多感官刺激对NICU早产儿经口喂养时间影响的网状Meta分析

Effects of multisensory stimulation on oral feeding time of NICU premature infants:a network Metaanalysis

目的比较不同的多感官刺激方案对新生儿重症监护病房(NICU)早产儿经口喂养时间的影响, 为临床进一步实施多感官刺激提供理论依据。方法系统检索中英文数据库中与多感官刺激对NICU早产儿经口喂养干预效果的随机对照试验, 检索时限为建库至2023年10月24日。经过文献筛选、资料提取, 采用Cochrane随机对照试验偏倚风险评估工具对纳入文献进行质量评价, 采用Stata 18.0软件进行贝叶斯网状Meta分析。结果共纳入39项随机对照试验, 涉及8种不同组合类型的多感官刺激方案, 分别为触觉听觉联合刺激、嗅觉味觉联合刺激、触觉味觉联合刺激、听觉味觉联合刺激、触觉动觉联合刺激、触觉味觉嗅觉联合刺激、触听视前庭觉四联刺激、触听视前庭嗅味觉六联刺激。网状Meta分析结果显示, 味觉听觉联合刺激缩短NICU早产儿经口喂养过渡时间的效果最好(P<0.05), 触觉味觉联合刺激缩短NICU早产儿完全经口喂养时间的效果最好(P<0.05)。结论多感官刺激方案能够不同程度地缩短NICU早产儿经口喂养时间, 其中味觉干预是多感官刺激方案中较为重要的, 而触觉和听觉的效果具有差异化。建议未来研究应关注味觉、触觉和听觉联合刺激方案对NICU早产儿经口喂养时间的影响, 并进一步探索多感官刺激干预的时长、频率等对干预效果的影响。

Objective To compare the effects of different multisensory stimulation on the oral feeding time of premature infants in the Neonatal Intensive Care Unit(NICU),so as to provide a theoretical basis for further implementing multisensory stimulation in clinical practice.Methods The randomized controlled trial on the effect of multisensory stimulation on the oral feeding in NICU premature infants was systematically searched in both Chinese and English databases.The search period was from database establishment to October 24,2023.After literature screening and data extraction,the quality of the included literature was evaluated using the Cochrane risk of bias tool for randomized controlled trials,and Bayesian network Meta-analysis was performed using Stata 18.0 software.Results A total of 39 randomized controlled trials were included,involving 8 different combinations of multisensory stimulation,namely tactile auditory combined stimulation,olfactory taste combined stimulation,tactile taste combined stimulation,auditory taste combined stimulation,tactile kinesthetic combined stimulation,tactile taste olfactory combined stimulation,tactile auditory visual vestibular combined stimulation,and tactile auditory visual vestibular olfactory taste combined stimulation.The network Meta-analysis showed that the taste auditory combined stimulation had the best effect on shortening the transition time of oral feeding in NICU premature infants(P<0.05),while the tactile taste combined stimulation had the best ffect on shortening the complete oral feeding time in NICU premature infants(P<0.05).Conclusions Multisensory stimulation can shorten the oral feeding time of NICU premature infants to varying degrees,among which taste intervention is important,and the effects of tactile sensation and auditory sensation are differentiated.Attention should be paid to the effect of the taste tactile auditory combined stimulation on the oral feeding time of NICU premature infants,and further exploration should be conducted on the impact of the duration and frequency of multisensory stimulation on the intervention effect.