间歇性经口至食管管饲法联合口周按摩在皮罗序列征患儿吞咽障碍中的应用价值

丁晶; 马蕾; 王媛媛; 涂晶晶

doi:10.7619/jcmp.20240072

间歇性经口至食管管饲法联合口周按摩在皮罗序列征患儿吞咽障碍中的应用价值

Application value of intermittent oral-to-esophageal tube feeding combined with perioral massage in treating dysphagia of children with Pierre-Robin Syndrome

摘要

摘要:
目的探讨间歇性经口至食管管饲法联合口周按摩在皮罗序列征(PRS)患儿吞咽障碍中的临床价值。
方法选取行下颌骨牵张成骨术的PRS患儿92例，采用分层随机化法分为观察组和对照组，每组46例。对照组采用持续性经鼻管饲法干预，观察组采用间歇性经口至食管管饲法联合口周按摩干预。比较干预前、干预1个月后2组患儿营养状况体质量指数(BMI)、血清血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)的变化，比较干预1个月后2组患儿临床指标(住院时间、开始经口喂养时间、全肠胃喂养时间)，记录2组吞咽情况以及并发症发生情况。
结果干预1个月后, 2组BMI、Hb、TP、ALB均上升，且观察组BMI(21.58±1.26) kg/m²、Hb(118.76±10.36) g/L、TP(55.28±6.74) g/L、ALB(33.46±4.37) g/L高于对照组的(20.30±1.22) kg/m²、(112.74±9.46) g/L、(51.68±6.33) g/L、(30.59±4.68) g/L, 差异有统计学意义(P < 0.05); 观察组喂奶时间(32.26±4.43) min、住院时间(21.48±3.11) d、开始经口喂养时间(14.26±3.16) d、全肠胃喂养时间(16.79±2.32) d, 分别短于对照组的(36.79±4.65) min、(24.39±3.31) d、(17.25±3.24) d、(20.48±3.29) d, 平均喂奶残留量(10.26±2.18) mL、流奶例数8例(17.39%)分别少于对照组的(12.79±2.31) mL、17例(36.95%), 差异有统计学意义(P < 0.05)。
结论间歇性经口至食管管饲法联合口周按摩可有效改善PRS患儿吞咽困难症状，缩短住院时间。

Abstract:
Objective To investigate the clinical value of intermittent oral-to-esophageal tube feeding combined with perioral massage in treating dysphagia of children with Pierre Robin Syndrome (PRS).
Methods A total of 92 PRS children with mandibular distraction osteogenesis were selected and divided into observation group and control group by stratified randomization, with 46 cases in each group. The control group received continuous nasal tube feeding intervention, while the observation group received intermittent oral-to-esophageal tube feeding combined with perioral massage intervention. The changes in nutritional statusbody mass index (BMI), serum hemoglobin (Hb), total protein (TP), albumin (ALB) before and after 1 month of intervention were compared between the two groups. The clinical indicators (hospital stay, time to start oral feeding, and time to full gastrointestinal feeding) were also compared 1 month after the intervention. The swallowing conditions and incidence of complications were recorded in both groups.
Results After 1 month of intervention, BMI, Hb, TP and ALB in both groups significantly increased, and the observation group had significant higher values in BMI of (21.58±1.26) kg/m², Hb of (118.76±10.36) g/L, TP of (55.28±6.74) g/L, ALB of (33.46±4.37) g/L compared to BMI of (20.30±1.22) kg/m², Hb of (112.74±9.46) g/L, TP of (51.68±6.33) g/L and ALB of (30.59±4.68) g/L in the control group (P < 0.05). In the observation group, the feeding time was (32.26±4.43) minutes, hospital stay was (21.48±3.11) days, time to start oral feeding was (14.26±3.16) days, and time to full gastrointestinal feeding was (16.79±2.32) days, which were significantly shorter than (36.79±4.65) min, (24.39±3.31) days, (17.25±3.24) days, and (20.48±3.29) days respectively in the control group (P < 0.05); the average residual feeding volume was (10.26±2.18) mL and the number of cases with milk flow was 8 (17.39%) in the observation group, which were significantly less than (12.79±2.31) mL and 17 (36.95%) in the control group (P < 0.05).
Conclusion Intermittent oral-to-esophageal tube feeding combined with perioral massage can effectively improve swallowing difficulty in children with PRS and shorten the hospital stay.

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