Abstract:

Objective To explore the trajectory of oral sucking function of premature infants with gestational age and its relationship with oral feeding progression. Methods From April 2018 to April 2019，we conveniently selected premature infants from a tertiary children’s hospital in Shanghai，and used a self-developed oral sucking evaluation tool to measure the oral sucking function of premature infants when their corrected gestational age was 32~36 weeks. The measurement parameters included average sucking negative pressure peak，average sucking positive pressure peak，average sucking peak interval of negative pressure，average sucking peak interval of positive pressure，average sucking peak interval of positive pressure to negative pressure，number of sucking negative pressure，number of sucking positive pressure. At the same time，the time for premature infants to start and complete oral feeding was recorded，and the correlation between oral sucking function and corrected gestational age at 32 weeks was analyzed. Results A total of 132 premature infants completed the evaluation of oral sucking function and were finally included. The results showed that with the increase of gestational age，the amplitude and number of positive and negative sucking pressure of premature infants increased significantly（P<0.001），and the interval duration decreased significantly（P<0.001）. At the same time，the positive sucking pressure amplitude at the time of correcting the gestational age of 32w was negatively correlated with the gestational age of starting oral feeding（r=-0.217，P=0.040），and the negative sucking pressure duration at the time of correcting the gestational age of 32w was positively correlated with the gestational age of complete oral feeding（r=0.334，P=0.002）. Conclusion The positive sucking pressure and negative sucking pressure of premature infants showed the same trend with the increase of gestational age. The average sucking peak of negative pressure at 32 weeks of gestational age was negatively correlated with the time to start oral feeding，and the average sucking negative pressure peak interval was positively correlated with full oral feeding. Caregivers should pay attention to the peak of positive sucking pressure at the beginning of oral feeding readiness assessment and its effect on sucking frequency when performing oral motor interventions to promote full oral feeding.

Key words: Preterm Infants, Oral Sucking Function, Trajectory, Oral Feeding, Neonatal Nursing

摘要：

目的 分析NICU早产儿的口腔吸吮功能随其纠正胎龄增长而变化的趋势，以及口腔吸吮功能与其经口喂养进程间的关系。 方法 2018年4月—2019年4月，便利选取上海市某三级甲等儿童专科医院NICU收治的早产儿作为调查对象，分别在其纠正胎龄为32~36周时，采用自行研发的早产儿口腔吸吮功能测量器评估其口腔吸吮功能，评价指标包括平均吸吮负压峰值、平均吸吮正压峰值、平均吸吮负压波峰间隔时间、平均吸吮正压波峰间隔时间、平均吸吮正压-负压波峰间隔时间、吸吮负压个数、吸吮正压个数。同时分析早产儿纠正胎龄32周时口腔吸吮功能与其开始经口喂养、达到完全经口喂养时纠正胎龄的相关性。 结果 最终纳入132例早产儿。分析结果显示，随着纠正胎龄增长，早产儿的平均吸吮负压峰值、平均吸吮正压峰值逐渐升高（P<0.001），吸吮负压和吸吮正压个数逐渐增多（P<0.001），平均吸吮负压波峰间隔时间、平均吸吮正压波峰间隔时间以及平均吸吮正压-负压波峰间隔时间逐渐缩短（P<0.001）。早产儿纠正胎龄32周时的平均吸吮正压峰值与其开始经口喂养时的纠正胎龄呈负相关（r=-0.217，P=0.040），纠正胎龄32周时的平均吸吮负压波峰间隔时间与其达到完全经口喂养时的纠正胎龄呈正相关（r=0.334，P=0.002）。 结论 NICU早产儿口腔吸吮正压和吸吮负压随其纠正胎龄增长而变化的趋势相同。纠正胎龄32周时，早产儿的平均吸吮正压峰值与其开始经口喂养时的纠正胎龄呈负相关，平均吸吮负压波峰间隔时间与其达到完全经口喂养时的纠正胎龄呈正相关。在开始经口喂养准备评估时，护理人员应关注早产儿吸吮正压的峰值，在进行口腔运动干预促进完全经口喂养时，应关注其吸吮频率。

关键词: 早产儿, 口腔吸吮功能, 变化趋势, 经口喂养, 新生儿护理