综合口腔运动干预对早产儿喂养表现及临床结局的影响
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摘要
目的探讨综合口腔运动干预对早产儿喂养表现及临床结局的影响。方法选取2016年12月—2017年8月在某三级甲等医院产科出生并入住NICU的早产儿为研究对象,采用随机分组方法,将早产儿随机分为综合口腔运动干预组、口腔运动干预组、对照组。综合口腔运动干预组接受3 min口腔刺激、2 min非营养性吸吮和2 min口腔支持;口腔运动干预组接受12 min口腔刺激和3 min非营养性吸吮;对照组接受常规发育支持护理。观察记录并比较3组早产儿喂养表现、喂养不耐受、高胆红素血症、坏死性小肠结肠炎的发生情况。结果综合口腔运动干预组早产儿开始经口喂养后第1、2、3、4天的喂养效率和喂养成效均高于对照组(P<0.05);3组早产儿喂养不耐受、高胆红素血症及坏死性小肠结肠炎发生率的比较,差异均无统计学意义(P>0.05)。结论综合口腔运动干预可以改善早产儿的喂养表现,且不增加早产儿相关并发症的发生。
Objective To explored the effect of Integrated Oral Motor Interventions on feeding performance and clinical outcomes in premature infants. Methods Premature infants born in a tertiary hospital from December 2016 to August 2017 and admitted to the neonatal intensive care unit(NICU) were selected as participants. Premature infants were randomly divided into the control group,Oral Motor Interventions group(OMIs group) and Integrated Oral Motor Interventions group(IOMIs group) by a randomized grouping method. IOMIs group received 3-min oral stimulate,2-min non-nutritive sucking,and 2-min oral support. OMIs group received 12-min oral stimulate and 3-min nonnutritive sucking. the control group received routine developmental support care. Feeding performance,feeding intolerance,hyperbilirubinemia(HB),necrotizing enterocolitis(NEC) of premature infants in three groups were compared. Results The feeding efficiency and feeding effectiveness on Day 1,2,3,and 4 in IOMIs group were better than those in other two groups(P<0.05). There was no significant difference in incidence of feeding intolerance,HB and NEC among three groups(P>0.05). Conclusion IOMIs can improve feeding performance without increasing incidence of related complications.
Objective To explored the effect of Integrated Oral Motor Interventions on feeding performance and clinical outcomes in premature infants. Methods Premature infants born in a tertiary hospital from December 2016 to August 2017 and admitted to the neonatal intensive care unit(NICU) were selected as participants. Premature infants were randomly divided into the control group,Oral Motor Interventions group(OMIs group) and Integrated Oral Motor Interventions group(IOMIs group) by a randomized grouping method. IOMIs group received 3-min oral stimulate,2-min non-nutritive sucking,and 2-min oral support. OMIs group received 12-min oral stimulate and 3-min nonnutritive sucking. the control group received routine developmental support care. Feeding performance,feeding intolerance,hyperbilirubinemia(HB),necrotizing enterocolitis(NEC) of premature infants in three groups were compared. Results The feeding efficiency and feeding effectiveness on Day 1,2,3,and 4 in IOMIs group were better than those in other two groups(P<0.05). There was no significant difference in incidence of feeding intolerance,HB and NEC among three groups(P>0.05). Conclusion IOMIs can improve feeding performance without increasing incidence of related complications.
引文
[1]Kish M Z.Oral feeding readiness in preterm infants:a concept analysis[J].Adv Neonatal Care,2013,13(4):230-237.
[2]Fucile S,Gisel EQ,Lau C.Effect of an oral stimulation program on sucking skill maturation of preterm infants[J].Dev Med Child Neurol,2005,47(3):158-162.
[3]Borion M,Da Nobrega L,Roux S,et al.Effect of oral stimulation and oral support on non-nutritive sucking and feeding performance in preterm infants[J].Dev Med Child Neurol,2007,49(6):439-444.
[4]Pickler RH,Mauck AG,Geldmaker B.Bottle-feeding histories of preterm infants[J].J Obstet Gynecol Neonatal Nurs,1997,26(4):414-420.
[5]Hwang YS,Vergara E,Lin CH,et al.Effects of prefeeding oral stimulation on feeding performance of preterm infants[J].Indian J Pediatr,2010,77(8):869-873.
[6]吕天蝉,张玉侠,胡晓静,等.早期口腔运动干预方案改善早产儿经口喂养的效果评价[J].中华护理杂志,2013,48(2):101-105.
[7]邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:401-405,340-342,351.
[8]Younesian S,Yadegari F,Soleimani F.Impact of oral sensory motor stimulation on feeding performance,length of hodpital stay,and weight gain of preterm infants in NICU[J].Iran Red Crescent Med J,2015,17(7):1-6.
[9]Harding C,Fank L,Van Someren V,et al.How does non-nurtritive sucking support infant feeding?[J].Infant Behav Dev,2014,37(4):457-464.
[10]Kamhawy H,Holditch-Davis D,Alshar-kawy S,et al.Non-nurtritive sucking for preterm infants in Egypt[J].J Obstet Gynecol Neonatal Nurs,2014,43(3):330-340.
