被动呼吸训练对不同胎龄的早产儿喂养障碍治疗作用的观察

Observation on the Therapeutic Effect of Passive Respiratory Training on Feeding Disorders in Preterm Infants of Different Gestational Ages

摘要: 目的：探究被动呼吸训练对不同胎龄的早产儿喂养障碍的影响，为制定精准的经口喂养策略提供依据。方法：选取2023年1月~2025年6月某三级甲等医院新生儿重症监护室的60例早产儿，按胎龄分为极早产儿(28~31⁺⁶周，n = 30)和中期早产儿(32~33⁺⁶周，n = 30)，再随机分为对照组(n = 15，接受口腔运动训练)和观察组(n = 15，额外增加被动呼吸训练)，均干预3周，每周5天。评估指标包括PIOFRA量表、喂养不耐受发生率、体重、身长、血清白蛋白、球蛋白、前白蛋白、血氧饱和度最低值及NBNA量表。结果：干预后，两组PIOFRA评分、体重、身长及血氧饱和度均显著改善，且观察组优于对照组(P < 0.05)；观察组喂养不耐受发生率显著降低(极早产儿从66.67%降至26.67%，中期早产儿从46.67%降至13.33%)，对照组无显著变化(P > 0.05)；极早产儿观察组体重、身长增长更显著，中期早产儿观察组前白蛋白升高更明显；观察组NBNA评分显著高于对照组(P < 0.05)。结论：常规吞咽训练联合被动呼吸训练可有效改善早产儿经口喂养能力、降低喂养不耐受、促进生长发育及神经行为成熟，且对不同胎龄早产儿的影响存在差异，为个体化喂养干预提供参考。

Abstract: Objective: To investigate the impact of passive breathing training on feeding difficulties in preterm infants of different gestational ages, and to provide a basis for formulating precise oral feeding strategies. Methods: A total of 60 preterm infants admitted to the neonatal intensive care unit of a tertiary grade A hospital from January 2023 to June 2025 were enrolled. They were divided by gestational age into extremely preterm infants (28~31⁺⁶ weeks, n = 30) and moderate preterm infants (32~33⁺⁶ weeks, n = 30). Each group was further randomly assigned to a control group (n = 15, receiving oral motor training) and an observation group (n = 15, additionally receiving passive breathing training). Both groups received interventions for 3 weeks, 5 days per week. Assessment indicators included the PIOFRA scale, incidence of feeding intolerance, body weight, body length, serum albumin, globulin, prealbumin, minimum oxygen saturation during breathing, and NBNA scale. Results: After intervention, both groups showed significant improvements in PIOFRA scores, body weight, body length, and oxygen saturation, with the observation group demonstrating superior outcomes compared to the control group (P < 0.05). The incidence of feeding intolerance in the observation group decreased significantly (from 66.67% to 26.67% in extremely preterm infants, and from 46.67% to 13.33% in moderate preterm infants), while no significant change was observed in the control group (P > 0.05). The observation group of extremely preterm infants exhibited more significant gains in body weight and length, and the observation group of moderate preterm infants showed a more pronounced increase in prealbumin. The NBNA scores in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: Conventional swallowing training combined with passive breathing training can effectively improve oral feeding ability, reduce feeding intolerance, and promote growth and neurobehavioral maturation in preterm infants. The effects vary among preterm infants of different gestational ages, providing a reference for individualized feeding interventions.