胃管喂養(yǎng)早產兒中母乳口腔護理的臨床應用分析

繆芳媛

【摘要】 目的：研究母乳口腔護理在胃管喂養(yǎng)早產兒中的臨床應用效果。方法：選取2018年1月-2019年12月到筆者所在醫(yī)院治療的60例經胃管喂養(yǎng)早產兒作為研究對象，采用數(shù)字盲選法將其分為A組（n=30）和B組（n=30）。A組采用生理鹽水口腔護理，B組采用母乳口腔護理。比較兩組口腔清潔度、致病微生物培養(yǎng)陽性率、喂養(yǎng)不耐受發(fā)生率、胃管留置時間、矯正胎齡37周體質量增長百分比。結果：B組口腔清潔度評分高于A組，差異有統(tǒng)計學意義（P<0.05）。B組致病微生物培養(yǎng)陽性率、喂養(yǎng)不耐受發(fā)生率均低于A組，差異有統(tǒng)計學意義（P<0.05）。B組胃管留置時間短于A組，差異有統(tǒng)計學意義（P<0.05）。B組矯正胎齡37周體質量增長百分比高于A組，差異有統(tǒng)計學意義（P<0.05）。結論：在胃管喂養(yǎng)早產兒中應用母乳口腔護理方式，能夠保證患兒口腔清潔，降低致病微生物培養(yǎng)陽性率、喂養(yǎng)不耐受率，縮短胃管留置時間，促進患兒成長發(fā)育，值得臨床推廣應用。

【關鍵詞】 胃管喂養(yǎng) 早產兒 母乳口腔護理 生理鹽水

doi：10.14033/j.cnki.cfmr.2020.16.041 文獻標識碼 B 文章編號 1674-6805（2020）16-0-03

Analysis of the Clinical Application of Breast Milk Oral Care in Gastric Tube Feeding Premature Infants/MIAO Fangyuan. //Chinese and Foreign Medical Research， 2020， 18（16）： -105

[Abstract] Objective： To study the clinical effect of breast milk oral care in gastric tube feeding premature infants. Method： From January 2018 to December 2019， 60 gastric tube feeding premature infants treated in our hospital were selected as the study object. They were divided into group A （n=30） and group B （n=30） by digital blind selection. Group A was given normal saline oral care， and group B was given breast milk oral care. The oral cleanliness， positive rate of pathogenic microorganism culture， incidence of feeding intolerance and gastric tube indwelling time and percentage increase of body quality at 37 weeks of corrected gestational age were compared between the two groups. Result： The oral cleanliness score of group B was higher than that of group A， and the difference was statistically significant （P<0.05）. The positive rate of pathogenic microorganism culture and the incidence of feeding intolerance of group B were lower than those of group A， and the difference was statistically significant （P<0.05）. The gastric tube indwelling time of group B was shorter than that of group A， and the difference was statistically significant （P<0.05）. The percentage increase of body quality at 37 weeks of corrected gestational age in group B was higher than that in group A， and the difference was statistically significant （P<0.05）. Conclusion： The application of breast milk oral care in gastric tube feeding premature infants can ensure the children's oral cleanliness， reduce the positive rate of pathogenic microorganism culture and feeding intolerance rate， shorten the indwelling time of gastric tube， and promote the children's growth and development， which is worthy of clinical promotion and application.

[Key words] Gastric tube feeding Premature infants Breast milk oral care Saline

First-authors address： Xiaogan Hospital Affiliated to Wuhan University of Science and Technology， Xiaogan 432000， China

早產兒即胎齡不足37周的新生兒，因其器官未發(fā)育成熟，存在吸吮、吞咽困難，不能夠經口腔喂養(yǎng)，多采用管飼喂養(yǎng)方式，其對臨床護理工作提出了相對比較高的要求[1]。早產兒免疫力低下，管飼喂養(yǎng)無自主進食誘導反射，導致患兒不能夠正常分泌唾液，無法對口腔形成保護，使口腔感染概率增加，稍有不慎，還會出現(xiàn)敗血癥，對早產兒的生命活動、生存質量產生嚴重影響，導致其無法處于良好的生長發(fā)育狀態(tài)，預后較差[2]。對于新生兒來說，母乳作為天然食物，益生菌、營養(yǎng)物質含量豐富，能夠使新生兒的免疫功能、抵抗力增強。當前，母乳口腔護理逐漸被應用到胃管喂養(yǎng)早產兒中，臨床效果顯著。本研究選取病例探討胃管喂養(yǎng)早產兒中母乳口腔護理的臨床價值，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料

研究時間為2018年1月-2019年12月，研究對象為60例經胃管喂養(yǎng)早產兒。納入標準：（1）胎齡不足37周;（2）出生后1 d內接受治療，住院1周以上;（3）胃管飼養(yǎng)3 d以上;（4）早產兒母親身體健康，無重癥、傳染類疾病?！?br>