不同护理体位对鼻饲喂养早产儿生命体征的影响及其安全性分析

Influence of different nursing positions on vital signs of premature infants receiving nasogastric feeding and its safety analysis

[目的]分析不同护理体位对鼻饲喂养早产儿生命体征的影响及其安全性。[方法]选择在我院住院的早产儿60例,按随机数字表将其分为A组、B组、C组、D组,采用不同的护理体位顺序进行鼻饲喂养,监测其心率（HR）、呼吸（RR）、经皮血氧饱和度（TcPO2）、血压（Bp）、胃内潴留量、呼吸暂停、周期性呼吸和腹胀情况,统计分析各体位之间的差异。[结果]各体位喂养早产儿的HR、RR、TcPO2在不同时间点均维持正常范围;俯卧位时RR随时间逐步下降,与0min的差异有统计学意义（P〈0.05）,而其他体位的变化差异无统计学意义（P〉0.05）;呼吸暂停及潴留量大于前一次喂养量50%的次数在各体位的差异均无统计学意义（P〉0.05）;腹胀及潴留量小于前一次喂养量25%和25%-50%的次数在左侧卧位均较其他体位时高,差异有统计学意义（P〈0.05）,早产儿的潴留量小于前一次喂养量的25%以及腹胀发生次数在右侧卧位时较仰卧或俯卧时均较低,差异有统计学意义（P〈0.05）。[结论]采用仰卧、俯卧、左侧卧以及右侧卧体位鼻饲喂养早产儿对其生命体征影响均较小,而俯卧位较为有利于呼吸,左侧卧位不利于胃排空,而右侧卧位有利于促进胃排空,减少早产儿腹胀的发生。

Objective：To analyze the influence of different nursing positions on vital signs of premature infants receiving nasogastric feeding and its safety.Methods：A total of 60 cases of premature infants hospitalized in our hospital were selected,and they were divided into group A,group B,C and D based on the number random ta-ble.The different nursing positions were adopted for nasogastric feeding in turn,and to monitor the heart rate （HR）,respiratory（RR）,percutaneous oxygen saturation（TcPO2 ）,blood pressure（BP）,gastric retention capaci-ty,apnea,periodic breathing and abdominal distention,then to statistically analyze the differences among all po-sitions.Results：The HR,RR,TcPO2 of premature infants receiving varies of position feeding were maintained in normal range at different time points;RR declined gradually in prone position with time,and there was statisti-cally significant difference compared with that at 0 min（P〈0.05）,while there was no statistically significant difference in change among other positions（P〉0.05）;there was no statistically significant difference in the fre-quency of apnea and retention volume more than 50% of previous feeding volume among all positions（P〉0.05）;The frequency of abdominal distension and retention amount less than the 25% of previous and 25% to 50% in the left lateral decubitus position was higher than that in other positions,and the difference was statistically sig-nificant（P〈0.05）.The frequency of retention amount of premature infants less than 25% of previous feeding volume and occurrence times of abdominal distention in the right lateral decubitus position were less than that in prone or supine position,and the difference was statistically significant（P〈0.05）.Conclusion：The influence of the supine,prone position,left side and right side position of nasogastric feeding of premature infants is little for vital signs,and prome position is more conducive to breathing,left lateral position is not conducive to the gastric emptying,while the right lateral position is conducive to promoting gastric emptying,reduce the occurrence of premature infants with abdominal distension.