口腔支持干预提高早产儿喂养效果
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摘要
为了观察口腔支持干预在早产儿喂养中的应用效果,本研究选取2016年6月至2017年12月在长沙市口腔医院接受治疗的早产儿为研究对象,并根据其喂养方式分为对照组和观察组。对照组给予常规喂养,观察组在此基础上给予口腔支持干预。观察两组早产儿喂养效果、体重增长、住院时间的差异,比较两组早产儿营养指标和预后的差异。结果表明,观察组早产儿的开始经口喂养效率、摄入奶量比和完全经口喂养效率均高于对照组(t=11.060, 3.324, 5.934, p<0.001);观察组早产儿的出院时体重、体重增长率均高于对照组(t=8.844, 3.577, p<0.001),住院时间较对照组短(t=9.515, p<0.001);两组早产儿干预前的红细胞(red blood cell,RBC)、血清白蛋白(blood albumin, ALB)和前白蛋白(prealbumin, PA)水平无差别,干预后,观察组早产儿的RBC、ALB和PA水平高于对照组(t=1.951, 7.999, 11.724, p<0.05);观察组早产儿吐奶、吸吮吞咽无力和便秘发生率低于对照组(χ~2=4.891, p=0.027)。口腔支持干预在早产儿喂养中的应用效果较好,可明显提高其喂养效率,改善营养状况,具有良好的临床应用价值。
In order to observe the effect of oral support intervention in premature infant feeding. The preterm infants who were treated in Changsha Stomatological Hospital from June 2016 to December 2017 were selected and divided into cozntrol group and observation group according to their feeding mode. The control group was given conventional feeding, and the observation group was given oral support intervention on this basis. The differences in feeding effect, weight gain, and length of hospital stay between the two groups were observed. The differences in nutritional indicators and prognosis between the two groups were compared. Results show that, The initial oral feeding efficiency, the intake of milk and the efficiency of complete oral feeding in the observation group were higher than those in the control group(t=11.060, 3.324, 5.934, p<0.001). The weight gain and weight gain rate of the premature infants in the observation group were higher than those in the control group(t=8.844, 3.577, p<0.001), and the length of stay in the observation group was shorter than that in the control group(t=9.515, p<0.001). Two groups of preterm infants had no difference in the levels of RBC, ALB and PA before intervention. After intervention, the levels of red blood cell(RBC), blood albumin(ALB) and prealbumin(PA) in the observation group were higher than those in the control group(t=1.951, 7.999, 11.724, p<0.05). The observation group premature infant spits, sucking and swallowing weakness and constipation was lower than the control group(χ~2=4.891, p=0.027). Oral support intervention has a good effect in the feeding of premature infants, which can significantly improve the feeding efficiency and nutritional status, and has good application value.
In order to observe the effect of oral support intervention in premature infant feeding. The preterm infants who were treated in Changsha Stomatological Hospital from June 2016 to December 2017 were selected and divided into cozntrol group and observation group according to their feeding mode. The control group was given conventional feeding, and the observation group was given oral support intervention on this basis. The differences in feeding effect, weight gain, and length of hospital stay between the two groups were observed. The differences in nutritional indicators and prognosis between the two groups were compared. Results show that, The initial oral feeding efficiency, the intake of milk and the efficiency of complete oral feeding in the observation group were higher than those in the control group(t=11.060, 3.324, 5.934, p<0.001). The weight gain and weight gain rate of the premature infants in the observation group were higher than those in the control group(t=8.844, 3.577, p<0.001), and the length of stay in the observation group was shorter than that in the control group(t=9.515, p<0.001). Two groups of preterm infants had no difference in the levels of RBC, ALB and PA before intervention. After intervention, the levels of red blood cell(RBC), blood albumin(ALB) and prealbumin(PA) in the observation group were higher than those in the control group(t=1.951, 7.999, 11.724, p<0.05). The observation group premature infant spits, sucking and swallowing weakness and constipation was lower than the control group(χ~2=4.891, p=0.027). Oral support intervention has a good effect in the feeding of premature infants, which can significantly improve the feeding efficiency and nutritional status, and has good application value.
