个体化吞咽在重症监护室喂养障碍早产儿中的应用效果及对并发症的影响  

Application effect of individualized swallowing in feeding impaired premature infants in Intensive Care Unit and the impact on complications

作　　者：程元辉 陈阿阮 CHENG Yuan-hui;CHEN A-ruan(Affiliated Obstetrics and Gynecology Hospital of Fudan University,Shanghai,200082,China;不详)

机构地区：[1]复旦大学附属妇产科医院,上海200082 [2]海南省妇女儿童医学中心

出　　处：《中国妇幼保健》2024年第21期4199-4203,共5页Maternal and Child Health Care of China

基　　金：海南省重点研发计划科技合作方向项目(ZDYF2019210)。

摘　　要：目的 观察个体化吞咽在重症监护室喂养障碍早产儿中的应用效果及对并发症的影响。方法 选择2021年7月—2023年7月在复旦大学附属妇产科医院治疗的86例重症监护室喂养障碍早产儿,采用随机数字表法分为两组,43例常规组患儿给予基础干预,43例个体化吞咽干预组患儿给予个体化吞咽干预。记录两组全经口喝奶时间、日均增奶量、NICU住院时间,记录干预前后两组患儿吸吮效率、喂奶时间、体质量、身长、胸围,干预前后给予两组新生儿口腔运动评定量表(NOMAS)评价,记录两组呛奶窒息、肺部感染、喂奶时呛咳等发生情况。结果 个体化吞咽干预组全经口喝奶时间[(12.13±2.51)d]、NICU住院时间[(8.29±1.82)d]均短于常规组的(21.51±5.76)d和(12.95±2.81)d,差异均有统计学意义(均P<0.05),个体化吞咽干预组日均增奶量[(12.86±2.68)ml]大于常规组[(9.45±2.02)ml],差异有统计学意义(P<0.05)。干预后,个体化吞咽干预组早产儿NOMAS评分[(25.26±4.06)分]高于常规组[(17.35±3.09)分],吸吮效率[(56.13±10.26)次/min]高于常规组[(40.25±5.13)次/min],患儿喂奶时间[(12.61±2.08)min]短于常规组[(15.93±3.56)min],差异均有统计学意义(均P<0.05)。干预后,个体化吞咽干预组早产儿体质量[(2 231.14±93.66)g]、身长[(45.16±2.84)cm]、头围[(32.17±1.73)cm]均大于常规组[(1 985.65±82.45)g、(43.01±2.43)cm、(30.43±1.45)cm],差异均有统计学意义(均P<0.05)。个体化吞咽干预组并发症发生率(4.65%)低于常规组(23.26%),差异有统计学意义(P<0.05)。结论 个体化吞咽干预重症监护室喂养障碍早产儿,可提升患儿吸吮功能,缩短全经口喝奶时间、NICU住院时间、喂奶时间,促进患儿生长发育,减少并发症。Objective To observe the application effect of individualized swallowing in feeding impaired premature infants in Intensive Care Unit and the impact on complications.Methods A total of 86 preterm infants with feeding disorder were selected from Intensive Care Unit of Affiliated Obstetrics and Gynecology Hospital of Fudan University from July 2021 to July 2023.All the infants were grouped by random number table method.Basic intervention was given to 43 infants in conventional group,and individualized swallowing intervention was given to 43 infants in individualized swallowing intervention group.The whole oral milk drinking time,daily milk gain,NICU length of stay of the two groups were recorded,as well as the sucking efficiency,feeding time,body weight,length,and chest circumference of the two groups before intervention and after intervention.Neonatal Oral Motion Rating Scale(NOMAS) was used to evaluate the infants before intervention and after intervention,and the incidence rates of choking,pulmonary infection,and coughing during feeding were recorded.Results The duration of whole oral milk drinking [(12.13±2.51) days] and hospitalization time of NICU [(8.29±1.82) days] in individualized swallowing intervention group were shorter than those in conventional group [(21.51±5.76) days,(12.95±2.81) days](P<0.05).The average daily milk increase in individual swallowing intervention group [(12.86±2.68) ml] was higher than that in conventional group [(9.45±2.02) ml](P<0.05).After intervention,NOMAS score in individualized swallowing intervention group(25.26±4.06) was higher than that in conventional group(17.35±3.09),and sucking efficiency [(56.13±10.26) times per minute] was higher than that in conventional group [(40.25±5.13) times per minute](P<0.05),the feeding time [(12.61±2.08) minutes] was shorter than that in conventional group [(15.93±3.56) minutes](P<0.05).After intervention,body weight,body length,and head circumference in individualized swallowing intervention group [(2 231.14±93.66) g,(45.16±2.

关 键 词：个体化吞咽 重症监护室 喂养障碍 早产儿 吸吮功能 并发症 

分 类 号：R722.6[医药卫生—儿科]