郑玉蔼，何璐，贺娟，徐开寿.新生儿重症监护室环境下行个体化吞咽治疗对早产儿喂养障碍的影响[J].中华物理医学与康复杂志,2017,39(7):513-517
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| 新生儿重症监护室环境下行个体化吞咽治疗对早产儿喂养障碍的影响 |
| The efficacy of individualized swallowing training for premature infants with feeding disorders: A randomized controlled trial |
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| DOI： |
| 中文关键词: 早产儿 喂养障碍 吞咽治疗 新生儿重症监护室 体重 |
| 英文关键词: Premature neonates Feeding disorders Swallowing training Body weight |
| 基金项目:国家自然科学基金（81672253）；广东省科技计划项目（2015A030401006，2014A020212469）；广州市科技计划项目（2014J4100136） |
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| 中文摘要: |
| 目的 观察新生儿重症监护室（NICU）环境的个体化吞咽治疗对早产儿喂养障碍的影响。 方法 选取喂养障碍早产儿62例，孕期28至32周，随机分为治疗组34例和对照组28例。2组均接受早产儿临床常规治疗，即留置胃管按需喂养，治疗组在此治疗方案的基础上增加个体化吞咽治疗，包括口腔感觉运动刺激、进食训练、指导家长参与治疗、进食环境的改善、喂养工具的选择等。治疗前2周（治疗前，根据病历资料计算）和治疗2周后（治疗后）评估2组早产儿的日均增加奶量（mL）和日均增加体重（g）、留置胃管的时间、全经口喝奶的时间（d）、总住院时间（d）。 结果 治疗后，治疗组和对照组早产儿的日均增加奶量分别为（11.47±3.64）mL和（9.92±4.04）mL，日均增加体重分别为（23.26±5.65）g和（18.78±3.91）g，2组的日均增加奶量和增加体重较组内治疗前均显著增加，差异均有统计学意义（P<0.05），且治疗组治疗后的日均增加奶量和增加体重均优于对照组，差异均有统计学意义（P<0.05）。治疗后，治疗组的全经口喝奶时间、胃管留置时间、总住院时间分别为（10.28±4.96）d、（35.38±1.44）周和（43.23±7.26）d，显著优于对照组的（25.47±7.30）d、（37.24±1.39）周和（49.74±8.65）d，差异均有统计学意义(P<0.05)。 结论 基于NICU环境下的早期个体化吞咽治疗，可有效提高早产儿的喝奶量和体重，使早产儿尽早达到全经口进食，明显缩短胃管留置时间和住院天数。 |
| 英文摘要: |
| Objective To observe the effect of individualized swallowing training in the neonatal intensive care unit on the swallowing function of premature infants with feeding disorders. Methods Sixty-two preterm (28 to 32 weeks) infants with feeding disorders were randomly divided into a treatment group (n=34) and a control group (n=28). Both groups were given routine gastric tube feeding, but the treatment group was additionally provided with individualized swallowing training twice a day for 2 weeks, including oral sensory and motor stimulation, milking, family participation, a better environment and a selection of feeding tools. The subjects′ daily milk consumption and weight were recorded, along with the age when the gastric tube was removed and the total length of the hospital stay. Results The treatment group showed significantly greater improvement than the control group in their daily milk consumption and weight gain, though both groups showed significant improvements. The average time to removing the gastric tube and the average hospital stay were both significantly shorter for the treatment group than for the control group. Conclusion Individualized swallowing training can effectively improve sucking and swallowing skills and shorten the period of using a gastric tube and the total hospital stay for premature infants. |
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