俯卧位联合抚触对鼻塞持续气道正压通气早产儿喂养不耐受的影响

Influence of prone-position combined with message on the feeding intolerance of premature infants with nasal continuous positive airway pressure

目的：探讨俯卧位联合抚触对鼻塞持续气道正压通气（ NCPAP）的早产儿喂养不耐受的影响。方法选择2013年1—12月温州医科大学附属第二医院新生儿重症监护室（ NICU）收治的早产儿134例，按单盲随机化分组对照原则，采用随机数字法分为4组进行观察：仰卧位组（33例）、俯卧位组（34例）、仰卧位联合抚触组（32例）、俯卧位联合抚触组（35例）。4组患儿均予NCPAP以及相关护理，比较4组喂养效果。结果对4组喂养不耐受程度进行比较，俯卧位联合抚触组呕吐、腹胀、胃潴留发生率较其他组少，差异有统计学意义（P〈0.05）。4组患儿的NCPAP时间、住院天数、鼻胃管留置时间、恢复出生体质量时间、达全肠道营养时间均存在差异，其中俯卧位联合抚触时间最短，差异有统计学意义（P〈0.05）。结论俯卧位联合抚触能增强早产儿胃肠道功能，改善喂养不耐受，减少患儿的机械通气时间和住院时间。

Objective To discuss prone-position combined with massage impacted on the feeding＆amp;nbsp;intolerance of premature infant with nasal continuous positive airway pressure. Methods The objects of study were the 134 premature infants with nasal continuous positive airway pressure （ NCPAP） in Neonatal Intensive Care Unit （ NICU ） the Second Affiliated Hospital of Wenzhou Medical University from January to December 2013. According to the single-blinded and random number table, they were divided into 4 groups, namely prone position group （ 33 cases ） , supine position group （ 34 cases ） , prone-position combined massage group （32 cases） and supine-position combined massage group （35 cases）. All these 4 groups were given NCPAP and relevant nursing treatment; the feeding effects of 4 groups were compared. Results With regard to feeding intolerance concerning vomit, abdominal distension and gastric retention in 4 groups, prone-position combined massage group was lower than the other groups with statistical significance （P〈0. 05）. The time of NCPAP, days of hospitalization, length of nasogastric tube indwelling, time of regaining birth weight and time of reaching full enteral nutrition existed differences in 4 groups, in which infants of prone-position combined with message used least time with statistical significance （P 〈0. 05）. Conclusions The prone-position combined with massage group attributes to the gastrointastinal tract function and feeding intolerance condition of premature infant and reduces mechanical ventilation time and length of hospitalization.