足月兒和高危險群早產兒在足月時的營養性吸吮動作型態

Nutritive Sucking Pattern of Term and High-risk Preterm Infants at Term

黃雅淑(Yea-Shwu Hwang) ； 林其和(Chyi-Her Lin) ； 施陳美津(Mei-Jin Chen-Sea)蔡文暉(Wen-Hui Tsai) ； 蔡佩倫(Pei-Luen Tsai)

《職能治療學會雜誌》 24卷 (2006/12) Pp. 1-10

https://doi.org/10.6594/JTOTA.2006.24.01

摘要

本研究目的旨在探討高危險群早產兒和健康足月兒於足月時的營養性吸吮動作型態之差異。26位嬰兒包含7位高危險群早產兒（新生兒醫療指數為3-5級）（參加本研究時的平均月經後孕齡為39.3±1.7週）和19位健康足月兒（參加本研究時的平均月經後孕齡為38.9±0.9週）參與本研究。在1次常規的喝奶時間，利用電腦化吸吮壓力測定儀器來評估每位嬰兒在前5分鐘喝奶期間吸吮動作的表現。
經由曼－惠特尼U考驗的統計分析(Mann-Whitney U test)結果顯示在喝奶期間，早產組的成熟型吸吮群組百分率（成熟型吸吮群組總數/吸吮群組總數×100%）(38.0±20.3 vs. 67.9±25.8%, p=.016)、每次成熟型吸吮群組內含的吸吮數（18.9±5.8 vs. 33.7±16.4次, p=.021）和每次成熟型吸吮群組的時間量（17.2±5.8 vs. 30.4±13.4秒, p=.039）等三項結果變項均明顯低於足月組。雖然相較於足月組，早產組整個喝奶過程中表現較少的吸吮次數和較長的休息時間量，但兩組的差異並未達到統計上的顯著意義。另外，經由重複性變異數分析法(Repeated measures analysis of variance)的統計結果顯示嬰兒的吸吮次數和休息時間量隨著喝奶時間的增加而有不同。足月和早產嬰兒在喝奶2分鐘後的吸吮次數呈現明顯下滑(p=.004) 而休息時間量則有顯著增加的現象(p=.007)。
由本研究結果發現相較於同齡的健康足月兒，高危險群早產兒在足月時的營養性吸吮動作表現仍明顯較不成熟。因此在臨床上，建議治療師在高危險群早產兒出院前對於這群嬰兒及其主要照顧者的餵奶技巧應做審慎的評估和衛教，以預防嬰兒在出院回家後發生喝奶的問題。

關鍵字

吸吮 ； 高危險群 ； 早產

並列摘要

The purpose of this study was to examine the nutritive sucking pattern of high-risk preterm infants (PT) compared to newly born full-term (FT) infants at term. Twenty-six infants consisting of 7 high-risk PT infants belonged to the levels III-V of the Neonatal Medical Index and 19 healthy FT infants were enrolled in the current study. The sucking performance of each infant during the initial 5-min feeding was assessed using a computerized suckometer at one regular feeding time. The results indicated that infants in the high-risk PT group demonstrated a significantly lower percentage of mature sucking bursts (≧10sucks/burst) (38.0±20.3 vs. 67.9±25.8%, p=.016), fewer number of sucks of mature sucking bursts (sucks/burst) (18.9±5.8 vs. 33.7±16.4, p=.021), and shorter duration of mature sucking bursts (17.2±5.8 vs. 30.4±13.4 sec, p=.039) than those in the FT group using the Mann-Whitney U test. Although less number of sucks and longer resting duration were found in the PT group during the initial 5-min feeding, the differences between the PT and FT groups did not reach statistic significance. In addition, a significant decrease of number of sucks (p=.004) and increase of resting duration (p=.007) was found in term and preterm infants following 2-min feeding. In conclusion, the study findings indicated that in comparison to FT infants, high-risk infants born prematurely displayed less mature nutritive sucking pattern at term. On the basis of the findings, the evaluation of the infant’s feeding ability and the primary caregiver's feeding skills is highly recommended for this population before discharge to prevent the occurrence of feeding problems after they are back home.

並列關鍵字

sucking ； high-risk ； preterm infants