早产儿出院后神经发育支持性照护的最佳证据总结

doi:10.16460/j.issn1008-9969.2022.06.044

摘要/Abstract

摘要： 目的筛选并提取早产儿出院后神经发育支持性照护的相关证据,总结出最佳证据。方法基于循证的方法与原则,检索数据库和相关网站中有关早产儿神经发育支持性照护的所有文献,由2名循证研究员独自对纳入文献进行质量评价、证据提取和归纳总结。结果共纳入文献19篇,含指南4篇、证据总结1篇、系统评价12篇、专家共识2篇。从居家养育环境、早期干预训练、日常照护管理、出院后随访管理、父母参与管理5个维度总结出24条最佳证据。结论总结出院后支持早产儿神经发育的最佳证据,建议在临床应用时,基于具体情况灵活运用,考虑社会生态因素,建立多学科合作的随访照护团队,对早产儿家长进行发育支持照护指导,为早产儿及家庭提供个性化的优质照护支持服务,以改善早产儿神经发育的远期结局。

关键词: 早产儿, 发育支持性照护, 出院后, 神经发育, 循证护理, 证据总结

Abstract: Objective To select and extract relevant evidence of post-hospital neurodevelopmental supportive care (NDSC) for preterm infants, and summarize the best evidence. Methods Based on evidence-based methods and principles, we retrieved and selected all the literature on NDSC for preterm infants in databases and websites. Two evidence-based researchers evaluated the quality of the included literature, extracted evidence, and summarized the findings independently. Results Nineteen articles were collected, including 4 guidelines, 1 evidence summary, 12 systematic reviews and 2 expert consensus. And 24 pieces of best evidence were obtained and categorized into the following five aspects including home nurturing environment, early intervention training, daily care management, post-hospital follow-up management, parental participation management. Conclusion We summarized the best evidence of NDSC of preterm infants discharged from the hospital. In clinical application, it is recommended to apply the evidence flexibly based on specific circumstances and taking social and ecological factors into account. A multidisciplinary cooperative follow-up care team to provide development support and care guidance for parents of preterm infants and personalized high-quality supportive care service for preterm infants are conducive to improving the long-term neuro-developmental outcomes of them.

Key words: preterm infant, developmental supportive care, post-hospital, neurodevelopment, evidence-based nursing, evidence summary

中图分类号:

R473.72

曹咪, 张军, 岳少婷. 早产儿出院后神经发育支持性照护的最佳证据总结[J]. 护理学报, 2022, 29(6): 44-49.

CAO Mi, ZHANG Jun, YUE Shao-ting. Best Evidence Summary for Post-hospital Neurodevelopmental Supportive Care for Preterm Infants[J]. Journal of Nursing, 2022, 29(6): 44-49.

