物理干预对早产儿喂养质量的临床效果分析

Clinical effect analysis of physical intervention on feeding quality of premature infants

目的探讨常规综合护理治疗联合物理干预对早产儿喂养质量的改善效果。方法2018年12月至2019年7月,在青岛大学附属医院新生儿重症监护病房收治的早产儿中,纳入102例为研究对象,随机分为干预组52例和对照组50例。所有早产儿均留置胃管,每3小时重力管饲喂养1次。对照组常规综合护理、口腔护理;干预组增加物理干预措施,包括初乳口腔护理、口腔运动干预以及腹部按摩,共10 d。记录并分析两组干预后的喂养质量及喂养进程的变化情况。采用t检验和χ^2检验进行统计学分析。结果①基本情况:干预组与对照组在胎龄、性别、出生体重、呼吸机辅助通气、母亲疾病、产前激素使用及生后1周排便次数等方面比较,差异均无统计学意义(P>0.05)。②喂养质量:研究第1天,干预组与对照组患儿的腹围、呕吐频率、胃潴留量、体重比较,差异均无统计学意义(P>0.05);研究第10天,干预组患儿的体重、奶量均高于对照组[体重(1775±401)与(1563±336)g,奶量(91±43)与(73±46)ml/(kg·d),P<0.05],腹围、胃潴留量均低于对照组[腹围(23.7±2.1)与(24.6±2.2)cm,胃潴留量(2.8±2.2)与(4.9±1.9)ml,P<0.05]。③喂养进程:干预组早产儿的开始经口喂养时间及管饲时间均低于对照组[开始经口喂养时间[(11.5±10.0)与(18.5±15.0)d,管饲时间(18±15)与(26±17)d,P<0.05]。结论对早产儿早期进行初乳免疫疗法、口腔运动干预及腹部按摩等物理干预措施,可改善早产儿喂养质量,缩短管饲时间,促进喂养进程,从而改善预后。

Objective To explore the improvement effect of routine comprehensive nursing treatment combined with physical intervention on feeding quality of premature infants.Methods From December 2018 to July 2019,102 premature infants admitted to the neonatal intensive care unit of Affiliated Hospital of Qingdao University were included in the study,and they were randomly divided into an intervention group of 52 infants and a control group of 50 infants.All the premature babies were fed with gravity tube every 3 hours.Control group were performed routine comprehensive nursing and oral care.In the intervention group,physical intervention measures were added,including colostrum oral care,oral motor intervention and abdominal massage,for a total of 10 days.Changes in feeding quality and feeding process were recorded and analyzed in the two groups after intervention.Then t-test andχ^2 test were used for statistical analysis.Results①Basic situation:There was no significant difference between the intervention group and the control group in terms of gestational age,gender,birth weight,ventilatoryassisted ventilation,maternal diseases,prenatal hormone use and defecation frequency in the first week after birth(P>0.05).②Feeding quality:On first day of the study,there was no statistically significant difference in abdominal circumference,vomiting frequency,gastric retention and body weight between the intervention group and the control group(P>0.05).On the 10th day of the study,the body weight and milk volume of the children in the intervention group were higher than those in the control group[body weight(1775±401)and(1563±336)g,milk volume(91±43)and(73±46)ml/(kg·d),P<0.05];and the abdominal circumference and gastric retention of the intervention group were lower than those in the control group[abdominal circumference(23.7±2.1)and(24.6±2.2)cm,gastric retention(2.8±2.2)and(4.9±1.9)ml,P<0.05].③Feeding process:The initial oral feeding time and tube feeding time of preterm infants in the intervention group were lower than those in the control group[initial oral feeding time(11.5±10.0)and(18.5±15.0)d,tube feeding time(18±15)and(26±17)d,P<0.05].Conclusion Physical interventions such as colostrum immunotherapy,oral motor intervention and abdominal massage can improve the feeding quality,shorten the tube feeding time,promote the feeding process and improve the prognosis of premature infants.