引文
Arvedson J.,Clark H.,Lazarus C.,Schooling T.,and Frymark T.,2010,Evidence-based systematic review:effect of oral motor interventions on feeding and swallowing in preterm infants,Am.J.Speech.Lang Pathol.,19(4):321-340
Chen L.,2015,Saccharomyces boulardii for preterm infant feeding intolerance and influence on early growth and development,Zhongguo Xinyao Yu Linchuang Zazhi(Chinese Journal of New Drugs and Clinical Remedies),29(1):36-39(陈玲,2015,布拉氏酵母菌对早产儿喂养不耐受及早期生长发育的影响,中国新药与临床杂志,29(1):36-39)
Chen L.,and He S.Z.,2015,The effects of oral support intervention on cardiopulmonary function of preterm infants during oral bottle feeding,Zhonghua Huli Zazhi(Chinese Journal of Nursing),50(9):1060-1064(陈琳,何淑贞,2015,口腔支持对经口奶瓶喂养早产儿心肺功能的影响,中华护理杂志,50(9):1060-1064)
Guo S.W.,Xie L.Q.,Chen K.Z.,Ke C.Y.,Dai D.H.,Zhang X.H.,Lin J.B.,and Zhang X.F.,2017,The effects of oral care using hydrogen peroxide combined with sodium bicarbonate on neonatal ventilator associated pneumonia,Zhongguo Huli Zazhi(Chinese Journal of Nursing),52(6):645-648(郭舒文,谢丽琴,陈开珠,柯翠云,戴冬凰,张秀虹,林娟斌,张小芳,2017,双氧水联合碳酸氢钠口腔护理对预防新生儿呼吸机相关性肺炎的效果研究,中华护理杂志,52(6):645-648)
Huang X.,Peng W.T.,Chen Q.,and Luo B.R.,2017,A co-word analysis of current researches on feeding intolerance in preterm infants,Chongqin Yixue(Chongqing Medicine),46(29):4093-4095(黄希,彭文涛,陈琼,罗碧如,2017,我国早产儿喂养不耐受研究现状的可视化分析,重庆医学,46(29):4093-4095)
Tao Y.Q.,Ma L.,Jiang P.H.,and Ling H.,2016,The effect of individualized semi-demand feeding in premature infants Zhongguo Huli Zazhi(Chinese Journal of Nursing),51(1):49-52(陶亚琴,马兰,蒋盘华,凌慧,2016,个性化半需求喂养法改善早产儿经口喂养效果的评价,中华护理杂志,51(1):49-52)
Tian X.,Yi L.J.,Zeng Z.,Shuai T.,Wang Y.,and Song G.M.2015,Effects of oral motor intervention on oral feeding in premature infant:a meta-analysis with trial sequential analysis,Zhongguo Huli Zazhi(Chinese Journal of Nursing),50(7)804-811(田旭,易莉娟,曾子,帅婷,王燕,宋国敏,2015,口腔运动干预用于早产儿经口喂养效果的meta分析,中华护理杂志,50(7):804-811)
Tian X.,Yi L.J.,Zhang L.,Zhou J.G.,Ma L.,Ou Y.X.,Shuai T.Zeng Z.,and Song G.M.,2015,Oral motor intervention improved the oral feeding in preterm infants:evidence based on a meta-analysis with trial sequential analysis,Medicine94(31):e1310
Wang Y.L.,Hung J.S.,Wang L.Y.,Ko M.J.,Chou W.,Kuo H.C.and Lin B.S.,2015,Development of wireless oral-feeding monitoring system for preterm infants,IEEE Journal of Biomedical&Health Informatics,19(3):866-873
Xiang X.Y.,Li Y.,Li Z.Y.,Tan T.J.,He L.,and Hei M.Y.,2016,Feasibility study of family-integrated-care in neonatal intensive care units in China:a parallel controlled trial,Zhongguo Xunzheng Erke Zazhi(Chinese Journal of Evidence Based Pediatrics),11(3):177-181(向希盈,李颖,李卓颖,谭彦娟,何利,黑明燕,2016,中国新生儿重症监护病房中实施家长参与早产儿住院期间综合管理与常规护理平行对照研究,中国循证儿科杂志,11(3):177-181)
Yang Y.Y.,2017,Research progress in promoting and hindering factors of breastfeeding in hospitalized premature infants,Linchuan Erke Zazhi(Journal of Clinical Pediatrics),35(9):708-712(杨园园,2017,住院早产儿母乳喂养的促进与阻碍因素研究进展,临床儿科杂志,35(9):708-712)
Zhang J.,Huang H.Y.,and Yang K.,2015,Effect of different premature infant formula feedings on the levels of calcium,magnesium and blood lipid in newborn,Zhongguo Linchuan Yaolixue Zazhi(The Chinese Journal of Clinical Pharmacol ogy),31(22):2266-2268(张静,黄宏云,杨坤,2015,不同早产儿配方奶喂养对新生儿钙镁及血脂水平的影响,中国临床药理学杂志,31(22):2266-2268)
Zhou M.,Yin H.Y.,Cheng X.,Li Y.W.,and Wen J.,2016,The association between early sucking patterns and neurodevelopmental outcomes at 6 months corrected age in preterm infants without obvious brain injury,Zhongguo Xunzheng Erke Zazhi(Chinese Journal of Evidence Based Pediatrics),11(1):8-12(周梅,尹华英,程茜,李语薇,文静,2016,无明显脑损伤早产儿早期口腔吸吮模式与6月龄时神经发育结局相关性研究,中国循证儿科杂志,11(1):8-12)
