小下颌-舌后坠综合征新生儿经口喂养规范化操作方案的构建及应用  

Construction and application of standardized operation scheme of oral feeding for neonates with Pierre Robin syndrome

作　　者：周莲娟[1] 袁天明[1] 朱海虹[2] 叶芳[3] 吴丽元[4] 沈清清 王玲[6] 沈雅芳[1] 诸纪华[2] ZHOU Lianjuan;YUAN Tianming;ZHU Haihong;YE Fang;WU Liyuan;SHEN Qingqing;WANG Ling;SHEN Yafang;ZHU Jihua

机构地区：[1]浙江大学医学院附属儿童医院/国家儿童健康与疾病临床医学研究中心新生儿科,杭州市310052 [2]浙江大学医学院附属儿童医院/国家儿童健康与疾病临床医学研究中心护理部,杭州市310052 [3]浙江大学医学院附属儿童医院/国家儿童健康与疾病临床医学研究中心健康管理中心,杭州市310052 [4]中南大学湘雅二医院新生儿科 [5]山东第一医科大学附属省立医院新生儿重症监护室 [6]郑州大学第三附属医院护理部

出　　处：《中华急危重症护理杂志》2024年第12期1074-1080,共7页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药科技适宜技术培育推广项目(2021ZH026)。

摘　　要：目的 构建小下颌-舌后坠综合征新生儿经口喂养规范化操作方案并探讨其应用效果。方法 基于最佳证据、专家小组讨论,构建小下颌-舌后坠综合征经口喂养操作方案。于2023年4月-6月对来自北京市、上海市、杭州市等8个地区的15名专家进行了2轮德尔菲专家函询,对小下颌-舌后坠综合征新生儿经口喂养技术操作方案进行修改,确定最终方案。采用便利抽样法,选取2023年9月-12月在杭州市、长沙市等地区的4所三级甲等医院入住的21例小下颌-舌后坠综合征新生儿作为试验组,2023年5月-8月入住的25例小下颌-舌后坠综合征新生儿作为对照组。试验组在常规护理基础上采用小下颌-舌后坠综合征新生儿经口喂养规范化操作方案,对照组采用常规护理,比较两组过渡时间、喂养效率、喂养成效、摄入奶量比、住院时间、不良事件发生率的差异。结果 2轮函询问卷有效回收率分别为93.75%、100%;2轮专家权威系数为0.91,变异系数分别为0~0.185和0~0.241,肯德尔和谐系数分别为0.168和0.205(P<0.05)。最终构建的小下颌-舌后坠综合征新生儿经口喂养规范化操作方案包括4个一级条目、13个二级条目、22个三级条目。在该方案的应用过程中,最终纳入46例患儿,其中试验组21例,对照组25例,两组患儿喂养过渡时间、喂养效率、喂养成效、摄入奶量比、住院时间、不良事件发生次数比较,差异均具有统计学意义(P<0.05)。结论 小下颌-舌后坠综合征新生儿经口喂养规范化操作方案构建过程科学,实用性较强,内容专科特色明显,可促进新生儿小下颌-舌后坠综合征喂养技术的规范化发展。Objective To establish a standardized operation scheme of oral feeding for neonates with Pierre Robin syndrome and to explore its application effects.Methods Based on the best evidence and expert group discussion,the oral feeding operation scheme of Pierre Robin syndrome was established.From April to June 2023,15 experts from 8 regions,including Beijing,Shanghai and Hangzhou,were invited to conduct 2 rounds of Delphi expert consultation to modify the operation scheme and clarify the final scheme.A total of 21 neonates with Pierre Robin syndrome admitted from September to December 2023 in four tertiary hospitals in Hangzhou City and Changsha City were selected as the experimental group,and 25 neonates with Pierre Robin syndrome admited from May to August 2023 were selected as the control group.On the basis of routine nursing,the experimental group was given the standardized operation scheme of oral feeding,and the control group was given the routine nursing.The differences of transition time,feeding efficiency,feeding effectiveness,milk intake ratio,length of hospital stay and incidence of adverse events were compared between the two groups.Results The effective recovery rates were 93.75%and 100%,respectively.The expert authority coefficient of the two rounds was 0.91.After the second round of expert correspondence,the coefficient of variation of importance and operability of each item was 0~0.185 and 0~0.241,and the Kendall harmony coefficient was 0.168 and 0.205,respectively(P<0.05).The standardized operation scheme of oral feeding for neonates with Pierre Robin syndrome included 4 first-level items,13 second-level items and 22 third-level items.In the application process of this protocol,46 children were finally included,including 21 in the experimental group and 25 in the control group.The differences between the two groups were statistically significant in terms of feeding transition time,feeding efficiency,feeding effectiveness,ratio of milk intake,length of hospital stay and incidence of adverse events(P<0.

关 键 词：新生儿 小下颌-舌后坠综合征 经口喂养 操作方案 儿科护理学 

分 类 号：R473.72[医药卫生—护理学]