Effects of Tactile/Motor Stimulation Massage on Feeding Outcomes and Neuromotor Development in Preterm Infants
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摘要:
目的 观察触觉/运动刺激按摩对早产儿喂养效果、神经及运动发育水平的影响。 方法 选取云南省第三人民医院新生儿科重症监护病房2024年1月至2024年7月住院早产儿136例，利用随机数字表法分为对照组和试验组各68例。对照组接受早产儿常规护理方法，在常规早产儿护理方法的基础上，试验组采用触觉/运动刺激按摩的方法进行干预。比较两组住院早产儿管饲喂养转为经口喂养时间（d）、完全经口喂养率（%）、喂养不耐受发生率（%），体重（g）、身长（cm）、头围（cm），新生儿行为神经测定评分（NBNA），运动发育指数（PDI）。 结果 试验组管饲喂养转为经口喂养时间（12.73±1.86）d明显短于对照组（13.66±1.68）d，差异具有统计学意义（P < 0.05），试验组完全经口喂养率（89.7%）明显大于对照组（70.6%），P < 0.05，试验组喂养不耐受发生率（8.8%）明显小于对照组（16.2%），P < 0.05；试验组体重、身长、头围优于对照组（P < 0.05）；试验组新生儿行为神经测定评分（36.16±1.53）分明显高于对照组（35.10±2.66）分（P < 0.05）；试验组运动发育指数（76.88±6.12）分明显高于对照组（74.34±5.07）分（P < 0.05）。 结论 触觉/运动刺激按摩可有效改善早产儿喂养情况，促进早产儿的神经及运动发育水平。 Abstract:Objective To observe the effects of tactile/motor stimulation massage on feeding outcomes and neuromotor development levels of preterm infants. Methods A total of 136 preterm hospitalized infants in the neonatal intensive care unit of a tertiary hospital in Yunnan Province from January 2024 to July 2024 were enrolled and randomly assigned to a control group and an experimental group, with 68 cases in each group. The control group received the routine care for preterm infants, while the experimental group received tactile/motor stimulation massage as an intervention in addition to the routine care. The time taken from gavage to oral feeding （d）, the rate of complete oral feeding （%）, the incidence of feeding intolerance （%）, the weight（g）, the length（cm）, the head circumference（cm）, neonatal behavioral neurometric score （NBNA） and Psychomotor development index （PDI） were compared between the two groups. Results The time from gavage to oral feeding in the experimental group （12.73±1.86） days was significantly shorter than that in the control group （13.66±1.68） days, and the difference was statistically significant （P < 0.05）; the rate of complete oral feeding in the experimental group （89.7%） was significantly higher than that in the control group （70.6%）, P < 0.05, and the incidence of feeding intolerance in the experimental group （8.8%） was significantly lower than that in the control group （16.2%）, P < 0.05; The experimental group showed superior results in weight, length, and head circumference compared to the control group （P < 0.05）; The neonatal behavioral neurometry score of the experimental group （36.16±1.53） was significantly higher than that of the control group （35.10±2.66） , P < 0.05, and the motor development index in the experimental group （76.88±6.12） was significantly higher than that in the control group （74.34±5.07）, P < 0.05. Conclusion Tactile/motor stimulation massage can effectively improve the feeding status and promote the neuromotor development of preterm infants. -
表 1 两组住院早产儿一般资料比较[n（%）/M（P25，P75）]
Table 1. Comparison of general data of two groups of hospitalized preterm infants [n（%）/M（P25，P75）]
项目 试验组（n = 68） 对照组（n = 68） χ2/Z P 性别[n（%）] 0.118 0.732 男 35（51.5） 31（45.6） 女 33（48.5） 37（54.4） 胎龄（周） 32（30，33） 32（29，33） 0.325 0.745 出生体重（g） 2429 （1991.25 ，2480 ）2257 （2109 ，2436.5 ）1.759 0.079 分娩方式[n（%）] 0.265 0.607 顺产 37（54.4） 28（41.2） 剖宫产 31（45.6） 40（58.8） 5 min Apgar评分（分） 9（8，9） 8（7.25，9） 0.961 0.337 
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表 2 两组住院早产儿管饲喂养转为经口喂养时间、完全经口喂养率、喂养不耐受发生率比较[（$\bar x \pm s $）/n（%）]
Table 2. Comparison of time taken from gavage to oral feeding，rate of complete oral feeding，and incidence of feeding intolerance between the two groups[（$ \bar x \pm s $）/n（%）]
组别 管饲喂养转为经口喂养时间（d） 完全经口喂养率 喂养不耐受发生率 试验组（n = 68） 12.73 ± 1.86 61（89.7） 6（8.8） 对照组（n = 68） 13.66 ± 1.68 48（70.6） 11（16.2） t/χ2 −3.057 49.111 76.50 P 0.003* < 0.001* < 0.001* *P < 0.05。
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表 3 两组住院早产儿体重、身长、头围比较（$\bar x \pm s $）
Table 3. The weight, length and head circumference of hospitalized preterm infants were compared between the two groups （$\bar x \pm s $）
组别 体重（g） 身长（cm） 头围（cm） 试验组（n=68） 2889.34 ±271.9650.29±1.68 34.32±0.83 对照组（n=68） 2721.13 ±363.2649.59±1.06 33.57±0.99 t 3.057 2.918 4.751 P 0.003* 0.004* <0.001* *P < 0.05。
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表 4 两组住院早产儿新生儿行为神经测定评分（$\bar x \pm s $）
Table 4. Comparison of neonatal behavioral neurometric scores and motor development index between the two groups （$\bar x \pm s $）
组别 总分（分） 行为能力（分） 被动肌张力（分） 主动肌张力（分） 原始反射（分） 一般评估（分） 试验组（n=68） 36.16±1.53 10.97±0.93 7.34±0.74 7.12±0.72 5.36±0.55 5.57±0.55 对照组（n=68） 35.10±2.66 9.99±1.57 6.41±1.14 6.40±0.81 4.78±0.67 5.15±0.79 t 2.844 4.443 5.578 5.461 5.322 3.622 P 0.005* <0.001* <0.001* <0.001* <0.001* <0.001* *P < 0.05。
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表 5 运动发育指数比较（$\bar x \pm s $）
Table 5. Comparison of motor development index （$\bar x \pm s $）
组别 运动发育指数（分） 试验组（n=68） 76.88±6.12 对照组（n =68） 74.34±5.07 t 2.638 P 0.009* *P < 0.05。
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