参考文献

[1] Jing S, Chen C, Gan Y, et al.Incidence and Trend of Preterm Birth in China, 1990-2016: A Systematic Review and Meta-analysis[J]. BMJ Open, 2020,10(12): e39303. DOI:10.1136/bmjopen-2020-039303.
[2] He C, Liu L, Chu Y, et al.National and Subnational All-cause and Cause-specific Child Mortality in China, 1996-2015: A Systematic Analysis with Implications for the Sustainable Development Goals[J]. Lancet Glob Health, 2017,5(2):e186-e197. DOI:10.1016/S2214-109X(16)30334-5.
[3] Chen C, Zhang JW, Xia HW, et al.Preterm Birth in China Between 2015 and 2016[J]. Am J Public Health, 2019,109(11):1597-1604. DOI:10.2105/AJPH.2019.305287.
[4] Chawanpaiboon S, Vogel JP, Moller AB, et al.Global, Regional,and National Estimates of Levels of Preterm Birth in 2014:A Systematic Review and Modelling Analysis[J]. Lancet Glob Health, 2019,7(1):e37-e46.DOI:10.1016/S2214-109X (18)30451-0.
[5] Lawn JE, Blencowe H,Oza S, et al.Every Newborn: Progress, Priorities, and Potential Beyond Survival[J]. Lancet, 2014,384(9938):189-205.DOI:10.1016/S0140-6736(14)60496-7.
[6] 李菲,丁宁,原新慧,等. 早期干预对早产儿神经心理发育的影响[J]. 医学综述, 2020,11(26):2256-2260.DOI:10.3969/j.issn.1006-2084.2020.11.031.
[7] 王茹霞,陈京立. 我国早产儿护理文献研究热点分析[J]. 护理学报, 2020,27(16):25-27. DOI:10.16460/j.issn1008-9969.2020.16.025.
[8] Soleimani F, Azari N, Ghiasvand H, et al.Do NICU Developmental Care Improve Cognitive and Motor Outcomes for Preterm Infants? A Systematic Review and Meta-analysis[J]. BMC Pediatr,2020,20(1):67.DOI:10.1186/s12887-020-1953-1.
[9] 余捷文,金伟. 发展性照顾理念在NICU早产儿护理中的应用[J].护理学报,2008,15(2):64-65.DOI:10.16460/j.issn1008-9969.2008.02.025.
[10] Khosravan S, Khoshahang M, Heidarzadeh M, et al.Effect of NIDCAP Home Care Follow-up Program of Preterm Newborns on Maternal Anxiety and Stress[J].Ann Ig, 2020,32(6):627-634. DOI:10.7416/ai.2020.2384.
[11] Griffiths N, Spence K, Loughran-Fowlds A, et al.Individualised Developmental Care for Babies and Parents in the NICU: Evidence-based Best Practice Guideline Recommendations[J]. Early Hum Dev, 2019,139:104840. DOI: 10.1016/j.earlhumdev.2019.104840.
[12] 朱政,胡雁,邢唯杰,等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017,32(21):1991-1994. DOI:10.16821/j.cnki.hsjx.2017.21.025.
[13] 胡雁,郝玉芳.循证护理学[M].2版.北京:人民卫生出版社, 2018.
[14] 谢利民,王文岳. 《临床指南研究与评价系统Ⅱ》简介[J]. 中西医结合学报, 2012, 10(2):160-165. DOI:10.3736/jcim20120206.
[15] 顾莺,张慧文,周英凤,等. JBI循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价[J]. 护士进修杂志, 2018,33(8):701-703. DOI:10.16821/j.cnki.hsjx.2018.08.008.
[16] 朱政,胡雁,周英凤,等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J]. 护士进修杂志, 2020,35(11):996-1000. DOI:10.16821/j.cnki.hsjx.2020.11.009.
[17] National Guideline Alliance (UK). Developmental follow-up of Children and Young People Born Preterm[M]. London: National Institute for Health and Care Excellence(UK), 2017.
[18] 中华预防医学会儿童保健分会. 婴幼儿喂养与营养指南[J]. 中国妇幼健康研究, 2019,30(4):392-417. DOI:10.3969/j.issn.1673-5293.2019.04.001.
[19] 国家卫生和计划生育委员会办公厅. 早产儿保健工作规范[J]. 中华围产医学杂志, 2017,6(20):401-406.DOI:10.3760/cma.j.issn.1007-9408.2017.06.001.
[20] Browne JV, Jaeger CB, Kenner C.Executive Summary: Standards, Competencies, and Recommended Best Practices for Infant- and Family-centered Developmental Care in the Intensive Care Unit[J]. J Perinatol, 2020,40(Suppl 1):5-10. DOI:10.1038/s41372-020-0767-1.
[21] Spittle A, Orton J, Anderson PJ, et al.Early Developmental Intervention Programs Post Hospital Discharge to Prevent Motor and Cognitive Impairments in Preterm Infants[J]. Cochrane Database Syst Rev,2015,11(24): D5495. DOI: 10.1002/14651858.CD005495.pub4.
