Objective:To investigate the current situation of the implementation of breastfeeding in the state of mother infant separation in 75 hospitals in China, based on the evidence-based guidelines for breastfeeding of hospitalized newborns (hereinafter referred to as the guidelines).Methods:Totally 75 hospitals in China were selected using the convenience sampling method to distribute questionnaires to compare the implementation of breastfeeding after separation of mother and infant.Results:All the hospitals selected in this survey were not satisfied with the overall implementation of the guide, but the general hospital's interpretation and learning of the guide was better than that of the specialized hospital, with a statistically significant difference ( χ2 value was 5.616, P <0.05); the breastfeeding rate was lower after the separation of mother and infant, and only 18.7% (14/75) of the units with the feeding rate ≥ 75%; they provided support related to breast milk collection, kangaroo nursing and professional professionals in the aspect of quality management, specialized hospital was better than general hospital, the difference was statistically significant ( χ2 values were 9.450, 10.516, 6.436, P<0.05); 62.1% (18/29) of the specialized hospitals have multi-disciplinary cooperation teams to promote the separation of mother and infant breastfeeding, while only 34.8% (16/46) of the comprehensive hospitals have multi-disciplinary cooperation teams , the difference was statistically significant ( χ2 value was 7.254, P<0.05). Conclusion:The evidence-based guidelines for breastfeeding of hospitalized newborns in China mostly refer to the relevant international standards. There are some difficulties in the implementation of the guidelines due to the large differences in the economy and policies of various regions in China. In order to improve the success rate of breastfeeding separation between mother and infant, China should establish a national standard that is in line with the national conditions, so as to facilitate the reference implementation of hospitals at all levels.

目的 探讨精细化护理在低出生体重儿胃管非计划性拔管中的应用效果.方法 选取2018年6月-2019年6月收治于我院NICU的200例留置胃管的低出生体重儿,按入院时间,将2018年6-12月收治的100例低出生体重儿作为对照组,采用常规胃管管道护理;2019年1-6月收治的100例低出生体重儿作为观察组,实行精细化护理.比较两组患儿胃管非计划性拔管率和护理人员风险识别意识情况.结果 观察组患儿胃管非计划性拔管率由原来的13％降至2％,差异有统计学意义(P<0.05);护理人员实施后风险识别意识高于实施前,差异有统计学意义(P<0.05).结论 精细化护理能有效降低新生儿胃管非计划性拔管率,提高护理人员风险意识,同时在一定程度上缩短住院时间,减少住院费用,提高护理满意度,值得临床推广.

目的 探究穴位按摩应用于新生儿缺氧缺血性脑病病儿中对生长发育及睡眠的影响.方法 选取2016年4月至2017年4月无锡市儿童医院收治的给予常规干预的新生儿缺氧缺血性脑病病儿47例作为对照组,给予病儿吸氧,酸中毒纠正及控制脑水肿抗惊厥等措施,同时采用国内改良简易按摩法,对病儿头、腹、手腕及踝足等部位进行揉按.另选取2017年5月至2018年5月无锡市儿童医院收治的给予穴位按摩的新生儿缺氧缺血性脑病病儿47例作为观察组;在对照组基础上给予穴位按摩,按背部-臀部-四肢-头面部-胸腹部顺序进行按摩.两组干预时间均为1个月.对比两组前后病儿生长发育、睡眠质量及新生儿行为神经测定情况.结果 观察组1个月后体质量、身高及摄入奶量分别为(5043.72±425.36)g、(56.37±2.54)cm,(605.67±43.81)mL,均优于对照组,差异有统计学意义(P<0.05);观察组1个月后入睡时间、睡眠时间、睡眠效率、睡眠紊乱、睡眠质量、辅助药物及日间功能障碍评分分别为(3.25±1.65)分、(0.69±0.52)分、(3.26±1.46)分、(7.58±1.68)分、(0.64±0.49)分、(1.15±0.95)分、(3.25±0.26)分,均低于对照组,差异有统计学意义(P<0.05);观察组7 d后、护理1个月后新生儿行为神经评分分别为(28.06±1.94)分和(37.76±2.83)分,均高于对照组,差异有统计学意义(P<0.05).结论 穴位按摩应用于新生儿缺氧缺血性脑病病儿中能有效促进病儿生长发育,提高其睡眠质量,改善其行为神经,值得推广.

目的 探索在新生儿重症监护病房(Neonatal intensive care unit,NICU)家庭病房母亲亲自母乳喂养低出生体重儿的效果.方法 将66例母乳喂养的低出生体重儿采用随机数字表分为实验组(n=34)和对照组(n=32),实验组在NICU住院期间母亲在家庭病房中亲自母乳喂养患儿;对照组用冷藏母乳人工用奶瓶喂养.收集并记录两组患儿喂养状况、并发症发生率、住院时间、家长满意度及6月龄时母乳喂养情况.喂养状况指标包括喂养不耐受情况及达到全胃肠营养的时间.结果 两组喂养不耐受情况和达到全胃肠营养时间比较,差异有统计学意义(P＜0.05);两组并发症发生率比较,差异均无统计学意义(P＞0.05);两组的住院时间、家长满意度及6月龄时纯母乳喂养率比较,差异有统计学意义(P＜0.05).结论 在NICU家庭病房中,母亲亲自母乳喂养低出生体重儿可改善患儿喂养状况,减少喂养不耐受时间,缩短住院时间,提升家长满意度,提高6月龄时纯母乳喂养率.

Objective To design a neonatal nasogastric fixation mount to decrease the complications during nasogastric feeding and facilitate the nurse's operation.Methods The mount was composed of a base,a hose rack,a clamp,a freelyrotating roll ball and a fixation knob.Totally 90 preterm infants hospitalized from January to September 2016 were equally and randomly divided into a fixation mount group,a gravity feeding group and a control group using conventional nasogastric feeding.The incidences of the complications during feeding were recorded including emesis,abdominal distension and apnea,and questionnaire survey was carried out on the nurse's satisfaction for the fixation mount.Results The mount reduced the complications related to nasal feeding,increased the nurse's satisfaction.The fixation mount group had the complications incidence rate (30.0％) significantly lower than those of the gravity feeding group (43.3％) and the control group (53.3％).The nurse's satisfaction in the fixation mount group (93.3％) was higher than those in the gravity feeding group (80.0％) and control group (52.0％).Conclusion The nasograstric fixation mount is applicable for the preterm infants in far-infrared radiation table,warmer and infanette,and thus is worthy promoting clinically.

Objective To discuss the application of ultrasonic blood flow imaging technology in pediatric Peripherally Inserted Central Catheter (PICC)placement.Methods 90 patients divided into two groups, the control group and the study group.Control group received PICC with routine method while study group received PICC with ultrasound-guided placement.The indicators including successful rate of puncture, operation time and the rate of local issue damage were compared between two groups.Results Study group had higher successful rate of puncture, shorter operation time and lower rate of local issue damage.Conclusions The method of pediatric PICC placement with ultrasonic blood flow imaging technology is safe, reliable, effective and feasible.