健康教育联合口腔运动指导对脑瘫高危儿家长喂养行为的影响

Influence of health education combined with oral-motor guidance on feeding behavior of infants at high-risk of cerebral palsy

目的改善脑瘫高危儿家长喂养行为,保证患儿营养摄入。方法将90例脑瘫高危儿按就诊时间编号,以随机数字表法分为干预组44例、对照组46例。对照组按常规对患儿家长进行喂养相关知识教育;干预组在此基础上对家长进行口腔运动指导,即由专人示范并指导家长进行口周肌肉按摩、口腔按摩、舌部运动、咀嚼训练、吞咽训练及吸吮力训练,餐前执行,每次5-10min,第1个月每天2次,第2个月每天1次,第3个月隔天1次。比较干预后1个月、2个月、3个月、6个月两组家长喂养行为评分。结果干预后干预组家长喂养行为评分在干预后1个月、2个月、3个月和6个月显著高于对照组,差异有统计学意义（均P〈0.01）。干预后6个月,两组在进餐时体位选择正确性较高、辅食添加的原则执行尚可,在安静环境下进餐的依从性较低。结论对脑瘫高危儿家长加强健康教育及口腔运动指导,可有效改善脑瘫高危儿家长的喂养行为。

Objective TO improve parents＇ feeding behavior to infants at high-risk of cerebral palsy so as to ensure the children＇s nutrition. Methods Totally 90 infants at high-risk of cerebral palsy were randomly divided into an intervention group of 44 patients and a control group of 46 patients using a random number table. Routine knowledge of infant feeding guidance was given to both groups. But oral massage instruction was only given to the parents whose infants belonged to the intervention group. Parents of the intervention group were demonstrated by specially-assigned persons how to perform perioral muscle ma：ssage, oral cavity massage, tongue movement training, chewing, swallowing and sucking training. The children of the intervention group received the massage and training twice a day during the first month, once a day during second month and once every 2 days during the third month before feeding, lasting 5--10 min every time. One month, two months, three months and six months after the intervention, the feeding behavior of parents in the 2 groups were evaluated. Results One month, two months, three months and six months after the in- tervention, the feeding behavior scores of parents in the intervention group were significantly higher than in the control group（P〈 0.01 for all）. Six months after the intervention, both groups were quite good at choosing correct position when feeding and following the rules for adding complementary food, but the infants were poor at compliance of dinning in quiet surroundings. Conclusion Health education in combination with oral-motor gui-dance can improve the feeding behavior of parents who have infants at highrisk of cerebral palsy.