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整骨手法治疗可缩短新生儿重症监护病房的住院时间并降低医疗成本。

Osteopathic Manipulative Treatment Decreases Hospital Stay and Healthcare Cost in the Neonatal Intensive Care Unit.

作者信息

Roland Hannah, Brown Amanda, Rousselot Amy, Freeman Natalie, Wieting J Michael, Bergman Stephen, Mondal Debasis

机构信息

DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA.

DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA.

出版信息

Medicines (Basel). 2022 Sep 21;9(10):49. doi: 10.3390/medicines9100049.

Abstract

Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients' recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care.

摘要

整骨手法治疗(OMT)可用于住院和门诊环境。有证据表明,OMT可以缩短患者的康复时间,并降低其急性医疗和康复的经济成本。本文介绍了多项来自新生儿重症监护病房(NICU)的研究,这些研究表明,接受OMT治疗的婴儿比未接受OMT治疗的婴儿康复得更快、出院更早,且医疗成本更低。数据清楚地表明,辅助性OMT有助于新生儿的喂养协调,如衔接、吸吮、吞咽和呼吸,并增加长期体重增加和维持,从而缩短住院时间(LOS)。整骨技术,如软组织手法、韧带张力平衡、肌筋膜松解和整骨颅骨手法(OCM),可以减少反流、呕吐、乳胆汁或血性分泌物,并减少便秘治疗的需求。OMT在降低早产儿肺炎并发症方面也可能有效。研究表明,使用OCM和淋巴泵技术(LPT)可减少吸入性肺炎和环境获得性肺炎的发生,从而显著降低婴儿的发病率和死亡率。根据已发表的研究结果,确定OMT在临床上是有效的、具有成本效益的,是一种侵入性较小的手术替代方法,也是一种毒性较小的药物选择。因此,在NICU中常规纳入OMT对患有多种疾病的婴儿可能有很大益处。未来的OMT研究应旨在启动临床试验设计,包括对入住NICU的更大婴儿队列进行随机对照试验。此外,为阐明与OMT有益效果相关的潜在分子机制而进行的简化和协同努力,将有助于理解将OMT纳入最佳患者护理的重要价值。

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