不同护理体位对鼻饲喂养早产儿的影响

目的 探讨不同体位护理对于鼻饲喂养早产儿临床效果及安全性的影响。方法 选择2015年3月至2017年9月我院新生儿科收治的早产儿66例为研究对象, 随机将其分成A、B、C、D 4组。A组(16例)采用15°仰卧位,B组(17例)采用30°仰卧位,C组(15例)采用15°俯卧位,D组(18例)采用30°俯卧位。比较4组心率(HR)、呼吸频率(RR)、经皮血氧饱和度(TcPO₂)、血压(Bp)等指标的变化,并观察早产儿胃内潴留及呼吸暂停、周期性呼吸的发生情况。结果 4组的HR、RR、TcPO₂及平均动脉压均维持在正常范围以内,C、D组HR、RR、平均动脉压较A、B组降低,而TcPO₂较A、B组升高,B、D组各指标分别优于A、C组;C、D组胃潴留量较A、B组显著减少;仅A组发生2例呼吸暂停,4组护理发生周期性呼吸的差异无统计学意义(χ²=2.269,P=0.519)。结论 仰卧、俯卧位护理对于鼻饲喂养早产儿的生命体征影响均较小,而取俯卧位、头部抬高体位进行护理,更有利于早产儿呼吸及胃部排空,减少并发症发生。

Effects of different nursing postures on the vital signs and gastric retention of preterm infants with nasal feeding

Objective To explore the effect of different nursing postures on preterm infants with nasal feeding. Methods Totally 66 premature infants admitted to the department of pediatrics of our hospital between March 2015 and September 2017 were randomly divided into 4 groups. Group A, B were given supine position at 15 degree and 30 degree respectively. Group C, D were given prone position at 15 degree and 30 degree, respectively. The changes of heart rate (HR), respiratory frequency (RR), percutaneous oxygen saturation (TcPO₂) , blood pressure (Bp) and the occurrence of intragastric retention, apnea, periodic respiration of 4 groups were compared. Results The HR, RR, TcPO₂ and mean arterial pressure of 4 groups were maintained within the normal range. The HR, RR and mean arterial pressure of group C, D were lower than those in the group A, B, while the TcPO₂ of the former was higher than the latter. Various vital signs were improved when raising the position of the head. The gastric retention in prone position was significantly lower than that in supine position. Only 2 cases of apnea occurred in group A. There was no significant difference in the periodic respiration among 4 groups(χ²=2.269, P=0.519). Conclusion Nursing at supine and prone position has little effect on vital signs of premature infants with nasal feeding, while taking prone position and raising heads up are more conducive to premature breathing and gastric emptying, and reducing complications.