[11]Barlow SM.Central pattern generation involved in oraland respiratory control for feeding in the terminfant[J].Curr Opin Otolaryngol Head Neck Surg,2009,17(3):187-193.
[12]陈琳,何淑贞.口腔支持对经口奶瓶喂养早产儿心肺功能的影响[J].中华护理杂志,2015,50(9):1060-1064.
[13]夏红萍,朱建幸.早产儿喂养不耐受[J].中国实用儿科杂志,2015,30(2):95-99.
[14]吕天婵,张玉侠.早产儿口腔运动干预研究现状[J].中华护理杂志,2013,48(1):86-89.
[15]Fanaro S.Feeding intolerance in the preterm infant[J].Early Hum Dev,2013,89(5):13-20.
[16]李锦玲,丁晓华,李胜玲.肠外营养联合不同肠内喂养添加量对早产儿相关并发症的影响[J].中国妇幼保健,2012,35(27):5714-5716.
[17]王东颖.中期早产儿高胆红素血症和胆红素脑病的临床特点研究[D].杭州:浙江大学,2016.
[18]Wallenstein MB,Bhutani VK.Jaundice and kemictems in the moderately preterm infant[J].Clin Perinatol,2013,40(4):679-688.
[19]Obladen M.Necrotizing enterocolitis 150 years of fruitless search for the cause[J].Neonatology,2009,96(4):203-210.
[20]Neu J,Walker WA.Necrotizing enterocolitis[J].N Engl J Med,2011,364(3):255-264.
[21]王小玲,李雄,康兰,等.预防性使用益生菌对降低极低出生体重早产儿坏死性小肠结肠炎发病率和病死率的Meta分析[J].中国当代儿科杂志,2015,17(8):852-858.
[2]Fucile S,Gisel EQ,Lau C.Effect of an oral stimulation program on sucking skill maturation of preterm infants[J].Dev Med Child Neurol,2005,47(3):158-162.
[3]Borion M,Da Nobrega L,Roux S,et al.Effect of oral stimulation and oral support on non-nutritive sucking and feeding performance in preterm infants[J].Dev Med Child Neurol,2007,49(6):439-444.
[4]Pickler RH,Mauck AG,Geldmaker B.Bottle-feeding histories of preterm infants[J].J Obstet Gynecol Neonatal Nurs,1997,26(4):414-420.
[5]Hwang YS,Vergara E,Lin CH,et al.Effects of prefeeding oral stimulation on feeding performance of preterm infants[J].Indian J Pediatr,2010,77(8):869-873.
[6]吕天蝉,张玉侠,胡晓静,等.早期口腔运动干预方案改善早产儿经口喂养的效果评价[J].中华护理杂志,2013,48(2):101-105.
[7]邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:401-405,340-342,351.
[8]Younesian S,Yadegari F,Soleimani F.Impact of oral sensory motor stimulation on feeding performance,length of hodpital stay,and weight gain of preterm infants in NICU[J].Iran Red Crescent Med J,2015,17(7):1-6.
[9]Harding C,Fank L,Van Someren V,et al.How does non-nurtritive sucking support infant feeding?[J].Infant Behav Dev,2014,37(4):457-464.
[10]Kamhawy H,Holditch-Davis D,Alshar-kawy S,et al.Non-nurtritive sucking for preterm infants in Egypt[J].J Obstet Gynecol Neonatal Nurs,2014,43(3):330-340.
[11]Barlow SM.Central pattern generation involved in oraland respiratory control for feeding in the terminfant[J].Curr Opin Otolaryngol Head Neck Surg,2009,17(3):187-193.
[12]陈琳,何淑贞.口腔支持对经口奶瓶喂养早产儿心肺功能的影响[J].中华护理杂志,2015,50(9):1060-1064.
[13]夏红萍,朱建幸.早产儿喂养不耐受[J].中国实用儿科杂志,2015,30(2):95-99.
[14]吕天婵,张玉侠.早产儿口腔运动干预研究现状[J].中华护理杂志,2013,48(1):86-89.
[15]Fanaro S.Feeding intolerance in the preterm infant[J].Early Hum Dev,2013,89(5):13-20.
[16]李锦玲,丁晓华,李胜玲.肠外营养联合不同肠内喂养添加量对早产儿相关并发症的影响[J].中国妇幼保健,2012,35(27):5714-5716.
[17]王东颖.中期早产儿高胆红素血症和胆红素脑病的临床特点研究[D].杭州:浙江大学,2016.
[18]Wallenstein MB,Bhutani VK.Jaundice and kemictems in the moderately preterm infant[J].Clin Perinatol,2013,40(4):679-688.
[19]Obladen M.Necrotizing enterocolitis 150 years of fruitless search for the cause[J].Neonatology,2009,96(4):203-210.
[20]Neu J,Walker WA.Necrotizing enterocolitis[J].N Engl J Med,2011,364(3):255-264.
[21]王小玲,李雄,康兰,等.预防性使用益生菌对降低极低出生体重早产儿坏死性小肠结肠炎发病率和病死率的Meta分析[J].中国当代儿科杂志,2015,17(8):852-858.