父母参与发展性照顾联合袋鼠式干预对极低出生体重儿生长发育、神经行为及胃饥饿素水平的影响

Effects of parental participation in developmental care combined with kangaroointervention on growth and development,neurobehavior and Ghrelin level in very low birth weight infants

目的研究父母参与发展性照顾联合袋鼠式干预措施对极低出生体重儿生长发育、神经行为及(胃饥饿素水平)Ghrelin的影响。方法选择2017年5月-2019年6月在四川省妇幼保健院接受治疗的106例极低出生体重儿进行回顾性分析。行常规干预基础上加以父母参与发展性照顾的49例婴儿为对照组,观察组的57例婴儿在对照组基础上加以袋鼠式干预措施。比较两组婴儿生长临床情况、发育情况、并发症发生情况、神经行为及Ghrelin水平。结果观察组婴儿达全肠喂养时间、恢复正常体重时间较对照组更短,观察组每日睡眠时间均明显较对照组更长(t=7.200、6.284、14.995,P<0.05)。干预前两组婴儿体重、头围及身长差异均无统计学意义(P>0.05),干预后观察组婴儿体重、头围及身长均大于对照组(t=10.257、2.155、3.559,P<0.05)。观察组并发症总发生率为8.77%,低于对照组的24.49%(χ^(2)=4.834,P<0.05)。干预前两组婴儿NBNA得分及Ghrelin水平差异无统计学意义(t=0.513、0.180,P>0.05),干预后观察组婴儿NBNA得分及Ghrelin水平均显著高于对照组(t=6.284、2.893,P<0.05)。结论父母参与发展性照顾联合袋鼠式干预措施较袋鼠式干预措施可明显缩短极低出生体重儿达全肠喂养时间、恢复正常体重时间,延长每日睡眠时间,提高婴儿体重、头围及身长,改善其神经行为并提高Ghrelin水平。

Objective To analyze the effects of parental participation in developmental care combined with kangaroo intervention on growth and development,neuro-behavior and Ghrelin level in very low birth weight(VLBW)infants.Methods A total of 106 extremely low birth weight infants treated in Sichuan Maternal and Child Health Hospital from May 2017 to June 2019 were enrolled in this study.Forty-nine cases whose parents participated in developmental care on the basis of conventional intervention were selected as the control group,and 57 infants in the observation group were given kangaroo intervention additionally.The clinical conditions,developmental conditions,complications,neurobehavioral development,and Ghrelin level in infants were compared between the two groups.Results The infants in the observation group had shorter enteral feeding time and time to return to normal weight than the control group,and the daily sleep time in the observation group was significantly longer than that in the control group(t=7.200,6.284,14.995,P<0.05).There was no significant difference in the weight,head circumference and length of the two groups before intervention(P>0.05).The weight,head circumference and length of the infants in the observation group were larger than those in the control group after intervention(t=10.257,2.155,3.559,P<0.05).The total incidence of complications in the observation group was 8.77%,significantly lower than that in the control group(24.49%)(χ^(2)=4.834,P<0.05).There was no significant difference in NBNA score and Ghrelin level between the two groups of infants before intervention(P>0.05),but the score of NBNA and Ghrelin in the observation group were significantly higher than those in the control group after intervention(t=6.284,2.893,P<0.05).Conclusion Compared with kangaroo intervention alone,parents′participation in developmental care combined with kangaroo intervention can significantly shorten the time for VLBW infants to reach total enteral feeding,recover normal body weight and sleep every day,improve their weight,head circumference and body length,and facilitate their neurobehavioral development and improve the level of Ghrelin.