,改善母婴分室的早产儿亲母母乳喂养情况。

Objective To compare the effect of breastfeeding quality improvement on the lactation in very low birth weight (VLBW) in the neonatal intensive care unit (NICU) between improvement group and stable improvement group. Methods A retrospective analysis was performed for the lactation of the VLBW mothers and these mother's own milk feeding in NICU.Patients admitted from August 2015 to January 2016 were assigned to the quality improvement group(QI group)and those admitted from February 2016 to July 2016 were assigned to the stable quality improvement group(SQI group).The parameters including condition of daily lactation (daily number of pumping or hand expressing,daily breast milk volume,days to reach the daily milk output ≥350 ml,number of the mothers for reach the daily milk output ≥350 ml in 7 days ),and condition of mother's own milk feeding (the rate and the volume of mother's own milk feeding). Results Compared with the QI group,the daily number of pumpings,daily milk output,and the mother's own milk feeding rate and amount all increased significantly in the SQI group (P<0.05).The mothers in the SQI group significantly shortened the time of daily milk output reaching 350 ml and increased the number of mothers of daily milk output≥350 ml (P<0.05). Conclusion High quality breastfeeding quality improvement measures can increase the condition of the lactation and the mother's own milk feeding for VLBW in the NICU.