口周按摩联合试喂对新生儿缺氧缺血性脑病吞咽障碍的效果研究  

Effect of oral massage combined with trial feeding on dysphagia in neonates with hypoxic-ischemic encephalopathy

作　　者：蒋名丽 赵磊[1] 李朝晖[1] 张耀东 李丹凤 石彩晓 Jiang Mingli;Zhao Lei;Li Zhaohui;Zhang Yaodong;Li Danfeng;Shi Caixiao(NICU,the Affiliated Children＇s Hospital of Zhenzhou University,Zhenzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院NICU,450007 [2]郑州大学附属儿童医院护理部,450007

出　　处：《中国实用护理杂志》2018年第33期2610-2614,共5页Chinese Journal of Practical Nursing

基　　金：河南省医学科技攻关项目（201701034;201702322）

摘　　要：目的观察口周按摩联合试喂的喂养方法对新生儿缺氧缺血性脑病（HIE）患儿后期导致吞咽障碍的效果。方法选择2016年1月至2017年12月在新生儿重症监护室住院的中重度HIE并吞咽障碍的患儿共30例，按随机数字表法平均分为对照组和研究组各15例，研究组采用口周按摩联合试喂喂养方法，对照组采用鼻饲喂养；对2组的流奶、吞咽后口腔奶液残留、喂奶时间、有无吸吮动作及经口喂养时间、胃管留置时间和住院时间等指标进行比较。结果干预5d后，研究组在流奶、吞咽后口腔奶液残留、喂奶时间、有吸吮动作分别为6例、（8．50±1．05）ml、（36．40±2．87）min、10例，对照组分别为15例、（10．80±0．39）ml、（42．29±1．60）min、3例，2组比较差异有统计学意义（X^2=12．86、6．66，t=7．52、6．93，均P〈0．05）；研究组在经口喂养时间、胃管留置时间和住院时间分别为（15．60±1．35）、（11．73±1．39）、（21．47±2．03）d，对照组分别为（17．00±0．65）、（14．13±0．99）、（23．27±1．16）d，2组比较差异有统计学意义（t=3．61、5．45、2，98，P〈0.05）。结论对于吞咽障碍患儿在每次喂养前给予口周按摩并联合试喂能促进患儿的口腔运动神经的改善，提高喂养效果，促进患儿康复。Objective To observe the effect of oral massage combined with trial feeding on dysphagia in neonates with hypoxic-ischemic encephalopathy （HIE）. Methods We enrolled 30 hospitalized newborns who were diagnosed moderate to severe HIE with dysphagia in the NICU of our hospital from January 2016 to December 2017. According to the random number table method, these newborns was divided into control group and study group. Oral massage combined with trial feeding were given in the study group, nasogastric feeding in the control group and family participatory care and the treatment of nutritional neurodrugs were also given in two groups. To campare the oral milk remnant, feeding time and sucking action after the flow of milk and swallowing, oral feeding time, gastric tube indwelling time and length of stay in two groups. Results After 5 days intervention, the clinical manifestations of dysphagia in two groups were compared, and there were 6 cases, （8.50 ± 1.05）ml, （36.40 ±2.87）min and 10 cases of oral milk remnant, feeding time and sucking action after the flow of milk and swallowing respectively in the study group, and 15 cases were 15 cases, （10.80 ± 0.39 ）ml, （42.29 ± 1.60） min, 3 cases in the control group, respectively. The difference between the two groups was statistically significant （X^2=12.86, t=7.52, 6.93, X^2=6.66, P〈0.05）. The oral feeding time, gastric tube indwelling time and hospitalization time of the study group were （15.60±1.35） d, （11.73± 1.39） d, and （21.47±2.03）d, and the control group were （17.00±0.65） d, （14.13±0.99） d, （23.27 ±1.16） d, respectively. The difference between the two groups was statistically significant （t=3.61, 5.45, 2.98, P〈0.05）. Conclusions For children with dysphagia, oral massage and combined feeding before each feeding can promote the improvement of oral motor nerves in children, and improve feeding effect, and promote rehabilitation of children.

关 键 词：口周按摩 试喂 新生儿缺氧缺血性脑病 吞咽障碍 

分 类 号：R473.72[医药卫生—护理学]