吊床体位促进早产儿生长发育效果的研究

doi:10.3761/j.issn.0254-1769.2022.03.008

摘要/Abstract

摘要：

目的探讨吊床体位对促进早产儿体重、身长、头围等生长发育指标的效果。方法采用便利抽样法,选取2020年1月—8月杭州市某三级甲等儿童医院收治的106例早产儿为研究对象,采用随机数字表法分为试验组（n=53）与对照组（n=53）。试验组在常规暖箱照护的基础上进行吊床体位干预,对照组采用常规暖箱照护。对两组干预后的生长发育情况进行比较。结果试验组第2~4周的体重增长、出院体重均高于对照组,第7天睡眠时长长于对照组,恢复至出生体重所需天数、住院时间均短于对照组,差异具有统计学意义（P<0.05）;试验组干预后,心率、呼吸频率下降,血氧饱和度升高,差异具有统计学意义（P<0.05）。结论吊床体位可促进早产儿的体重增长、缩短恢复至出生体重所需天数、增加睡眠时长、稳定生命体征及缩短住院时间,可有效促进早产儿生长发育。

关键词: 早产儿, 吊床体位, 发育支持照顾, 儿科护理学

Abstract:

Objective To investigate the effects of hammock positioning on the growth and development indexes of premature infants,such as weight,body length and head circumference. Methods From January to August 2020,106 premature infants admitted to a tertiary children’s hospital in Hangzhou were selected as the research subjects. They were divided into an experimental group（n=53） and a control group（n=53） by random number table method. The control group was treated with conventional heating box. The experimental group was treated with hammock positioning in addition to conventional warm box care. The growth and development of infants in the 2 groups were compared. Results The weight gain of premature infants in the experimental group at the 2nd to 4th weeks,the 24 - hour sleep duration and the discharge weight were higher than those of the control group;the number of days required to restore birth weight and the length of hospital stay are lower than those of the control group,and the difference was statistically significant（P<0.05）. After using hammock therapy,the heart rate and respiratory rate of the experimental group decreased,and the oxygen saturation increased,and the difference was statistically significant（P<0.05）. Conclusion Hammock positioning plays a positive role in promoting the average weight gain per week,reducing the number of days to regain birth weight,increasing the duration of 24 hours sleep,stabilizing vital signs of premature infants and reducing the length of hospital stay,which can effectively promote the growth and development of premature infants.

Key words: Preterm Infant, Hammock Positioning, Developmental Support Care, Pediatric Nursing

慎斐, 罗飞翔, 商祯茹, 凌云. 吊床体位促进早产儿生长发育效果的研究[J]. 中华护理杂志, 2022, 57(3): 301-305.

SHEN Fei, LUO Feixiang, SHANG Zhenru, LING Yun. Study on the effect of hammock positioning in promoting the growth and development of premature infants[J]. Chinese Journal of Nursing, 2022, 57(3): 301-305.

图/表 5

图1 简易吊床示意图

Figure 1 Schematic diagram of a simple hammock

表1 两组出生后身长、头围变化比较（cm,

\bar{x} \pm s

）

Table 1 Comparison of postnatal body length and head circumference changes between the two groups(cm,

\bar{x} \pm s

)

表1 两组出生后身长、头围变化比较（cm, $\bar{x} \pm s$ ）

Table 1 Comparison of postnatal body length and head circumference changes between the two groups(cm, $\bar{x} \pm s$ )

表2 两组出生后体重变化比较（g,

\bar{x} \pm s

）

Table 2 Comparison of postnatal weight changes between the two groups（g,

\bar{x} \pm s

）

表2 两组出生后体重变化比较（g, $\bar{x} \pm s$ ）

Table 2 Comparison of postnatal weight changes between the two groups（g, $\bar{x} \pm s$ ）

表3 两组恢复至出生体重所需天数、住院时间、出院时校正胎龄及出院体重比较（

\bar{x} \pm s

）

Table 3 Comparison of restored birth weight time, hospitalization time, and adjusted gestational age at discharge and discharge weight between the two group（

\bar{x} \pm s

）

表3 两组恢复至出生体重所需天数、住院时间、出院时校正胎龄及出院体重比较（ $\bar{x} \pm s$ ）

Table 3 Comparison of restored birth weight time, hospitalization time, and adjusted gestational age at discharge and discharge weight between the two group（ $\bar{x} \pm s$ ）

