CAJ | 학술논문

目的：探讨综合护理干预对极低出生体重儿胃肠功能恢复的影响。方法将转入NICU的112例极低出生体重儿作为研究对象，随机分为观察组(综合护理干预组)和对照组(未综合护理干预组)各56例。观察组在出生后4h内给予生理盐水洗胃、胃肠减压、6h内给予温生理盐水洗肠通便，建立早期母乳胃肠内营养及音乐抚触疗法。对照组按传统的方法对出生后48 h内不能哺乳、腹胀、未排胎便者给予针对性对症护理。结果观察组腹胀缓解时间、吸吮吞咽功能建立时间、体重增长情况及达足量喂养时间均优于对照组( P<0.01)；观察组患儿入院时血清胃肠激素即应激素比较明显优于对照组( P<0.01)；患儿腹胀、喂养不耐受、呼吸暂停、坏死性小肠结肠炎发生率均少于对照组( P<0.01)；观察组患儿静脉营养时间、住暖箱时间、住院时间及恢复出生时体重时间均明显短于对照组( P<0.01)。结论综合护理干预促进了极低出生体重儿胃肠功能发育成熟，促进了生长发育，减少了并发症，提高了抢救成功率及存活质量，预后达到最优化。
목적：탐토종합호리간예대겁저출생체중인위장공능회복적영향。방법장전입NICU적112례겁저출생체중인작위연구대상，수궤분위관찰조(종합호리간예조)화대조조(미종합호리간예조)각56례。관찰조재출생후4h내급여생리염수세위、위장감압、6h내급여온생리염수세장통편，건립조기모유위장내영양급음악무촉요법。대조조안전통적방법대출생후48 h내불능포유、복창、미배태편자급여침대성대증호리。결과관찰조복창완해시간、흡전탄인공능건립시간、체중증장정황급체족량위양시간균우우대조조( P<0.01)；관찰조환인입원시혈청위장격소즉응격소비교명현우우대조조( P<0.01)；환인복창、위양불내수、호흡잠정、배사성소장결장염발생솔균소우대조조( P<0.01)；관찰조환인정맥영양시간、주난상시간、주원시간급회복출생시체중시간균명현단우대조조( P<0.01)。결론종합호리간예촉진료겁저출생체중인위장공능발육성숙，촉진료생장발육，감소료병발증，제고료창구성공솔급존활질량，예후체도최우화。
Objective To explore the effect of early comprehensive nursing intervention on gastrointestinal function recover of very low birth weight infant. Methods Transferred to the NICU 112 cases of very low birth weight children as research subjects were randomly divided into two groups of 56 cases of the observation group ( early care and intervention group) and the control group ( non-early intervention group) 56 cases. Within 4 h after birth, in the obser-vation group the children were given saline gastric lavage, decompression and colonic cleansing purge of warm saline within 6 hours, the establishment of early breast milk gastrointestinal nutrition and music massage therapy. The control group adopted the routine care according to traditional methods, no breast-feeding within 48 hours after birth, abdomi-nal distension, no row of meconium were given targeted symptomatic care. Results In the observation group bloating ease time, sucking swallowing function set-up time, weight gain and up sufficient quantities of feeding time were signifi-cantly shorter than those in the control group ( P<0. 01 );serum gastrointestinal hormones in the observation group was significantly superior to them in the control group (P<0. 01);children with abdominal distension, feeding intolerance, apnea, necrotizing enterocolitis were significantly less than those in the control group (P<0. 01); parenteral nutrition time, living in warm box time, hospitalization time and to regain birth weight time in the observation group were signifi-cantly lower than those in the control group ( P<0. 01 ) . Conclusions Early comprehensive nursing intervention can promote the maturation of gastrointestinal function in very low birth weight children, and promote the growth and devel-opment, reduce complications and improve the success rate and quality of survival, the prognosis is to achieve the most optimized.