NICU出院早产儿睡眠情况的调查及护理启示

doi:10.3761/j.issn.0254-1769.2023.22.002

摘要/Abstract

摘要：

目的调查NICU出院早产儿在矫正1月龄时的睡眠情况，分析相关影响因素。方法采用方便抽样法，选取2021年5月—2022年3月湖北省3所三级甲等综合医院NICU收治的早产儿作为调查对象，在其出院后采用简明婴儿睡眠问卷调查其矫正1月龄时的睡眠情况，包括睡眠潜伏时间、夜醒次数、夜间睡眠时间、白天睡眠时间、24 h总睡眠时间等，采用多元线性回归分析相关影响因素。结果招募130例早产儿，研究过程中脱落6例，最终纳入124例。多元线性回归分析结果显示，睡眠潜伏时间的影响因素包括喂养方式和入睡方式；夜醒次数的影响因素包括出生胎龄、机械通气时间、母亲的文化水平以及入睡方式；夜间睡眠时间的影响因素为机械通气时间和喂养方式；白天睡眠时间以及24 h总睡眠时间的影响因素为喂养方式和母亲的文化水平。结论 NICU出院早产儿矫正1月龄时的睡眠受出生胎龄、机械通气时间、喂养方式、母亲的文化水平及入睡方式的影响，护理人员应关注其睡眠情况，并基于上述影响因素制订针对性的干预方案，以改善早产儿的睡眠。

关键词: 早产儿, 睡眠, 重症监护病房, 新生儿, 影响因素分析, 新生儿护理

Abstract:

Objective To investigate the status and influencing factors of sleep in preterm infants at 1 month corrected age. Methods 130 preterm infants admitted to the NICU of 3 tertiary hospitals in Hubei Province were recruited as participants during May 2021 and March 2022. Sleep assessment of preterm infants was conducted at 1 month corrected age. Infants’ sleep was assessed using the Brief Infant Sleep Questionnaire（BISQ）. Multivariate linear regression model was used to analyze the influencing factors of sleep status（sleep latency，night awakenings，nocturnal sleep duration，daytime sleep duration，24 h sleep duration） of preterm infants. Results A total of 124 preterm infants completed the follow-up at 1 month corrected age. Multiple linear regression analysis showed that feeding patterns and sleep initiation patterns affected the sleep latency；gestational age，mechanical ventilation duration，maternal education level，and sleep initiation patterns were influencing factors of night awakenings；nocturnal sleep duration was influenced by mechanical ventilation duration and feeding patterns；daytime sleep duration and 24 h sleep duration were influenced by feeding patterns and maternal educational level. Conclusion The preterm infant sleep is influenced by gestational age，duration of mechanical ventilation，feeding patterns，maternal education level，and sleep initiation patterns. Neonatology staff should focus on the preterm infants discharged from NICU and develop targeted intervention plans based on the determined influencing factors to improve the sleep status of preterm infants.

Key words: Preterm Infants, Sleep, Intensive Care Units, Neonate, Root Cause Analysis, Neonatal Nursing

张丹, 张军, 闫敬敏, 朱璐阳, 杨钰荣, 杨心怡. NICU出院早产儿睡眠情况的调查及护理启示[J]. 中华护理杂志, 2023, 58(22): 2702-2709.

ZHANG Dan, ZHANG Jun, YAN Jingmin, ZHU Luyang, YANG Yurong, YANG Xinyi. Investigation of sleep status of preterm infants discharged from NICU[J]. Chinese Journal of Nursing, 2023, 58(22): 2702-2709.

图/表 4

表1 早产儿矫正1月龄睡眠情况的单因素分析结果（n=124）

Table 1 Univariate analysis of factors influencing sleep status of preterm infants at 1 month of corrected age（n=124）

表2 早产儿矫正1月龄睡眠情况的一元线性回归分析结果（n=124）

Table 2 Univariate linear regression analysis of factors influencing sleep status of preterm infants at 1 month of corrected age（n=124）

表3 自变量赋值方式

Table 3 Independent variable assignment

表4 早产儿矫正1月龄时睡眠情况影响因素的多元线性回归分析结果（n=124）

Table 4 Multiple linear regression analysis of factors influencing sleep status of preterm infants at 1 month of corrected age（n=124）

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