Boiron M, Da Nobrega L, Roux S, Henrot A, Saliba E
Laboratoire de Physiologie et Motricité Digestive, Faculté de Médecine, Tours, France.
Dev Med Child Neurol. 2007 Jun;49(6):439-44. doi: 10.1111/j.1469-8749.2007.00439.x.
This study compared the effects of oral stimulation with those of oral support on non-nutritive sucking and feeding parameters in preterm infants. Preterm infants (23 males, 20 females) born between 29 and less than 34 weeks' gestational age (GA; mean GA 31.2wks [standard error of mean{SEM} 0.39]; mean birth-weight 1580g [SEM 120]) were allocated to one of three experimental groups: (Stimulation+support [five males, four females]; Stimulation [four males, seven females]; and Support [seven males, five females]) or a control group. Non-nutritive sucking pressure and sucking activity were quantified in the gavage and transition periods. Oral support minimizes fluid loss, stabilizes the jaw, and organizes deglutition. The time of transition, the quantity of milk ingested per day, and the number of bottle feeds per day were recorded. Variables were analyzed by repeated-measures analysis of variance, with birth-weight as covariate (ANCOVA). Transition time was reduced (p<0.0001) for the Stimulation+support and Support groups. ANCOVA computed during gavage showed increased non-nutritive sucking pressure and sucking activity (p<0.001) for the Stimulation and Stimulation+support groups. ANCOVA computed during transition revealed increases in non-nutritive sucking pressure and daily bottle feeds (p<0.001) for the three experimental groups and in daily milk ingested (p=0.002) for the Stimulation+support and Support groups. We demonstrated that oral support is the result of both the action of chin and cheek support, and the aid to deglutition. An analysis of the organization of sucking patterns should be undertaken to provide better understanding of the mechanisms involved in oral support.
本研究比较了口腔刺激与口腔支撑对早产儿非营养性吸吮和喂养参数的影响。孕周在29至不足34周之间（平均孕周31.2周[平均标准误差{SEM}0.39]；平均出生体重1580克[SEM 120]）的早产儿（23名男性，20名女性）被分配到三个实验组之一：（刺激+支撑组[5名男性，4名女性]；刺激组[4名男性，7名女性]；支撑组[7名男性，5名女性]）或一个对照组。在管饲期和过渡期中对非营养性吸吮压力和吸吮活动进行量化。口腔支撑可减少液体流失、稳定下颌并协调吞咽。记录过渡时间、每日摄入的奶量以及每日奶瓶喂养次数。以出生体重作为协变量，通过重复测量方差分析（ANCOVA）对变量进行分析。刺激+支撑组和支撑组的过渡时间缩短（p<0.0001）。管饲期间计算的ANCOVA显示，刺激组和刺激+支撑组的非营养性吸吮压力和吸吮活动增加（p<0.001）。过渡期间计算的ANCOVA显示，三个实验组的非营养性吸吮压力和每日奶瓶喂养次数增加（p<0.001），刺激+支撑组和支撑组的每日摄入奶量增加（p=0.002）。我们证明口腔支撑是下巴和脸颊支撑作用以及吞咽辅助的结果。应进行吸吮模式组织分析，以更好地理解口腔支撑所涉及的机制。