Chen L.,2015,Saccharomyces boulardii for preterm infant feeding intolerance and influence on early growth and development,Zhongguo Xinyao Yu Linchuang Zazhi(Chinese Journal of New Drugs and Clinical Remedies),29(1):36-39(陈玲,2015,布拉氏酵母菌对早产儿喂养不耐受及早期生长发育的影响,中国新药与临床杂志,29(1):36-39)
Chen L.,and He S.Z.,2015,The effects of oral support intervention on cardiopulmonary function of preterm infants during oral bottle feeding,Zhonghua Huli Zazhi(Chinese Journal of Nursing),50(9):1060-1064(陈琳,何淑贞,2015,口腔支持对经口奶瓶喂养早产儿心肺功能的影响,中华护理杂志,50(9):1060-1064)
Guo S.W.,Xie L.Q.,Chen K.Z.,Ke C.Y.,Dai D.H.,Zhang X.H.,Lin J.B.,and Zhang X.F.,2017,The effects of oral care using hydrogen peroxide combined with sodium bicarbonate on neonatal ventilator associated pneumonia,Zhongguo Huli Zazhi(Chinese Journal of Nursing),52(6):645-648(郭舒文,谢丽琴,陈开珠,柯翠云,戴冬凰,张秀虹,林娟斌,张小芳,2017,双氧水联合碳酸氢钠口腔护理对预防新生儿呼吸机相关性肺炎的效果研究,中华护理杂志,52(6):645-648)
Huang X.,Peng W.T.,Chen Q.,and Luo B.R.,2017,A co-word analysis of current researches on feeding intolerance in preterm infants,Chongqin Yixue(Chongqing Medicine),46(29):4093-4095(黄希,彭文涛,陈琼,罗碧如,2017,我国早产儿喂养不耐受研究现状的可视化分析,重庆医学,46(29):4093-4095)
Tao Y.Q.,Ma L.,Jiang P.H.,and Ling H.,2016,The effect of individualized semi-demand feeding in premature infants Zhongguo Huli Zazhi(Chinese Journal of Nursing),51(1):49-52(陶亚琴,马兰,蒋盘华,凌慧,2016,个性化半需求喂养法改善早产儿经口喂养效果的评价,中华护理杂志,51(1):49-52)
Tian X.,Yi L.J.,Zeng Z.,Shuai T.,Wang Y.,and Song G.M.2015,Effects of oral motor intervention on oral feeding in premature infant:a meta-analysis with trial sequential analysis,Zhongguo Huli Zazhi(Chinese Journal of Nursing),50(7)804-811(田旭,易莉娟,曾子,帅婷,王燕,宋国敏,2015,口腔运动干预用于早产儿经口喂养效果的meta分析,中华护理杂志,50(7):804-811)
Tian X.,Yi L.J.,Zhang L.,Zhou J.G.,Ma L.,Ou Y.X.,Shuai T.Zeng Z.,and Song G.M.,2015,Oral motor intervention improved the oral feeding in preterm infants:evidence based on a meta-analysis with trial sequential analysis,Medicine94(31):e1310
Wang Y.L.,Hung J.S.,Wang L.Y.,Ko M.J.,Chou W.,Kuo H.C.and Lin B.S.,2015,Development of wireless oral-feeding monitoring system for preterm infants,IEEE Journal of Biomedical&Health Informatics,19(3):866-873
Xiang X.Y.,Li Y.,Li Z.Y.,Tan T.J.,He L.,and Hei M.Y.,2016,Feasibility study of family-integrated-care in neonatal intensive care units in China:a parallel controlled trial,Zhongguo Xunzheng Erke Zazhi(Chinese Journal of Evidence Based Pediatrics),11(3):177-181(向希盈,李颖,李卓颖,谭彦娟,何利,黑明燕,2016,中国新生儿重症监护病房中实施家长参与早产儿住院期间综合管理与常规护理平行对照研究,中国循证儿科杂志,11(3):177-181)
Yang Y.Y.,2017,Research progress in promoting and hindering factors of breastfeeding in hospitalized premature infants,Linchuan Erke Zazhi(Journal of Clinical Pediatrics),35(9):708-712(杨园园,2017,住院早产儿母乳喂养的促进与阻碍因素研究进展,临床儿科杂志,35(9):708-712)
Zhang J.,Huang H.Y.,and Yang K.,2015,Effect of different premature infant formula feedings on the levels of calcium,magnesium and blood lipid in newborn,Zhongguo Linchuan Yaolixue Zazhi(The Chinese Journal of Clinical Pharmacol ogy),31(22):2266-2268(张静,黄宏云,杨坤,2015,不同早产儿配方奶喂养对新生儿钙镁及血脂水平的影响,中国临床药理学杂志,31(22):2266-2268)
Zhou M.,Yin H.Y.,Cheng X.,Li Y.W.,and Wen J.,2016,The association between early sucking patterns and neurodevelopmental outcomes at 6 months corrected age in preterm infants without obvious brain injury,Zhongguo Xunzheng Erke Zazhi(Chinese Journal of Evidence Based Pediatrics),11(1):8-12(周梅,尹华英,程茜,李语薇,文静,2016,无明显脑损伤早产儿早期口腔吸吮模式与6月龄时神经发育结局相关性研究,中国循证儿科杂志,11(1):8-12)