口腔运动干预改善早产儿吸吮能力的临床研究  

A clinical study on the value of oral motor intervention in improving sucking ability in preterm infants

作　　者：方灿然 张莲玉 章容 张玲萍 刘元玲 吴谢敏 FANG Canran;ZHANG Lianyu;ZHANG Rong;ZHANG Lingping;LIU Yuanling;WU Xiemin(Department of Neonatology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichun Prov-ince,China)

机构地区：[1]西南医科大学附属医院新生儿科,四川泸州646000

出　　处：《西南医科大学学报》2018年第5期449-452,共4页Journal of Southwest Medical University

基　　金：西南医科大学附属医院科研项目(编号:16090)

摘　　要：目的:通过口腔运动干预,观察早产儿生长发育临床指标及胃肠相关激素的变化,以评估口腔运动干预临床运用价值及其可能的作用机制。方法:根据纳入排除标准,共入选西南医科大学附属医院新生儿科收治早产儿120例,随机分为对照组,口腔按摩组,非营养性吸吮组,非营养性吸吮联合口腔按摩组。根据研究方案规范给予临床护理后观察各组胃肠道功能监测情况,包括患儿呕吐、腹胀、胃潴留及坏死性小肠结肠炎(necrotizing enterotolitis,NEC)发生率;各组临床指标监测情况,包括第7 d体重增长,第14 d体重增长,入院第20 d喂养效率(m L/min);出生后14 d胃肠道功能相关激素胃泌素、胃动素水平。结果:与对照组相比,三组干预组中胃肠道不良反应发生率明显降低(P <0.05)。出生后14 d,与对照组相比,其余三组早产儿体重均增长明显(P <0.05),胃动素,胃泌素水平均升高(P <0.05);与非营养性吸吮组相比,口腔按摩组与非营养性吸吮联合口腔按摩组的体重增长明显,血胃动素、胃泌素水平明显升高(P <0.05)。在入院第20 d时,与对照组相比,其余三组进奶效率均明显提高(P <0.05);与非营养性吸吮组比较,口腔按摩组与非营养性吸吮联合口腔按摩组喂养效率增加(P <0.05)。结论:临床中给予早产儿口腔运动功能训练,可采用非营养性吸吮联合口腔按摩,其作用可能通过神经调节促进胃动素和胃泌素的分泌,使早产儿营养适应更好以改善其吸吮能力和胃肠道功能,促进早产儿的生长发育。Objective To investigate the changes in growth and development indices and gastrointestinal hor-mones in preterm infants after oral motor intervention, as well as the clinical value and the possible mechanism oforal motor intervention. Methods： According to the inclusion and exclusion criteria, 120 preterm infants who wereadmitted to Department of Neonatology in The Affiliated Hospital of Southwest Medical University were enrolled andrandomly divided into control group, oral motor group, non-nutritive sucking group, and non-nutritive sucking＋oralmotor group. After clinical nursing was given according to the regimen, gastrointestinal function was observed ineach group, including the incidence of vomiting, abdominal distension, gastric retention, and necrotizing enterocolitis（NEC）, and related clinical indices were also monitored, including the increase in body weight on days 7 and 14,feeding efficiency （ml/min） on day 20 after admission, and the levels of gastrin and motilin on day 14 after birth. Results：Compared with the control group, the three intervention groups had significant reductions in the incidencerates of gastrointestinal adverse events （P 〈 0.05）. On day 14 after birth, compared with the control group, the threeintervention groups had significant increases in body weight and levels of motilin and gastrin （P 〈 0.05）. Comparedwith the non-nutritive sucking group, the oral motor group and the non-nutritive sucking＋oral motor group had sig-nificant increases in body weight and levels of motilin and gastrin （P 〈 0.05）. On day 20 after admission, the three in-tervention groups had a significant increase in feeding efficiency compared with the control group （P 〈 0.05）. Com-pared with the non-nutritive sucking group, the oral motor group and the non-nutritive sucking＋oral motor group had a significant increase in feeding efficiency （P 〈 0.05）. Conclusion： Oral motor intervention for preterm infantscan be performed by non-nutritive sucking combined with oral m

关 键 词：早产儿 口腔运动干预 胃泌素 胃动素 

分 类 号：R248.4[医药卫生—中医临床基础]