Applied Research Of Kangaroo Mother Care In Extremely Preterm Infant Who Require Non-invasive Assisted Ventilation

Objective1.Non-invasive assisted ventilation for extremely preterm infants(gestational age less than 28 weeks)should use kangaroo mother care,observe its clinical outcome,and demonstrate the feasibility of implementing kangaroo mother care in non-invasive assisted ventilation for extremely preterm infants.2.Compare the experimental group and control group with non-invasive assisted ventilation time,apnea times,hood oxygen time,breastfeeding,maternal anxiety,total gastrointestinal feeding time.Explore effective measures to promote rehabilitation of extremely preterm infants.Methods1.The random number table method was used to randomly divide the extremely preterm infants with a gestational age of less than 28 weeks in the NICU into an experimental group and a control group,with a total of 150 cases(75 cases for each group).The control group received routine nursing all the time.In contrast,after 3weeks’ routine nursing to make life signs stable,the kangaroo mother care was performed to the experimental group once a day for 3 hours,and the intervention continued for 2 weeks.2.Collect observation indicators,including relevant indicators of digestive system of extremely preterm infants,feeding ingredients 24 hours before discharge,to achieve full enteral feeding time,complete oral feeding time;the indicators of respiratory system of extremely preterm infants,non-invasive ventilation time,apnea times,hood oxygen time;Anxiety scale was used to measure the anxiety of mothers(fathers)in the experimental group before and after kangaroo mother care;other related complications and hospitalization,including nosocomial infections,necrotizing enterocolitis,bronchopulmonary,dysplasia,Retinopathy of prematurity,length of hospitalization,etc.3.Statistical analysis of non-invasive assisted ventilation time,apnea times,hood oxygen time,breastfeeding rate,total gastrointestinal feeding time,total oral feeding time,and other indicators of extremely preterm infants in the two groups;comparison of experimental group mothers(father)Anxiety before and after kangaroo mother care.Results1.There was no statistically significant difference in baseline comparison between the two groups.The experimental group lost 3 cases,including 1 case of death,2 cases of giving up treatment,and 72 cases were actually included;2 cases of shedding in the control group,of which 1 case died,1 case of giving up treatment,and73 cases were actually included.There was no difference in general information between the two groups(P> 0.05).2.Multivariate regression analysis and Logistic regression analysis showed that the time to reach complete enteral feeding in the experimental group was shorter than that in the control group(β =-5.615,95% CI: 8.330 ~-2.901,P <0.01),and breastfeeding 24 hours before discharge The rate of the experimental group was increased compared with the control group(OR=2.430,95%CI:1.235~4.780,P=0.01).3.Multivariate regression analysis showed that the number of apnea in the experimental group was less than that in the control group(β =-6.461,95% CI:-8.803 to-4.120,P <0.01);the non-invasive assisted ventilation time in the experimental group was reduced compared with the control group,(β=-10.791,95%CI:-14.136~-7.446,P<0.01).4.The anxiety of the mothers(fathers)of the extremely preterm infants in the experimental group after KMC was significantly lower than that before KMC(54.528± 8.668 VS 40.653 ± 6.343,P<0.01).Conclusion1.KMC is safe and feasible for extremely preterm infants with non-invasive assisted ventilation.2.KMC can reduce the number of apnea in extremely preterm infants who need non-invasive assisted ventilation,shorten the time of non-invasive assisted ventilation in extremely preterm infants,and improve respiratory function.3.KMC can shorten the time for non-invasive assisted ventilation of extremelypreterm infants to achieve full enteral feeding,Increase the exclusive breastfeeding rate of 24 hours before discharge for extremely preterm infants requiring non-invasive assisted ventilation.4.KMC can reduce the anxiety of mothers(fathers)in extremely preterm infants who need non-invasive assisted ventilation.