目的 探讨口腔运动干预联合音乐疗法在早产儿喂养障碍中的应用效果,为制定喂养障碍早产儿规范化诊疗方案提供参考依据。 方法 采用前瞻性研究方法,选取2022年8月—2023年8月于青岛市市立医院新生儿重症监护室(NICU)进行住院治疗的68例喂养障碍早产儿为研究对象,根据是否采用口腔运动联合音乐疗法进行随机分组,按随机数字法分为对照组与观察组各34例。对照组由护理团队进行抚触,观察组在此基础上实施口腔运动联合音乐疗法,两组均治疗两周。比较两组患儿体重增长情况、留置胃管时间、总住院时间、并发症发生率、营养学指标、开始经口喂养和干预后新生儿口腔运动评定量表(NOMAS)评分。结果 干预后观察组患儿日均体重增长显著高于对照组(t=3.180)、留置胃管时间(t=3.549)和总住院时间(t=3.238)均较对照组缩短、喂养并发症(χ2=4.802)发生率降低, 差异均有统计学意义(P＜0.05);干预后,观察组白蛋白(t=3.388)、球蛋白(t=3.128)、前白蛋白(t=3.105)水平均高于对照组,差异有统计学意义(P＜0.05)。干预后两组NOMAS 评分比较,观察组正常吸吮NOMAS评分显著高于干预前及对照组干预后(t=5.274、3.338,P＜0.05),吸吮紊乱和吸吮障碍NOMAS评分显著低于干预前及对照组干预后(t=5.559、7.102、3.462、3.217,P＜0.05)。 结论 口腔运动干预联合音乐疗法可显著缩短患儿留置胃管及总住院时间,降低喂养并发症发生率,改善患儿营养学指标,治疗早产儿喂养障碍方面的临床疗效显著,具有较好的临床推广价值。
Abstract
Objective To investigate the efficacy of oral motor intervention combined with music therapy in preterm infants with feeding difficulties, in order to provide evidence for establishing standardized clinical protocols. Methods A prospective study was conducted involving 68 preterm infants with feeding disorders admitted to the Neonatal Intensive Care Unit (NICU) of Qingdao Municipal Hospital between August 2022 and August 2023. Participants were randomly assigned using a random number table to either the control group (n=34) or the intervention group (n=34). The control group received standard touch by the nursing team, while the intervention group received additional oral motor intervention combined with music therapy. Both groups underwent a two-week treatment period. Outcome measures included daily weight gain, duration of gastric tube retention, total hospitalization length, incidence of complications, nutritional indicators, initiation of oral feeding, and Neonatal Oral Motor Assessment Scale (NOMAS) scores before and after intervention. Results Post-intervention, the intervention group exhibited significantly greater daily weight gain (t=3.180), shorter gastric tube retention time (t=3.549), reduced hospitalization duration (t=3.238), and lower incidence of feeding complications (χ2=4.802) compared to the control group (P<0.05). Nutritional markers, including albumin (t=3.388), globulin (t=3.128), and prealbumin (t=3.105) levels, were also significantly higher in the intervention group (P<0.05). NOMAS assessment revealed that the intervention group demonstrated significantly higher scores for normal sucking (t=5.274, 3.338, P<0.05) and lower scores for sucking disorganization and dysfunction (t=5.559, 7.102, 3.462, 3.217, P<0.05) compared to both baseline and the control group. Conclusion The combination of oral motor intervention and music therapy significantly reduces gastric tube dependence and hospitalization duration, decreases feeding-related complications, improves nutritional status, and demonstrates notable clinical efficacy in managing feeding difficulties in preterm infants, suggesting strong potential for widespread clinical application.
关键词
口腔运动干预 /
音乐疗法 /
喂养障碍 /
早产儿
Key words
oral exercise intervention /
music therapy /
feeding disorders /
premature infants
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基金
山东省医药卫生科技面上项目(202306031042)
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