[22] Benzies KM, Magill-Evans JE, Hayden KA, et al.Key Components of Early Intervention Programs for Preterm Infants and Their Parents: A Systematic Review and Meta-analysis[J]. BMC Pregnancy Childbirth, 2013,13(Suppl 1): S10.DOI:10.1186/1471-2393-13-S1-S10.
[23] Puthussery S, Chutiyami M, Tseng PC, et al.Effectiveness of Early Intervention Programs for Parents of Preterm Infants: A Meta-review of Systematic Reviews[J]. BMC Pediatr, 2018,18(1):223. DOI:10.1186/s12887-018-1205-9.
[24] Goyal NK, Teeters A, Ammerman RT.Home Visiting and Outcomes of Preterm Infants:A Systematic Review[J]. Pediatrics, 2013,132(3):502-516. DOI:10.1542/peds.2013-0077.
[25] Neel M, Stark AR, Maitre NL.Parenting Style Impacts Cognitive and Behavioural Outcomes of Former Preterm Infants: A Systematic Review[J]. Child Care Health Dev, 2018,44(4):507-515. DOI:10.1111/cch.12561.
[26] Herd M, Whittingham K, Sanders M, et al.Efficacy of Preventative Parenting Interventions for Parents of Preterm Infants on Later Child Behavior: A Systematic Review And Meta-Analysis[J]. Infant Ment Health J, 2014,35(6):630-641. DOI:10.1002/imhj.21480.
[27] Vanderveen JA, Bassler D, Robertson CM, et al.Early Interventions Involving Parents to Improve Neurodevelopmental Outcomes of Premature Infants: A Meta-analysis[J]. J Perinatol, 2009,29(5):343-351. DOI:10.1038/jp.2008.229.
[28] Zhang X, Kurtz M, Lee SY, et al.Early Intervention for Preterm Infants and Their Mothers: A Systematic Review[J]. J Perinat Neonatal Nurs,2021,35(4):E69-E82.DOI:10.1097/JPN.0000000000000065.
[29] Orton J, Spittle A, Doyle L, et al.Do Early Intervention Programmes Improve Cognitive and Motor Outcomes for Preterm Infants after Discharge? A Systematic Review[J]. Dev Med Child Neurol, 2009,51(11):851-859.DOI:10.1111/j.1469-8749.2009.03414.x.
[30] Moore ER, Bergman N, Anderson GC, et al. Early Skin-to-skin Contact for Mothers and Their Healthy Newborn Infants[J].Cochrane Database Syst Rev,2016,11(11):CD003519. DOI:10.1002/14651858.CD003519.pub4.
[31] Aita M, De Clifford FG, Lavallée A, et al.Effectiveness of Interventions on Early Neurodevelopment of Preterm Infants: A Systematic Review and Meta-analysis[J]. BMC Pediatr, 2021,21(1):210. DOI:10.1186/s12887-021-02559-6.
[32] Khurana S, Kane AE, Brown SE, et al.Effect of Neonatal Therapy on the Motor, Cognitive, and Behavioral Development of Infants Born Preterm: A Systematic Review[J]. Dev Med Child Neurol, 2020,62(6):684-692. DOI:10.1111/dmcn.14485.
[33] 陈光福,栾佐. 婴幼儿脑损伤神经修复治疗专家共识[J]. 中国当代儿科杂志, 2018,20(10):785-792. DOI:10.7499/j.issn.1008-8830.2018.10.001.
[34] 中国医师协会儿童健康专业委员会第一届儿童早期健康发展专业委员会.早产儿出院后随访及管理意见[J].中国妇幼健康研究,2019, 30(9):1048-1052. DOI:10.3969/j.issn.1673-5293.2019.08.002.
[35] 王春青,胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015,30(11):964-967. DOI:10.16821/j.cnki.hsjx.2015.11.002.
[36] 陈琼,方进博. 新生儿个体化发展照顾及评估程序的循证研究进展[J]. 护理学报, 2014,21(3):31-33.DOI:10.16460/j.issn1008-9969.2014.03.009.
[37] O'Callaghan N, Dee A, Philip RK. Evidence-based Design for Neonatal Units: A Systematic Review[J]. Matern Health Neonatol Perinatol,2019,5:6.DOI:10.1186/s40748-019-0101-0.
[38] 王晶,童梅玲. 婴幼儿养育照护的框架和策略[J]. 中国儿童保健杂志, 2020, 28(9):993-996. DOI:10.11852/zgetbjzz2020-0489.
[39] 路简羽,岳洁雅,袁艳丽,等. 早产儿袋鼠式护理方法的最佳证据总结[J]. 中华现代护理杂志, 2019,25(22):2778-2782. DOI: 10.3760/cma.j.issn.1674-2907.2019.22.002.
[40] Wang CJ, McGlynn EA, Brook RH, et al. Quality-of-care Indicators for the Neurodevelopmental Follow-up of Very Low Birth Weight Children: Results of an Expert Panel Process[J]. Pediatrics, 2006,117(6):2080-2092. DOI:10.1542/peds.2005-1904.
[41] 田园,张宇鸣,陈菲,等. 多学科合作的早产儿系统管理对新生儿重症监护室出院早产儿神经精神发育结局的影响[J]. 中国儿童保健杂志, 2018,26(3):294-297. DOI:10.11852/zgetbjzz2018-26-03-18.

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