Effect of oral application of colostrum and formula milk combined with three-step prone position on very low birth weight premature infants
初乳与配方奶口腔涂抹联合三阶梯俯卧位对极低出生体重早产儿的影响

摘要

目的 探讨初乳与配方奶口腔涂抹联合三阶梯俯卧位对极低出生体重早产儿的影响。方法 选取2020 年 1 月 - 2022 年 1 月，将入住我院新生儿重症监护室的早产极低出生体重儿设定为研究对象。按照随机分组的原则分为配方奶口腔涂抹联合三阶梯俯卧位组和初乳口腔涂抹组，每组各 35例。比较两组早产儿开始经口喂养、达全胃肠喂养、完全经口喂养日龄、喂养不耐受发生率、经口喂养当天SPO2、发生呼吸暂停、使用呼吸机辅助通气及氧疗时间、咖啡因使用、达完全胃肠喂养及出院体重、住院时间等指标有无统计学意义。结果 配方奶口腔涂抹联合三阶梯俯卧位组在开始经口喂养、全经口喂养、常压氧疗时间、总住院时间短于初乳口腔涂抹组，差异有统计学差异（均P＜0.05）而初乳组出院时平均体重大于早产儿配方奶口腔涂抹联合三阶梯俯卧位组，差异有统计学意义（P＜0.05），但在达全胃肠喂养日龄、喂养不耐受发生率、经口喂养当天SPO2、发生呼吸暂停、使用呼吸机辅助通气、咖啡因使用、达完全胃肠喂养体重差异无统计学意义（P＞0.05）。结论 配方奶口腔涂抹联合三阶梯俯卧位干预在促进极低出生体重早产儿更快开始经口喂养，缩短全口喂养时间、促进生产发育减少住院时间方面效果比初乳组更理想，而初乳组出院时平均体重比配方奶组更理想。并且配方奶组口腔涂抹操作简单、方便、安全且不增加喂养不耐受及呼吸暂停等并发症的发生。

Abstract

Objective To explore the effect of oral application of colostrum and formula milk combined with three-step prone position on very low birth weight premature infants.
Methods Premature very low birth weight infants admitted to the neonatal intensive care unit of our hospital from January 2020 to January 2022 were selected as the research subjects. According to the principle of random grouping, they were divided into a formula milk oral application combined with a three-step prone position group and a colostrum oral application group, with 35 cases in each group. The two groups were compared for whether there was any statistical significance in the initiation of oral feeding, reaching full enteral feeding, age of full oral feeding, incidence of feeding intolerance, SPO2 on the day of oral feeding, occurrence of apnea, time of ventilator-assisted ventilation and oxygen therapy, caffeine use, weight of reaching full enteral feeding and discharge, and length of hospital stay.
Results The formula milk oral smearing combined with three-step prone position group had shorter initiation of oral feeding, full oral feeding, normobaric oxygen therapy time, and total length of hospital stay than the colostrum oral smearing group (all P＜0.05), while the average weight of the colostrum group at discharge was greater than that of the formula milk oral smearing combined with three-step prone position group (P＜0.05), but there was no statistical significance in the age of reaching full enteral feeding, incidence of feeding intolerance, SPO2 on the day of oral feeding, occurrence of apnea, use of ventilator-assisted ventilation, caffeine use, and weight of reaching full enteral feeding (P＞0.05).
Conclusion   Formula milk oral smear combined with three-step prone position intervention is more effective than the colostrum group in promoting very low birth weight premature infants to start oral feeding faster, shortening the time of full oral feeding, promoting production and development, and reducing hospitalization time. The average weight of the colostrum group at discharge is more ideal than that of the formula milk group. In addition, the oral smear operation of the formula milk group is simple, convenient, and safe, and does not increase the incidence of complications such as feeding intolerance and apnea.