口腔按摩和非营养性吸吮改善早产儿吸吮能力的比较

摘要

目的观察口腔按摩、非营养性吸吮2种口腔运动干预方法以及纠正胎龄对早产儿吸吮能力的影响.方法将91例胎龄29~32周早产儿采用随机数字表法分成3组.口腔按摩组在常规护理的基础上给予口腔按摩刺激干预；非营养性吸吮组在常规护理的基础上给予非营养性吸吮干预；常规护理组采取常规护理.观察比较3组早产儿不同纠正胎龄期每分钟吸吮脉冲的数目，吸吮脉冲的持续时间和吸吮间隔的持续时间.结果3组早产儿纠正胎龄32~36周，随着胎龄的逐渐增长，每分钟吸吮脉冲的数目、吸吮脉冲的持续时间呈现逐渐上升的趋势，吸吮间隔的持续时间呈现逐渐下降的趋势，且以纠正胎龄34周最为显著.不同纠正胎龄期，口腔按摩组与非营养性吸吮组在每分钟吸吮脉冲的数目、吸吮脉冲的持续时间、吸吮间隔的持续时间均优于常规护理组，差异有统计学意义(P<0.01)；且在纠正胎龄32~34周，口腔按摩组每分钟吸吮脉冲的数目、吸吮脉冲的持续时间、吸吮间隔的持续时间优于非营养性吸吮组，差异有统计学意义(P<0.01或P<0.05)，纠正胎龄35~36周，口腔按摩组与非营养性吸吮组两组间差异逐渐缩小，无统计学意义(P>0.05).结论口腔按摩和非营养性吸吮均能促进早产儿吸吮能力的发育，早产儿随着纠正胎龄的增长，其吸吮能力不断成熟和改善.%Objective To observe the effects of oral stimulation, non-nutritive sucking and corrected gestational age on sucking ability of preterm newborns. Methods Totally 91 preterm newborns were randomly divided into oral stimulation group, non-nutritive sucking group and control group. Sucking bursts per minute, the duration of the bursts and the duration of pauses of three groups at different corrected gestational ages were compared. Results (1) From corrected gestational age of 32 weeks to 36 weeks, the average number of sucking bursts per minute and the duration of the bursts showed a gradually rising trend, while the duration of sucking pauses showed a gradually declining trend, which was the most significant at 34 weeks among three groups. (2) At different corrected gestational ages, sucking bursts per minute, the duration of the bursts and the duration of pauses in oral stimulation group and non-nutritive sucking group were better than those in control group (P<0.01). Between 32 to 34 weeks, there were a bigger average number of sucking bursts per minute, a longer duration of sucking bursts and a shorter duration of pauses in oral stimulation group than those in non-nutritive sucking stimulation group (P<0.01 or P<0.05). From 35 to 36 weeks, the differences between oral stimulation group and non-nutritive sucking group were gradually reduced, and showed no statistically significant difference (P>0.05). Conclusion The stimulation of non-nutritive sucking and oral stimulation in preterm newborns modify the post-natal development of sucking rhythm. The process of maturation, represented by the corrected gestational age, is considered a responsible factor for this process.