两种量表在早产儿首次经口喂养评估中的比较研究

Comparison of two scales in the evaluation of first oral feeding in premature infants

目的比较早产儿准备经口喂养评估量表(PIOFRA)、早产儿经口喂养能力评估量表(POFARA)对早产儿首次经口喂养结局的预测效能。方法本研究为横断面研究,采用便利抽样法,选取276例于2021年2月—2022年2月在空军军医大学第二附属医院和陕西中医药大学第二附属医院的新生儿重症监护室治疗的早产儿为研究对象,根据首次经口喂养结局将其分为首次经口喂养成功组(n=227)和首次经口喂养失败组(n=49)。采用PIOFRA和POFARA对其进行评估,采用受试者工作特征曲线下的面积(area under the curve,AUC)、灵敏度、特异度、约登指数等指标比较2种量表对早产儿首次经口喂养结局的预测效能。结果早产儿首次经口喂养成功率为82.25%(227/276)。首次经口喂养成功组的PIOFRA和POFARA评分均高于首次经口喂养失败组(P<0.01)。PIOFRA的AUC为0.830,当总分为27.00分时,灵敏度为78.40%、特异度为75.50%、约登指数为0.539(P<0.01),预测效能最高;POFARA的AUC为0.928,当总分为33.00分时,灵敏度为79.70%、特异度为95.90%、约登指数为0.757(P<0.01),预测效能最高。POFARA的AUC、灵敏度、特异度、约登指数均大于PIOFRA。结论 POFARA预测效能高于PIOFRA,建议采用POFARA进行早产儿首次经口喂养结局的评估和预测。

Objective To compare the efficacy of the Preterm Infant Oral Feeding Readiness Assessment Scale(PIOFRA)and Preterm Infant Oral Feeding Ability Readiness Assessment Scale(POFARA)in predicting the outcome of first oral feeding in preterm infants.Methods This study was a cross-sectional study.From February 2021 to February 2022,276 premature infants treated in the Neonatal Intensive Care Unit of the Second Affiliated Hospital of Air Force Medical University of People's Liberation Army and the Second Affiliated Hospital of Shaanxi University of Chinese Medicine were selected by convenience sampling method.According to the outcome of the first oral feeding,the premature infants were divided into a successful first oral feeding group(n=227)and a failed first oral feeding group(n=49).PIOFRA and POFARA were used to evaluate premature infants.The area under the receiver operating characteristic curve(AUC),sensitivity,specificity,Youden index and other indicators were used to compare the predictive efficacy of the two scales for the first oral feeding outcome of premature infants.Results The success rate of first oral feeding for premature infants was 82.25%(227/276).The PIOFRA and POFARA scores of the successful first oral feeding group were higher than those of the failed first oral feeding group(P<0.01).The AUC of PIOFRA was 0.830.When the total score of PIOFRA was 27.00,the sensitivity was 78.40%,the specificity was 75.50%,and the Youden index was 0.539(P<0.01),and its prediction efficiency was the highest.The AUC of POFARA was 0.928.When the total score of POFARA was 33.00,the sensitivity was 79.70%,the specificity was 95.90%,and the Youden index was 0.757(P<0.01),and its prediction efficiency was the highest.The AUC,sensitivity,specificity and Youden index of POFARA were higher than those of PIOFRA.Conclusions The predictive efficacy of POFARA is higher than that of PIOFRA.It is recommended to use POFARA for the evaluation and prediction of the outcome of first oral feeding in premature infants.