鸟巢俯卧位联合非营养性吸吮干预对早产儿胃肠道功能及生长发育的影响

Effect of bird′s nest prone position combined with non-nutritive sucking intervention on the gastrointestinal function and growth of preterm infants

目的探究鸟巢俯卧位联合非营养性吸吮(NNS)对早产儿胃肠道功能及生长发育的影响。方法选取2019年1—12月重庆市某医院新生儿重症监护室收治的150例早产儿为研究对象,采用随机数字表法将早产儿分为3组,每组50例。对照组早产儿予以常规早产护理,NNS组早产儿在常规护理的基础上予以NNS干预,联合组在NNS组早产儿护理基础上予以鸟巢俯卧位护理。比较3组早产儿干预第1天、第5天、第10天每日摄入奶量、经口喂养评估量表(PIOFRA)及新生儿口腔运动评估量表(NOMAS)评分。结果干预第5天和干预第10天时,联合组早产儿每日摄入奶量均多于NNS组和对照组,差异均有统计学意义(P<0.05)。干预第5天和干预第10天时,联合组早产儿PIOFRA及NOMAS评分均高于NNS组和对照组,差异均有统计学意义(P<0.05)。联合组早产儿的喂养不耐受率为4.0%,均低于NNS组的16.0%及对照组的26.0%,差异均有统计学意义(P<0.05)。联合组早产儿日均体质量增长速度、身长周均增长速度、头围周均增长速度显著快于NNS组和对照组,差异均有统计学意义(P<0.05)。结论鸟巢俯卧位联合NNS干预能够改善早产儿的吸吮吞咽能力,促进消化道功能的成熟及早产儿生长发育,提高早产儿生存质量,值得临床推广应用。

Objective To investigate the effect of bird′s nest prone position combined with non-nutritive sucking(NNS)on the gastrointestinal function and growth of preterm infants.Methods One hundred and fifty preterm infants admitted to the neonatal intensive care unit of a hospital in Chongqing from January to December 2019 were selected for the study.The subjects were divided into 3 groups using the random number table method,with 50 cases in each group.The preterm infants in the control group were given routine preterm care,those in the NNS group were given NNS intervention on the basis of routine care,and the subjects in the combined group were given bird′s nest prone position care on the basis of NNS group care.The daily milk intake,Preterm Infant Oral Feeding Readiness Assessment(PIOFRA)and Neonatal Oral-Motor Assessment Scale(NOMAS)scores were compared among the three groups on days 1,5 and 10 of the intervention.Results The daily milk intake of preterm infants in the combined group was higher than that in the NNS and control groups on both day 5 and day 10 of the intervention,with statistically significant differences(P<0.05).The PIOFRA and NOMAS scores of preterm infants in the combined group were higher than those in the NNS and control groups on both day 5 and day 10 of the intervention,and the differences were statistically significant(P<0.05).The feeding intolerance rate of preterm infants in the combined group was 4.0%,which was lower than that in the NNS group(16.0%)and the control group(26.0%),and the differences were statistically significant(P<0.05).The average daily growth rate of body mass,average weekly growth rate of body length,and average weekly growth rate of head circumference were significantly higher in the combined group than in the NNS and control groups,and the differences were all statistically significant(P<0.05).Conclusion Bird′s nest prone position combined with NNS intervention can improve the sucking and swallowing ability of preterm infants,promote the maturation of their digestive tract function and growth of preterm infants,improving the quality of life of preterm infants.Therefore,it is worthy of wider clinical application.