在极低出生体重儿喂养中“三管齐下”护理的应用分析

摘要

Objective To investigate the clinical effect of the application of "triple" nursing including music therapy, touching and non-nutritional sucking method for feeding in very low birth weight infants.Methods A total of 100 very low birth weight infants treated in our hospital from January 2012 to December 2014 were drawn into study, and they were randomly divided into control group and intervention group, with each group 50 cases. The infants of control group were given daily timing quantitative amino acids, glucose and parenteral nutrition via vein and hydrolyzed protein formula milk were given gradually increase to adequate enteral feeding by stomach tube. The infants of intervention group were nursed by music therapy combined with touching and non-nutritional sucking method on the basis of the control group fed. The time of recovery to the birth weight, the quantity of daily body mass increasing, the time of parenteral nutrition and reaching enough enteral feeding, the length of hospital stay and the incidence of feeding intolerance of the two groups were compared.Results Compared with the control group, the quantity of daily body mass increasing of the intervention group's infants was significantly higher, the time of recovery to birth weight, parenteral nutrition, reaching enough enteral feeding and hospitalization were shorter, the incidence of feeding intolerance was lower, and the differences were statistically significant (P<0.05).ConclusionThe "triple" nursing of music therapy combined with touching and non-nutritional sucking method was better than the "single" nursing of touching or non-nutritional sucking method. It can improve the ability sucking and swallowing, improve gastrointestinal digestive function, prevention the incidence of feeding intolerance, improve children's feeding. Therefore, it is worthy of the popularization and application in clinical.%目的：探讨音乐疗法、抚触法和非营养性吸吮法联合应用的“三管齐下”护理法对极低出生体重儿喂养的临床效果。方法根据标准纳入100例于2012年1月~2014年12月在我院接受治疗的极低出生体重儿，随机分为对照组和干预组，各50例。对照组每天定时定量给予氨基酸、葡萄糖等胃肠外营养，同时经胃管逐渐增加给予深度水解蛋白配方奶至足量肠内喂养。干预组在对照组的喂养基础上，在生后第4天开始实施音乐疗法、抚触法和非营养性吸吮法结合的“三管齐下”护理。比较两组早产儿恢复出生体重所用时间、每天体重增长量、胃肠外营养时间、达到足量肠内喂养时间、住院时间及两组喂养不耐受发生率。结果干预组患儿每天体重增长比对照组的大，恢复出生体重所用时间、胃肠外营养时间、达到足量肠内喂养时间、住院时间均短于对照组，发生喂养不耐受的概率明显比对照组低，差异均有统计学意义（P＜0.05）。结论音乐疗法、抚触法和非营养性吸吮法的“三管齐下”护理的效果良好，可改善极低出生体重儿吸吮、吞咽能力，完善胃肠道的消化功能，预防喂养不耐受的发生，改善患儿的喂养情况。