非營養性吸吮對早產兒抽痰生理指標之成效

The Effects of Non-nutritive Sucking on Physiological Parameters for Preterm Infants Undergoing Suctioning

非營養性吸吮為早產兒發展性照護措施之一，可以減緩早產兒在新生兒加護病房因侵入性刺激所造成的不適。本研究目的在探討早產兒執行口鼻抽痰後非營養性吸吮對穩定生理指標之成效。採類實驗研究設計之交叉配對，進行重覆測量。選取中部某醫學中心新生兒加護病房，共30名符合收案條件的早產兒。以生理指標監測儀(Dragerfer EKG)於抽痰前10分鐘、抽痰時及抽痰後10分鐘，每分鐘記錄早產兒心跳、呼吸及血氧值之變化。實驗組，抽痰後立即於早產兒口中放入含蒸餾水之安撫奶嘴，對照組則未提供合蒸餾水之安撫奶嘴。資料分析與統計以平均值、標準差、最大值、最小值及一般線性模式混合模式(GLM-Mixed Model)等。研究結果顯示接受非營養性吸吮之早產兒在抽痰後1分鐘之心跳比對照組平穩7.93次/分，具統計上之顯著差異(t=2.066,P<.05)。血氧值方面，實驗組與對照組之血氧值於抽痰後第一至二分鐘有組別間之顯著差異(t=-4.186,-2.962,P=.000,.003)，實驗組的早產兒血氧值比對照組的上升1.9%，但在呼吸方面則無統計上顯著差異。非學養性吸吮能使早產兒抽痰後血氧值較穩定，期盼本研究能提供臨床護理人員於早產兒抽痰後，給予非營養性吸吮之實證基礎。

The purpose of this study was to examine the effects of nonnutritive sucking on the physiologicalresponse of preterm infants after suctioning. A quasi-experimental cross over and repeatedmeasurement was employed. Thirty preterm infants were recruited. Heart rate, respiratory rate,and oxygen saturation were recorded at 1-minute intervals using EKG monitor 10 minutes before,during, and 10 minutes after suctioning. In the intervention group, water-moistened pacifiers wereplaced into preterminfants'mouths immediately after suctioning.Results indicated that after suctioning1 minute intervention group had a more stable heart rate 7.93 bpm (t=2.066, P<.05).There was asignificant difference on oxygen saturation between two groups after suctioning 1 to 2 minutes(t=-4.186,-2.962, P=.000,.003) showing 1.9% higher oxygen saturation in the intervention group.We hope to provide this evidence to the clinical setting.