Zhang Yuxia, Lyu Tianchan, Hu Xiaojing, Shi Peng, Cao Yun, Latour Jos M
1Nursing Department, Children's Hospital of Fudan University, Shanghai, People's Republic of China. 2Neonatal Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, People's Republic of China. 3Department of Information, Children's Hospital of Fudan University, Shanghai, People's Republic of China. 4School of Nursing and Midwifery, Faculty of Health, Education and Society, Plymouth University, Plymouth, United Kingdom. 5School of Nursing and Midwifery, Faculty Health Science, Curtin University, Perth, Australia. 6Department of Pediatrics, Intensive Care Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Pediatr Crit Care Med. 2014 Sep;15(7):608-14. doi: 10.1097/PCC.0000000000000182.
To evaluate the effectiveness of nonnutritive sucking (NNS) and oral stimulation (OS), either applied alone or in combination, to reduce the transition time from tube feeding to independent oral feeding.
Randomized controlled trial.
A 40-bed neonatal ICU in a university hospital in the People's Republic of China.
A total of 120 preterm infants were admitted to the neonatal ICU from December 2012 to July 2013.
Oral motor interventions.
One hundred twelve preterm infants were assigned to three intervention groups (NNS, OS, and combined NNS + OS) and one control group. Primary outcome was the number of days needed from introduction of oral feeding to autonomous oral feeding (transition time). Secondary outcome measures were the rate of milk transfer (mL/min), proficiency (intake first 5 min/volume ordered), volume transfer (volume transferred during entire feeding/volume prescribed), weight, and hospital length of stay. Transition time was reduced in the three intervention groups compared with the control group (p < 0.001). The milk transfer rate in the three intervention groups was greater than in the control group (F3,363 = 15.37; p < 0.001). Proficiency in the NNS and OS groups did not exceed that in the control group while the proficiency in the NNS + OS group was greater than that in the control group at the stage when the infants initiated the oral feeding (p = 0.035). Among all groups, no significant difference was found on weight gain and length of stay.
The combined NNS + OS intervention reduced the transition time from introduction to independent oral feeding and enhanced the milk transfer rate. The combined intervention seems to have a beneficial effect on oral feeding proficiency in preterm infants.
评估非营养性吸吮（NNS）和口腔刺激（OS）单独应用或联合应用对缩短从管饲过渡到自主口腔喂养时间的有效性。
随机对照试验。
中华人民共和国一所拥有40张床位的大学医院的新生儿重症监护病房。
2012年12月至2013年7月期间，共有120名早产儿入住新生儿重症监护病房。
口腔运动干预。
112名早产儿被分配到三个干预组（NNS组、OS组和NNS + OS联合组）和一个对照组。主要结局是从开始口腔喂养到自主口腔喂养所需的天数（过渡时间）。次要结局指标包括乳汁转移率（毫升/分钟）、熟练程度（最初5分钟摄入量/订购量）、乳汁转移量（整个喂养过程中转移的量/规定量）、体重和住院时间。与对照组相比，三个干预组的过渡时间均缩短（p < 0.001）。三个干预组的乳汁转移率高于对照组（F3,363 = 15.37；p < 0.001）。在婴儿开始口腔喂养阶段，NNS组和OS组的熟练程度未超过对照组，而NNS + OS联合组的熟练程度高于对照组（p = 0.035）。在所有组中，体重增加和住院时间方面未发现显著差异。
NNS + OS联合干预缩短了从开始到自主口腔喂养的过渡时间，并提高了乳汁转移率。联合干预似乎对早产儿的口腔喂养熟练程度有有益影响。
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