力量支持协同护理模式在经口喂养不耐受<34孕周新生儿中的应用

目的:探讨力量支持协同护理模式在经口喂养不耐受<34孕周新生儿中的应用效果。方法:选取2019年1月—2020年8月收治的102例<34孕周经口喂养不耐受新生儿作为研究对象,将2019年1月—2019年10月接受常规护理的51例患儿作为对照组,将2019年11月—2020年8月接受力量支持协同护理模式的51例患儿作为观察组。比较两组经口喂养进程(留置胃管时间、过渡时间、住院时间)、喂养效率及患儿行为状态变化。结果:观察组患儿留置胃管时间、过渡时间、住院时间均短于对照组(P<0.05);观察组患儿干预第3天、实现全口喂养时吸吮效率和喂养效率均高于对照组(P<0.05);观察组患儿干预3 d、干预5 d后行为状态优于对照组(P<0.05)。结论:力量支持协同护理模式能有效改善早产儿经口喂养表现,减轻经口喂养不耐受症状,进一步推进经口喂养进程,缩短经口喂养过渡时间。     

机械致手外伤的流行病学特点

目的探讨机械致手外伤的流行病学特点。方法分析深圳市宝安区西乡人民医院自2002年1月至2008年12月因机械致手外伤的7692例病史。根据致伤机械的类别、受伤特点,分析该群体的流行病学特征。结果该类手外伤占手外科疾病的95％以上,外伤高发月为第一季度。每天以交接班前后为高发时段。最常见的致伤机械为模具,多指复合伤为其特点。结论重视外企及国企的手外伤预防工作,是减少事故发生的有效方法。     

Sharing the science on human milk feedings with mothers of very-low-birth-weight infants

Mother's milk provides protection from serious and costly morbidity for very-low-birth-weight infants (<1500 g), including enteral feeding intolerance, nosocomial infection, and necrotizing enterocolitis. However, NICU and maternity nurses may be hesitant to encourage mothers to initiate lactation because of a reluctance to make mothers feel guilty or coerced. This article reviews the evidence for the health outcomes of mothers' milk feeding in very-low-birth-weight infants and provides examples of ways to share this science with mothers so that they can make an informed feeding decision.     

Recognition of and response to postpartum hemorrhage in rural northern India

This study describes the results of a Morbidity and Performance Assessment (MAP) conducted to provide insight into the medical factors contributing to maternal and newborn morbidity and mortality in a rural district of northern India, and to use these insights to develop a locally appropriate, community-based safe motherhood program The MAP study was based on verbal autopsy method. Five hundred ninety-nine women (or in the case of 9 maternal deaths, a family member) participated in the study. This article describes a subsample of women who reported signs or symptoms suggesting excessive bleeding (n = 159). Findings include a poor knowledge of danger signs; poor problem recognition during labor, birth, and the immediate postpartum period; and a low level of health seeking that was consistent with poor recognition. Maternal sociodemographic characteristics, antenatal care use, and knowledge of danger signs were generally not associated with problem recognition and health seeking. The case fatality rate was 4%. These findings suggest an urgent need to understand the phenomenon of problem recognition and to integrate this into the design of interventions to reduce delays in health seeking.     

Factors Associated With Exclusive Direct Breastfeeding in the First 3 Months

ObjectiveTo identify factors associated with exclusive direct breastfeeding in the first 3 months among mother and infant dyads living in the United States.DesignA secondary analysis of data collected using a cross-sectional online survey completed over a 4-month period in late 2019.ParticipantsWe recruited a convenience sample of 370 mothers with healthy full-term singleton infants between 1 and 12 weeks of age whose feeding methods consisted of direct breastfeeding at least once a day. Mothers had not returned to work/school at the time of the survey completion.MeasurementsThe questionnaire consisted of 34 questions about maternal and infant factors that influence decisions about infant feeding, professional support, and parental preferences.ResultsMothers who practiced feeding on demand (adjusted OR [aOR] = 35.76, 95% confidence interval [CI] [2.04, 500.00]) and mothers of infants 1 to 4 weeks of age (aOR = 2.74, 95% CI [1.54, 4.85]) were more likely to use exclusive direct breastfeeding. The odds of exclusive direct breastfeeding decreased with mothers who breastfed with a nipple shield while in the hospital/birth center/home (aOR = 0.13, 95% CI [0.05, 0.35]), used pacifiers (aOR = 0.31, 95% CI [0.21, 0.65]), or had perceptions of insufficient milk (aOR = 0.11, 95% CI [0.04, 0.26]).ConclusionDemand feeding and an infant’s age of 1 to 4 weeks contributed to exclusive direct breastfeeding. Lower rates of exclusive direct breastfeeding were associated with the use of nipple shields immediately after birth, pacifier use, and perceptions of insufficient milk. Further investigation is warranted to fully differentiate exclusive direct breastfeeding from exclusive breastfeeding.     

多学科团队管理模式在新生儿病房早产儿喂养中的应用效果

目的 研究多学科团队管理模式在新生儿病房早产儿喂养中的应用效果。方法 选择2019年3月至2020年10月深圳市宝安区妇幼保健院新生儿科病房的早产儿作为研究对象,其中,2019年3月至12月的431例作为对照组,给予常规新生儿喂养护理,2020年1月至10月的431例作为观察组,给予多学科团队管理模式下喂养护理,统计两组住院期间纯母乳喂养率、达到全肠道喂养时间、住院天数、出院后坚持6个月纯母乳喂养率、出院后生长发育合格率及出院后不良反应发生情况。结果 观察组住院期间纯母乳喂养率明显高于对照组,达到全肠道喂养时间和住院天数明显少于对照组,差异有统计学意义(P<0.05);随访6个月,观察组的出院后坚持6个月纯母乳喂养率、出院后生长发育合格率均明显高于对照组,出院后不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论 多学科团队管理模式能有效提高新生儿病房早产儿纯母乳喂养率,缩短新生儿达到全肠道喂养的时间,改善早产儿的生长发育结局,效果较好,值得推广。     

早期肠内营养耐受性分级干预对重症患者的应用效果

目的:研究早期肠内营养(EEN)耐受性分级干预对重症患者的应用效果.方法:将我院2018年1月1日-2021年1月31日期间收治的87例重症患者纳入研究.以电脑随机数字表法将其分成分级组43例和对照组44例.对照组开展常规肠内营养干预;分级组则开展EEN耐受性分级干预方案进行干预.分析2组热卡达标情况,干预前后营养指标...     

工作场所母乳喂养支持量表的汉化及信效度检验

目的:翻译并修订工作场所母乳喂养支持量表（WBSS）,并检验其信效度。方法:采用Brislin翻译模式对WBSS进行翻译-回译;通过文化调试和预试验对量表条目进行修改完善。采用便利抽样法,于2020年6—9月,选取铜仁市妇幼保健院320名儿保科儿童母亲作为研究对象。采用中文版WBSS调查儿童母亲的工作场所母乳喂养支持情...