DiPietro J A, Cusson R M, Caughy M O, Fox N A
Department of Maternal and Child Health, Johns Hopkins University, Baltimore, Maryland 21205.
Pediatr Res. 1994 Aug;36(2):207-14. doi: 10.1203/00006450-199408000-00012.
Behavioral and physiologic responsivity to nasogastric gavage feeding was assessed in 36 preterm infants on 2 consecutive d. On one of these days, a pacifier was provided during and after the gavage segment of the standardized protocol. The protocol was divided into segments that included baseline, preparatory handling, pregavage, gavage, and postgavage periods. Patterns of cardiac (heart period and vagal tone), oxygen saturation, behavioral state, and defensive behavioral responses to gavage were quantified. These stable preterm infants responded to handling and gavage feeding with reduction in heart period, vagal tone, and oxygen saturation. These responses were not altered by provision of a pacifier, although there was a tendency for fewer episodes of bradycardia and oxygen desaturation. Conversely, behavioral state was affected significantly by nonnutritive sucking: when provided with a pacifier, infants exhibited less behavioral distress, spent less time in fussy and active awake states during and after feeding, and returned to a sleep state significantly faster. There is converging evidence to suggest that nonnutritive sucking lessens behavioral distress to iatrogenic stressors but does not alter physiologic responsiveness.
对36名早产儿连续两天进行了鼻饲喂养的行为和生理反应性评估。在其中一天，在标准化方案的鼻饲期间及之后提供了安抚奶嘴。该方案分为基线、准备处理、鼻饲前、鼻饲和鼻饲后等阶段。对心脏（心动周期和迷走神经张力）、血氧饱和度、行为状态以及对鼻饲的防御性行为反应模式进行了量化。这些稳定的早产儿对处理和鼻饲喂养的反应是心动周期、迷走神经张力和血氧饱和度降低。尽管心动过缓和血氧饱和度下降的情况有减少的趋势，但提供安抚奶嘴并未改变这些反应。相反，行为状态受到非营养性吸吮的显著影响：当提供安抚奶嘴时，婴儿表现出的行为痛苦较少，在喂养期间和之后处于烦躁和清醒活跃状态的时间较短，并且更快地恢复到睡眠状态。越来越多的证据表明，非营养性吸吮可减轻对医源性应激源的行为痛苦，但不会改变生理反应性。
