Effects Of Different Interventions On Enteral Nutrition In Premature Infants

ObjectiveThis thesis comparatively studied the influences of oral exercise,abdominal massage,and their combination on intestinal nutrition in the premature infants,and evaluated the effects of oral exercise,feeding performance,feeding intolerance and growth and development indicators for premature infants.The major objective of the study was to find effective intervention methods that promote premature infants to complete the transition from nasal feeding to oral feeding as early as possible.MethodsA total of 140 preterm infants were convenience selected from a NICU of a third-grade hospital in Linyi,Shandong Province during December 2016 and September2017.These infants were divided into four groups:control group,oral exercise group,abdominal massage group and combined group,each group with 35 cases.After premature infants were born,they all received parenteral nutrition support therapy but for different groups with different enteral nutrition interventions.Specifically,the control group infants were given NICU premature infant feeding care routine,the oral exercise group ones were given oral exercise 30 minutes before feeding,the abdominal massage group had abdominal massage 1 hour before the feeding,and the joint group infants were given oral exercise and abdominal massage.All the interventions were carried out until the premature infants reached complete oral feeding.The nursing records of critically ill children and the observation table of premature infant feeding were used to record relevant conditions and data in the feeding process of premature infants.The data were processed and analyzed by SPSS22.0 statistical software.One-way anova and chi-square test were used to compare the differences in feeding performance,feeding process,feeding intolerance,growth and development indicators and hospitalization time of the four groups of premature infants in the process of oral feeding.Results1.Feeding performance:during the early stage of oral feeding,there were no statistically significant differences in feeding efficiency and effectiveness among the four groups?P>0.05?;after the time of completed oral feeding,the feeding efficiency and effectiveness of the four groups were significantly different(F=5.324,P=0.002;F=40.617,P=1.80*10^-18<0.001),the feeding efficiency and feeding effect of the combined group and the oral exercise group were higher than those of the abdominal massage group and the control group?P<0.05?,and there was no difference between the other groups?P>0.05?.2.Feeding process:during the beginning of oral feeding,there was no significant difference in gestational ages of the four groups of premature infants?P>0.05?;after the time of completed oral feeding,the gestational ages of the four groups of premature infants were significantly different(F=31.258,P=3.36*10^-15<0.001),which was manifested as combination group<oral exercise group<abdominal massage group and blank group?P<0.01?.Also,there was a significant difference in feeding transition time between the four groups?F=9.336,P=0.004?,which was manifested as combination group<oral exercise group<abdominal massage group and blank group?P<0.05?.3.Feeding tolerance:there was no statistically significant difference in the incidence of abdominal distension and three-day defecation among the four groups?P>0.05?from the beginning of intervention to the period of complete oral feeding?P>0.05?.Compared with the other three groups,the combined group had the shortest meconium excretion time?P<0.01?,and there was no difference among the other three groups?P>0.05?.Compared with the abdominal massage group and the control group,the incidence of feeding intolerance was lower in the combined group and the oral exercise group?P<0.01?,and there was no difference between the other groups?P>0.05?.4.Other indicators:compared with the other three groups,the combined group had the lowest bilirubin level at the time of completed oral feeding?P<0.01?,and there was no difference among the other three groups?P>0.05?.There was no significant difference in the growth rate and time of hospitalization between the four groups?P>0.05?.Conclusions1.Oral exercise can improve the performance of oral feeding for premature infants and promote the process of oral feeding.2.Compared with oral exercise alone,a combined intervention treatment makes premature infants reach complete oral feeding at a younger gestational age,and shorten the time of oral feeding and meconium excretion,and reduce the serum bilirubin level.3.The application of abdominal massage alone has no significant effect on enteral nutrition of premature infants.