目的 分析母乳喂养质量改进对极/超低出生体重儿的影响,为对极/超低出生体重儿救治提供有效措施。方法 以本院2018年1月—2019年12月出生且收治入院、出生体重＜1 500g的160例早产儿为研究对象,以2019年为干预年,2018年收治的87例新生儿为对照组,2019年收治的73例新生儿为干预组,采用母乳喂养质量改进措施,分析两组患儿质量改进评价指标情况。结果 干预组开始泵奶的时间、禁食次数、禁食天数、静脉营养的时间均少于对照组,差异有统计学意义(t=2.007、2.666、2.222、3.187,P<0.05),两组泌乳开始时间、平均每日泵奶次数、第一次亲母母乳喂养时间、住院期间亲母母乳量、开始喂养时间、微量喂养持续时间、达到全肠道喂养的时间比较,差异均无统计学意义(P＞0.05)。干预组喂养不耐受、支气管肺发育不良发生率低于对照组,差异有统计学意义(χ²=4.368、3.963,P<0.05)。干预组与对照组间新生儿坏死性小肠结肠炎、败血症、新生儿胆汁淤积综合症发生率比较差异均无统计学意义(P＞0.05)。结论 母乳喂养质量改进可以缩短开始泵奶及静脉营养持续的时间,减少禁食次数、禁食天数,降低喂养不耐受、支气管肺发育不良发生率,为临床救治极/超低出生体重儿提供有效措施。

Objective To analyze the effect of breastfeeding quality improvement on in very/extremely low birth weight infants, so as to provide effective measures for clinicians. Methods Totally 160 very/extremely low birth weight infants admitted in Wuxi Maternity and Child Health Care Hospital during January 2018 to December 2019 were analyzed. Newborns admitted in 2018 were selected into the control group, while those admitted in 2019 were enrolled in the intervention group receiving breastfeeding quality improvement measures. Feeding indexes were compared between the two groups. Results The onset time for pumping milk, fasting times, fasting days and intravenous nutrition time in intervention group were shorter than those in control group(t=2.007, 2.666, 2.222, 3.187, P＜0.05). But there were no significant differences in the lactation start time, the average daily number of milk pumps, the first breastfeeding time, the amount of mother's breast milk during hospitalization, the starting time of feeding, the duration of micro feeding, and the time for reaching full enteral feeding between the two groups(P>0.05). The rates of feeding intolerance and bronchopulmonary dysplasia in the intervention group were significantly higher than that in control group (χ²=4.368, 3.963, P＜0.05), but the differences were not significant on the rates of neonatal necrotizing enterocolitis, sepsis and neonatal cholestasis syndrome(P>0.05). Conclusion The improvement of breastfeeding quality can shorten the time of starting to pump milk and intravenous nutrition, reduce the times and days of fasting, reduce the incidence of feeding intolerance and bronchopulmonary dysplasia, which can provide effective measures for clinicians to treat very/extremely low birth weight infants.