Chang Ying-Ju, Lin Chun-Ping, Lin Yuh-Jyh, Lin Chyi-Her
Department of Nursing, College of Medicine, National Cheng Kung University & Nursing Department, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
J Nurs Res. 2007 Sep;15(3):215-23. doi: 10.1097/01.jnr.0000387617.72435.c6.
The purpose of this study was to compare the amount of total milk intake, feeding time, sucking efficiency, heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2) of premature infants when fed with either signal-hole or cross-cut nipple units. Twenty stable infants admitted to a level II nursery in a tertiary care center with gestational ages averaging 32.2+/-3.2 wks were enrolled. Subjects had an average postmenstrual age of 34.1+/-1.6 wks, and average body weight of 1996+/-112 gm. A crossover design was used and infants were observed for two consecutive meals separated by a four-hour interval. They were bottle fed with equal feeding amounts using a single-hole and cross-cut nipple administered in random order. Results showed that infants fed with single-hole nipple units took more milk (57.5+/-8.3 ml vs. 51.6+/-9.5 ml, p=.011), had a shorter feeding time per meal (11.5+/-4.9 min vs. 20.9+/-5.0 min, p<.001), and sucked more efficiently (5.8+/-2.5 ml/min vs. 2.7+/-1.0 ml/min, p<.001) compared to those fed through cross-cut nipples. Infants using cross-cut nipple units had a higher RR (44.4+/-4.6 breaths/minutes vs. 40.8+/-4.9 breaths/minutes, p=.002) and SpO2 (96.1+/-1.4% vs. 94.6+/-3.2%, p=.044) than those using single-hole nipples. Oxygen desaturation (SpO2<90% and lasting for longer than 20 sec) and bradycardia were not recorded in either group of infants during feeding. Compared to using cross-cut nipple units, premature infants using single-hole nipple units take more milk and tend to tolerate feedings better. A single-hole nipple may be a choice for physiologically stable bottle-fed premature infants.
本研究的目的是比较使用单孔乳头或十字切口乳头喂养早产儿时的总奶量摄入量、喂养时间、吸吮效率、心率（HR）、呼吸频率（RR）和血氧饱和度（SpO2）。纳入了20名入住三级护理中心二级保育室的稳定婴儿，其平均胎龄为32.2±3.2周。受试者的平均月经后年龄为34.1±1.6周，平均体重为1996±112克。采用交叉设计，观察婴儿连续两餐，间隔4小时。使用单孔乳头和十字切口乳头以随机顺序给婴儿奶瓶喂养等量的奶。结果显示，与使用十字切口乳头喂养的婴儿相比，使用单孔乳头的婴儿摄入的奶量更多（57.5±8.3毫升对51.6±9.5毫升，p = 0.011），每餐喂养时间更短（11.5±4.9分钟对20.9±5.0分钟，p < 0.001），吸吮效率更高（5.8±2.5毫升/分钟对2.7±1.0毫升/分钟，p < 0.001）。使用十字切口乳头的婴儿的RR（44.4±4.6次/分钟对40.8±4.9次/分钟，p = 0.002）和SpO2（96.1±1.4%对94.6±3.2%，p = 0.044）高于使用单孔乳头的婴儿。两组婴儿在喂养过程中均未记录到血氧饱和度下降（SpO2 < 90%且持续超过20秒）和心动过缓。与使用十字切口乳头相比，使用单孔乳头的早产儿摄入的奶量更多，且似乎对喂养的耐受性更好。对于生理状况稳定的奶瓶喂养早产儿，单孔乳头可能是一种选择。
