Pizzolorusso Gianfranco, Turi Patrizia, Barlafante Gina, Cerritelli Francesco, Renzetti Cinzia, Cozzolino Vincenzo, D'Orazio Marianna, Fusilli Paola, Carinci Fabrizio, D'Incecco Carmine
EBOM - European Institute for Evidence Based Osteopathic Medicine, viale Unità d'Italia 1, 66100 Chieti, Italy.
Chiropr Man Therap. 2011 Jun 28;19(1):15. doi: 10.1186/2045-709X-19-15.
Organizational improvement of neonatal intensive care units requires strict monitoring of preterm infants, including routine assessment of physiological functions of the gastrointestinal system and optimized procedures for the definition of appropriate discharge timing.
We conducted a prospective study on the effect of osteopathic manipulative treatment in a cohort of N = 350 consecutive premature infants admitted to a neonatal intensive care unit without any major complication between 2005 and 2008. In addition to ordinary care, N = 162 subjects received osteopathic treatment. Endpoints of the study were differences between study and control groups in terms of excessive length of stay and gastrointestinal symptoms, defined as the upper quartiles in the distribution of the overall population. Statistical analysis was based on crude and adjusted odds ratios from multivariate logistic regression.
Baseline characteristics were evenly distributed across treated/control groups, except for the rate of infants unable to be oral fed at admission, significantly higher among those undergoing osteopathic care (p = .03). Osteopathic treatment was significantly associated with a reduced risk of an average daily occurrence of gut symptoms per subject above .44 (OR = 0.45; 0.26-0.74). Gestational age lower or equal to 32 weeks, birth weight lower or equal to 1700 grams and no milk consumption at admission were associated with higher rates of length of stay in the unit of at least 28 days, while osteopathic treatment significantly reduced such risk (OR = 0.22;0.09-0.51).
In a population of premature infants, osteopathic manipulative treatment showed to reduce a high occurrence of gastrointestinal symptoms and an excessive length of stay in the NICU. Randomized control studies are needed to generalize these results to a broad population of high risk newborns.
新生儿重症监护病房的组织改进需要对早产儿进行严格监测，包括对胃肠系统生理功能的常规评估以及确定合适出院时间的优化程序。
我们对2005年至2008年间连续收治入新生儿重症监护病房且无任何重大并发症的350例早产儿进行了一项关于整骨手法治疗效果的前瞻性研究。除常规护理外，162名受试者接受了整骨治疗。研究的终点是研究组和对照组在住院时间过长和胃肠道症状方面的差异，胃肠道症状定义为总体人群分布中的上四分位数。统计分析基于多变量逻辑回归的粗比值比和调整后比值比。
除入院时无法经口喂养的婴儿比例外，基线特征在治疗组/对照组中分布均匀，整骨治疗组中该比例显著更高（p = 0.03）。整骨治疗与每位受试者每天肠道症状平均发生率降低显著相关，发生率高于0.44（比值比 = 0.45；0.26 - 0.74）。胎龄小于或等于32周、出生体重小于或等于1700克以及入院时无奶摄入与在该病房住院至少28天的发生率较高相关，而整骨治疗显著降低了这种风险（比值比 = 0.22；0.09 - 0.51）。
在早产儿群体中，整骨手法治疗显示可减少胃肠道症状高发率和在新生儿重症监护病房的住院时间过长情况。需要进行随机对照研究以将这些结果推广到广大高危新生儿群体。
