ObjectiveTo observe the clinical efficacy of non-nutritional sucking and 10% glucose water plus non-nutritional sucking in relieving the venipuncture pain for premature infants. MethodA total of 167 premature infants between April and December 2014 were selected as our study subjects, and they were randomly divided into three groups:intervention group Ⅰ (n=53), intervention group Ⅱ (n=58), and the control group (without any intervention, n=56). Two minutes before venous indwelling needle puncture, blood oxygen saturation and heart rate of the infants were recorded during their quiet state. In the process of venipuncture, the intervention group Ⅰ was given non-nutritional sucking, intervention group Ⅱ was given 10% glucose water plus non-nutritional sucking, and the control group did not accept any intervention. Premature pain rating scale (PIPP) was used to compare the three groups of infants in terms of pain score, heart rate and blood oxygen saturation 1 minute and 5 minutes after intravenous indwelling needle puncture. SPSS 17.0 software was applied for statistical analysis. ResultsOf the 167 premature infants, one-time puncture was successful in 152 infants, with 46 in intervention group Ⅰ, 54 in intervention group Ⅱ, and 52 in control group. One minute after intravenous indwelling needle puncture, PIPP score of intervention group Ⅰ and Ⅱ was significantly lower than that of the control group (P<0.05). The PIPP score of intervention group Ⅱ was significantly lower than that of intervention group Ⅰ (P<0.05). One minute and 5 minutes after intravenous indwelling needle puncture, heart rate in the intervention groups was significantly lower than that in the control group (P<0.05), blood oxygen saturation in the intervention groups was signficantly higher than that in the control group (P<0.05), and they were significantly lower in intervention group Ⅱ than in intervention group Ⅰ (P<0.05). ConclusionsNon-nutritional sucking is effective in alleviating venipuncture pain for premature infants, especially when it is used together with 10% glucose water. The method is worthy of clinical promotion.
ObjectiveTo systematically review the efficacy and safety of ibuprofen for premature infants with patent ductus arteriosus. MethodsDatabases including PubMed, Ovid-EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) and quasi-RCTs about ibuprofen for premature infants with patent ductus arteriosus from inception to December 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 37 RCTs, involving 2 370 patients were included. The results of meta-analysis showed that, compared with the placebo/blank group, ibuprofen could increase the closure rate of PDA (LBWI:RR=1.93, 95%CI 1.25 to 2.99，P=0.003; VLBW:RR=1.23, 95%CI 1.02 to 1.48, P=0.03; ELBWI:RR=2.86, 95%CI 1.51 to 5.41, P=0.001) and decrease the incidence of sepsis (VLBW:RR=0.21, 95%CI 0.07 to 0.64，P=0.006); Compared with the indometacin groups, ibuprofen could decrease the incidence of the increase of serum creatinine (LBWI:RR=0.11, 95%CI 0.04 to 0.37, P=0.000 2), NEC (LBWI, RR=0.52, 95%CI 0.29 to 0.95, P=0.03) and oliguria (LBWI: RR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; VLBW:RR=1.40, 95%CI 1.03 to 1.92, P=0.03); Compared with the intravenous ibuprofen, Oral ibuprofen could increase the closure rate of PDA (VLBW: RR=1.35, 95%CI 1.12 to 1.62, P=0.002; ELBWI, RR=1.42, 95%CI 1.07 to 1.87, P=0.01). ConclusionCurrent evidence shows that there is not indeterminate between ibuprofen and paracetamol groups. Compared with other general drugs, ibuprofen has an advantage over curing PDA and obviously reduces side effects. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the risk factors of premature infants death. Methods The medical records of hospitalized premature infants admitted to West China Second University Hospital of Sichuan University between January 2015 and December 2022 were collected. Premature infants were divided into the death group and the non-death group (control group) based on discharge diagnosis of death. Parturient and premature infants related information were collected, and the disease classification and diagnosis of premature infants were analyzed. Results A total of 13 739 premature infants were included, with 53 deaths and a mortality rate of 3.85‰ (53/13 739). The ages of death were 1-49 days, and the median age of death was (9.68±9.35) days. According to the matching method, 212 premature infants were ultimately included. Among them, there were 53 premature infants in the death group and 159 premature infants in the control group. Compared with the control group, premature infants in the death group had lower gestational age, birth weight, lower 1-minute Apgar scores, lower 5-minute Apgar scores and shorter hospital stay (P<0.05), and received more delivery interventions (P<0.05). There was no statistically significant difference in other indicators between the two groups of premature infants (P>0.05). A total of 212 parturient were included. Among them, there were 53 parturients in the death group and 159 parturients in the control group. The use rate of prenatal corticosteroids in the control group was higher than that in the death group (55.35% vs. 54.72%). There was no statistically significant difference in other related factors between the two groups of parturient (P>0.05). The results of logistic regression analysis showed that longer hospital stay [odds ratio (OR)=0.891, 95% confidence interval (CI) (0.842, 0.943), P<0.001], prenatal use of corticosteroids [OR=0.255, 95%CI (0.104, 0.628), P=0.003] reduced the risk of premature infant death. However, tracheal intubation [OR=10.738, 95%CI (2.893, 39.833), P<0.001] increased the risk of premature infant death. Conclusions Clinicians should pay attention to prenatal examination of newborns and pay attention to evaluation of newborn status. Obstetricians and neonatologists should make joint plans for women with high risk factors for preterm delivery. During the hospitalization, after the diagnosis is clear, standardized treatment should be carried out in strict accordance with the guidelines for systemic diseases and expert consensus.