母乳用于新生儿尿布皮炎护理的系统评价分析

Systematic Evaluation and Analysis of Breast Milk Used in the Nursing of Neonatal Diaper Dermatitis

摘要: 目的：利用循证医学的原理系统评价母乳用于新生儿尿布皮炎的护理效果。方法：计算机检索英文文献数据库：PubMed、EMBASE、The Cochrane Library和Web of Science；中文文献数据库：中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(维普网)，同时追溯相关参考文献，搜集母乳用于新生儿臀部护理的随机对照试验(RCT)，检索时间为数据库建立至2021年10月8日。依据纳入标准和排除标准由两名研究者独立筛选文献、提取资料，并采用Cochrane Handbook (5.1.0)质量评价标准对纳入文献进行偏倚风险评估，采用Revman5.4软件进行Meta分析。二分类资料选择相对危险度(RR)效应指标进行统计学数据分析。连续性资料选择均数差(MD)效应指标进行统计学数据分析。结果：最终纳入5项随机对照试验，共涉及301例研究对象，试验组152例，对照组149例，结果显示在3天总有效率中[RR = 0.84, 95% CI (0.67, 1.05), P > 0.05]，7天总有效率中[RR = 0.97, 95% CI (0.83, 1.13), P > 0.05]，母乳和护臀霜的差异均无统计学意义，母乳和护臀霜的作用一致，可代替护臀霜用于新生儿臀部护理。母乳和常规护理的对比显示[RR = 1.40, 95% CI (1.07, 1.83), P < 0.05]，母乳可用于新生儿尿布皮炎的护理。结论：结果显示母乳和护臀霜用于新生儿尿布皮炎护理的差异无统计学意义，母乳和护臀霜的作用一致，但比护臀霜更加经济实惠，安全方便，可以作为护臀霜的平替来护理新生儿尿布皮炎。

Abstract: Objective: To systematically evaluate the nursing effect of breast milk on neonatal diaper dermati-tis by using the principle of evidence-based medicine. Methods: English databases: PubMed, EMBASE, The Cochrane Library and Web of Science; Chinese Literature Database: China National Knowledge Infrastructure (CNKI), Chinese Academic Journal Database (Wanfang Data), Chinese Biomedical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), and trace the relevant references. The randomized controlled trials (RCTS) of breast milk for neo-natal hip care were collected from the establishment of the database to October 8, 2021. According to the inclusion and exclusion criteria, two researchers independently screened the literatures and extracted the data, and Cochrane was used Handbook (5.1.0) quality evaluation standard was used to assess the risk of bias of the included literature. Revman5.4 software was used to conduct me-ta-analysis of dichotomous data to select the relative risk (RR) effect index for statistical data analy-sis. Continuous data were selected the mean difference (MD) effect index for statistical data analysis. Results: Finally, 5 randomized controlled trials were included, involving 301 subjects, 152 in the experimental group and 149 in the control group. The results showed that the 3-day total response rate [RR = 0.84, 95% CI (0.67, 1.05), P > 0.05], 7-day total effective rate [RR = 0.97, 95% CI (0.83, 1.13), P > 0.05], there was no significant difference between breast milk and hip care cream, the ef-fect of breast milk and hip care cream is the same, can replace the hip cream in neonatal hip care breast milk and routine care comparison showed [RR = 1.40, 95% CI (1.07, 1.83), P < 0.05], breast milk can be used for neonatal diaper dermatitis nursing. Conclusions: The results show that there is no significant difference in the nursing of neonatal diaper dermatitis between breast milk and hip care cream. The effect of breast milk and hip care cream is the same, but it is more affordable, safe and convenient than hip care cream, and can be used as the replacement of hip care cream to care neonatal diaper skin.