缪芳媛

【摘要】 目的：研究母乳口腔護理在胃管喂养早产儿中的临床应用效果。方法：选取2018年1月-2019年12月到笔者所在医院治疗的60例经胃管喂养早产儿作为研究对象，采用数字盲选法将其分为A组（n=30）和B组（n=30）。A组采用生理盐水口腔护理，B组采用母乳口腔护理。比较两组口腔清洁度、致病微生物培养阳性率、喂养不耐受发生率、胃管留置时间、矫正胎龄37周体质量增长百分比。结果：B组口腔清洁度评分高于A组，差异有统计学意义（P<0.05）。B组致病微生物培养阳性率、喂养不耐受发生率均低于A组，差异有统计学意义（P<0.05）。B组胃管留置时间短于A组，差异有统计学意义（P<0.05）。B组矫正胎龄37周体质量增长百分比高于A组，差异有统计学意义（P<0.05）。结论：在胃管喂养早产儿中应用母乳口腔护理方式，能够保证患儿口腔清洁，降低致病微生物培养阳性率、喂养不耐受率，缩短胃管留置时间，促进患儿成长发育，值得临床推广应用。

【关键词】 胃管喂养 早产儿 母乳口腔护理 生理盐水

doi：10.14033/j.cnki.cfmr.2020.16.041 文献标识码 B 文章编号 1674-6805（2020）16-0-03

Analysis of the Clinical Application of Breast Milk Oral Care in Gastric Tube Feeding Premature Infants/MIAO Fangyuan. //Chinese and Foreign Medical Research， 2020， 18（16）： -105

[Abstract] Objective： To study the clinical effect of breast milk oral care in gastric tube feeding premature infants. Method： From January 2018 to December 2019， 60 gastric tube feeding premature infants treated in our hospital were selected as the study object. They were divided into group A （n=30） and group B （n=30） by digital blind selection. Group A was given normal saline oral care， and group B was given breast milk oral care. The oral cleanliness， positive rate of pathogenic microorganism culture， incidence of feeding intolerance and gastric tube indwelling time and percentage increase of body quality at 37 weeks of corrected gestational age were compared between the two groups. Result： The oral cleanliness score of group B was higher than that of group A， and the difference was statistically significant （P<0.05）. The positive rate of pathogenic microorganism culture and the incidence of feeding intolerance of group B were lower than those of group A， and the difference was statistically significant （P<0.05）. The gastric tube indwelling time of group B was shorter than that of group A， and the difference was statistically significant （P<0.05）. The percentage increase of body quality at 37 weeks of corrected gestational age in group B was higher than that in group A， and the difference was statistically significant （P<0.05）. Conclusion： The application of breast milk oral care in gastric tube feeding premature infants can ensure the children's oral cleanliness， reduce the positive rate of pathogenic microorganism culture and feeding intolerance rate， shorten the indwelling time of gastric tube， and promote the children's growth and development， which is worthy of clinical promotion and application.

[Key words] Gastric tube feeding Premature infants Breast milk oral care Saline

First-authors address： Xiaogan Hospital Affiliated to Wuhan University of Science and Technology， Xiaogan 432000， China

早产儿即胎龄不足37周的新生儿，因其器官未发育成熟，存在吸吮、吞咽困难，不能够经口腔喂养，多采用管饲喂养方式，其对临床护理工作提出了相对比较高的要求[1]。早产儿免疫力低下，管饲喂养无自主进食诱导反射，导致患儿不能够正常分泌唾液，无法对口腔形成保护，使口腔感染概率增加，稍有不慎，还会出现败血症，对早产儿的生命活动、生存质量产生严重影响，导致其无法处于良好的生长发育状态，预后较差[2]。对于新生儿来说，母乳作为天然食物，益生菌、营养物质含量丰富，能够使新生儿的免疫功能、抵抗力增强。当前，母乳口腔护理逐渐被应用到胃管喂养早产儿中，临床效果显著。本研究选取病例探讨胃管喂养早产儿中母乳口腔护理的临床价值，现报道如下。

1 资料与方法

1.1 一般资料

研究时间为2018年1月-2019年12月，研究对象为60例经胃管喂养早产儿。纳入标准：（1）胎龄不足37周;（2）出生后1 d内接受治疗，住院1周以上;（3）胃管饲养3 d以上;（4）早产儿母亲身体健康，无重症、传染类疾病。……