表4 试验组干预前后心率、呼吸频率及血氧饱和度的比较（n=44,

\bar{x} \pm s

）

Table 4 The observation group compared the heart rate, respiratory rate and peripheral blood oxygen saturation before and after using the hammock position（n=44,

\bar{x} \pm s

）

表4 试验组干预前后心率、呼吸频率及血氧饱和度的比较（n=44, $\bar{x} \pm s$ ）

Table 4 The observation group compared the heart rate, respiratory rate and peripheral blood oxygen saturation before and after using the hammock position（n=44, $\bar{x} \pm s$ ）

参考文献 22

[1]	Cooke RJ, Ainsworth SB, Fenton AC. Postnatal growth retardation:a universal problem in preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2004,89(5):F428-F430. DOI URL
[2]	Jesus VR, Oliveira PMN, Azevedo VMGO. Effects of hammock positioning in behavioral status,vital signs,and pain in preterms:a case series study[J]. Braz J Phys Ther, 2018,22(4):304-309. DOI URL
[3]	Ribas CG, Andreazza MG, Neves VC, et al. Effectiveness of ham-mock positioning in reducing pain and improving sleep-wakefulness state in preterm infants[J]. Respir Care, 2019,64(4):384-389. DOI URL
[4]	Bezerra IFD, Torres VB, Lopes JM, et al. Assessment of the influence of the hammock on neuromotor development in nurs-ing full-term infants[J]. Rev Bras Crescimento Desenvolv Hum, 2014,24(1):106-111.
[5]	李琴, 李惠玲, 阐玉英. 光暗循环在早产儿环境照护中的应用进展[J]. 2016,22(17):2503-2507.
	Li Q, Li HL, Chan YY. Application progress of light-dark cycle on care environment for premature infants:a review[J]. Chin J Mod Nurs, 2016,22(17):2503-2507.
[6]	廖金花, 钱小芳, 林颖, 等. 早产儿重症监护环境噪声水平的调查分析[J]. 护理学杂志, 2018,33(8):21-23.
	Liao JH, Qian XF, Lin Y, et al. Noise level in preterm neonatal intensive care unit[J]. J Nurs Sci, 2018,33(8):21-23.
[7]	中华医学会肠外肠内营养学分会儿科协作组, 中华医学会儿科学分会新生儿学组, 中华医学会小儿外科学分会新生儿学组. 中国新生儿营养支持临床应用指南[J]. 中国当代儿科杂志, 2006,8(5):352-356.
	The Group of Pediatrics,Parenteral and Enteral Nutrition Society, Chinese Medical Association,the Group of Neonatology,Pediatric Society,Chinese Medical Association, the Group of Neonatology,Pediatric Surgical Society,Chinese Medical Association. Chinese guideline for newborn nutrition support in neonates[J]. Chin J Contemp Pediatr, 2006,8(5):352-356.
[8]	中国医师协会新生儿科医师分会营养专业委员会, 中国医师协会儿童健康专业委员会母乳库学组, 《中华儿科杂志》编辑委员会. 新生儿重症监护病房推行早产儿母乳喂养的建议[J]. 中华儿科杂志, 2016,54(1):13-16.
	Nutrition Committee of Neonatal Pediatrician Branch, Chinese Medical Doctor Association Breast-milk Bank Group of Child Health Committee, Chinese Medical Doctor Association Editorial Committee of Chinese Journal of Pediatrics. Recommendations for breastfeeding premature infants in neonatal intensive care units[J]. Chin J Pediatr, 2016,54(1):13-16.
[9]	李颖馨, 胡艳玲, 李凡, 等. 四种不同体位对早产儿胃排空影响的网状Meta分析[J]. 护士进修杂志, 2021,36(16):1453-1459.
	Li YX, Hu YL, Li F, et al. Effect of four different positions on gastric emptying in preterm infants:a network Meta-analysis[J]. J Nurses Train, 2021,36(16):1453-1459.
[10]	任尉华, 吴亚楠. 鸟巢护理对低体质量早产儿生长发育系统影响的研究进展[J]. 中国医药指南, 2017,15(27):11-12.
