新生儿重症监护室早产儿经口喂养过渡时间的影响因素分析  

Influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit

作　　者：赵丽金 丁文雯 张涛梅 张莹[1] Zhao Lijin;Ding Wenwen;Zhang Taomei;Zhang Ying(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学护理学院,200025

出　　处：《中国实用护理杂志》2020年第1期2-7,共6页Chinese Journal of Practical Nursing

基　　金：上海市教育委员会护理高原学科项目-国际合作科研基金(H1gy1804gj);上海交通大学医学院护理科研重点项目(Jyhz1602)。

摘　　要：目的调查并分析新生儿重症监护室(NICU)的早产儿经口喂养过渡时间的影响因素。方法采用方便抽样法,共纳入上海市第一妇婴保健院NICU的早产儿及其母亲251对,通过查阅病史资料获得早产儿的基本信息及喂养情况,采用焦虑自评量表(SAS)、贝克抑郁量表第2版(BDI-Ⅱ)对早产儿母亲进行焦虑及抑郁的测评。结果NICU早产儿经口喂养过渡时间为(5.31±2.93)d。多元回归分析显示,早产儿出生胎龄越大(β=-0.484,P<0.01)、第一次经口母乳喂养时间越早(β=0.042,P=0.003),早产儿经口喂养过渡时间越短。患有先天性心脏疾病(β=0.587,P=0.050)、母亲焦虑(β=0.206,P<0.01)、抑郁(β=0.727,P<0.01)、母亲焦虑与抑郁的交互作用(β=0.014,P<0.01)对经口喂养过渡时间有负向影响。多元回归方程共解释总变异的58.2%。结论NICU早产儿经口喂养过渡时间受多因素影响,出生胎龄可作为预测其经口喂养以及评估经口喂养实施的指标。经口喂养尽早使用母乳,有利于早产儿加快实现经口喂养过渡。疾病状态尤其是合并心脏疾病是影响经口喂养过渡的一个重要因素。母亲焦虑、抑郁会延长早产儿经口喂养过渡时间。临床可通过控制影响经口喂养的因素,关注NICU早产儿母亲的心理状况,为早产儿制订科学合理的喂养干预,以促进经口喂养。Objective To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit(NICU).Methods A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected.Finding the medical records to obtain the basic information of the premature infants and feeding conditions,the Self-rating Anxiety Scale(SAS)and the Beck Depression Scale-Ⅱ(BDI-Ⅱ)was used to assess the mothers′anxiety and depression.Results The transition time to achieve full oral feeding of NICU preterm infants was(5.31±2.93)days.Greater gestational age(β=-0.484,P<0.01),time of breast milk feeding through mouth(β=0.042,P=0.003)had a positive effect on the transition time to achieve full oral feeding.Congenital heart disease(β=0.587,P=0.050),maternal anxiety(β=0.206,P<0.01),depression(β=0.727,P<0.01)and interaction between maternal anxiety and depression(β=0.014,P<0.01)were risk factors of longer time to achieving full oral feeding.The multiple linear regression accounting for a total of 58.2%of all the variation.Conclusions Oral feeding progression in premature infants was influenced by many factors.Gestational age can be the indicators of implementing oral feeding.It is beneficial to initiate oral feeding and feed with breast milk early.If the infants have heart diseases,oral feeding progression would be retardant.Maternal anxiety and depression may prolong the transition time to achieve full oral feeding.Control the factors which affect oral feeding progression,pay attention on mothers′emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.

关 键 词：婴儿 早产 新生儿重症监护 经口喂养 母亲 焦虑 抑郁 

分 类 号：R722[医药卫生—儿科]