目的 分析水疗联合抚触对早产儿发育指标和黄疸指数的影响,为临床实践提供参考。方法 2015年6月-2017年8月前瞻性纳入168例早产儿作为研究对象,按照数字表法将所有研究对象分为干预组(n=84)和对照组(n=84),干预组采用水疗辅助抚触干预,对照组采用常规治疗干预,对比两组早产儿出生当天、3、7、30、60 d和90 d生长发育指标和黄疸指数的变化。结果 出生7~90 d,干预组体重、身长、头围和摄乳量增长大于对照组(P＜0.05),干预组早产儿神经心理发育评价量表评分高于对照组(P＜0.05),干预组纠正胎龄3个月后大运动、精细动作、语言、交往能力均高于对照组(P＜0.05);两组早产儿经皮胆红素值均与出生第2天至第4天出现上升趋势,对照组上升幅度大于干预组(P＜0.05),第4天之后两组均出现下降趋势,干预组下降幅度大于对照组(P＜0.05);干预组黄疸消退时间、首次胎粪时间、胎粪转黄时间、胎粪排净时间均低于对照组(P＜0.05),干预组高胆红素血症率低于对照组(P＜0.05)。结论 水疗辅助抚触有助于早产儿生长发育,加速黄疸消退过程。

Objective To explore the effect of touch therapy combined with hydrotherapy on the developmental index and jaundice index of preterm infants. Methods Totally 168 premature infants were prospectively enrolled as subjects, and were divided into intervention group (n=84) and control group (n=84) according to the number table method. The intervention group was treated with touch therapy combined with hydrotherapy, while the control group received routine intervention. The growth and development index and icteric index of two groups on the day of birth,the 3rd, 7th, 30th, 60th and 90th day after birth were compared. Results The body weight, body length, head circumference and milk consumption of the intervention group increased significantly more than those of the control group on the 7th, 30th, 60th and 90th day after birth(P＜0.05). The neuropsychological development assessment score of premature infants in the intervention group was significantly higher than that in the control group on the 7th, 30th, 60th and 90th day after birth(P＜0.05). The ability of gross motor, fine motor, language and communication in the intervention group were significantly higher than those in control group in 3 months(P＜0.05). Both groups showed an upward trend in the transcutaneous bilirubin levels from the second to the fourth day of birth, and the increase in control group was significantly greater than that in the study group(P＜0.05). However, there was a downward trend in the two groups after the fourth day of birth, and the decrease in the intervention group was larger than that in control group(P＜0.05). The remission time for jaundice, time for the first meconium, meconium turning yellow and meconium excretion in the intervention group were significantly lower than those in the control group(P＜0.05). The rate of hyperbilirubinemia in the intervention group was lower than that in control group(P＜0.05). Conclusion Touching combined with hydrotherapy can help the growth and development of preterm infants, as well as accelerate the process of jaundice regression.