	Ren WH, Wu YN. Research progress of the effect of bird nest type nursing on growth and development system of low birth weight premature infants[J]. Guid China Med, 2017,15(27):11-12.
[11]	Başdaş Ö, Erdem E, Elmalı F, et al. The Brazelton Neonatal Behavioral Assessment Scale:a validity and reliability study in a Turkish sample[J]. Turkish J Med Sci, 2018,48(2):399-404.
[12]	van der Heijden MJ, Oliai Araghi S, Jeekel J, et al. Do hospitalized premature infants benefit from music interventions? A systematic review of randomized controlled trials[J]. PLoS One, 2016,11(9):e0161848. DOI URL
[13]	项崇悟, 高丽娟, 施维, 等. 早产儿生长发育中“鸟巢式”体位的护理应用及效果[J]. 中国现代医生, 2016,54(15):160-163, 168.
	Xiang CW, Gao LJ, Shi W, et al. Application and effects of “bird nest type” nursing in the growth and development of premature infants[J]. China Mod Dr, 2016,54(15):160-163, 168.
[14]	范歆颀, 叶天惠. 鸟巢式多功能新生儿护理用具的设计及应用[J]. 中华护理杂志, 2020,55(9):1436-1438.
	Fan XQ, Ye TH. The design and application of the multi-functional bird nest type care tool[J]. Chin J Nurs, 2020,55(9):1436-1438.
[15]	平凌, 王珠琳, 陈菊红. 鸟巢式沐浴垫的设计及应用[J]. 中华护理杂志, 2021,56(3):478-480.
	Ping L, Wang ZL, Chen JH. Design and application of bird-nest-shaped shower mat[J]. Chin J Nurs, 2021,56(3):478-480.
[16]	肖冬素, 曾水英, 郭晶. 初乳口腔免疫疗法联合水床式鸟巢护理在极低出生体重儿中的应用[J]. 中国现代医生, 2021,59(11):167-169,175.
	Xiao DS, Zeng SY, Guo J. Application of colostrum oral immunotherapy combined with waterbed bird nest nursing in very low birth weight infants[J]. Chin Mod Dr, 2021,59(11):167-169,175.
[17]	邓红珊. “鸟巢式”护理模式在早产儿康复过程中的应用价值[J]. 中国医药指南, 2021,19(13):11-13.
	Deng HS. Application value of “bird nest nursing” mode in the rehabilitation of premature infants[J]. Guid Chin Med, 2021,19(13):11-13.
[18]	Costa KS, Beleza LO, Souza LM, et al. Hammock position and nesting:comparison of physiological and behavioral effects in preterm infants[J]. Rev Gaucha Enferm, 2017,37(spe):e62554. DOI URL
[19]	丘碧华. 袋鼠式护理对促进新生儿神经行为、体格发育的临床影响[J]. 实用临床护理学电子杂志, 2018,3(22):133.
	Qiu BH. Clinical effects of kangaroo nursing on neonatal neu-robehavioral and physical development[J]. J Clin Nursing’s Pract, 2018,3(22):133.
[20]	Keller A, Arbel N, Merlob P, et al. Neurobehavioral and autonomic effects of hammock positioning in infants with very low birth weight[J]. Pediatr Phys Ther, 2003,15(1):3-7. PMID
[21]	严恺, 季福婷, 袁皓, 等. 音乐干预增加早产儿安静睡眠时间的随机对照试验[J]. 中国循证儿科杂志, 2020,15(4):269-273.
	Yan K, Ji FT, Yuan H, et al. Musical intervention increases quiet sleep time of preterm infants:a randomized controlled trial[J]. Chin J Evid - Based Pediatr, 2020,15(4):269-273.
[22]	Liu C, Meng Z, Wiggin TD, et al. A serotonin-modulated circuit controls sleep architecture to regulate cognitive function independent of total sleep in drosophila[J]. Curr Biol, 2019,29(21):3635-3646. DOI URL

编辑推荐 0

Metrics

阅读次数

全文

HTML			PDF

最新录用	在线预览	正式出版	最新录用	在线预览	正式出版
0	0	3	0	0	17

来源	本网站	其他网站

次数	20	0
比例	100%	0%

摘要

635

最新录用	在线预览	正式出版

0	0	635

	来源	本网站

	次数	635
	比例	100%