新生儿病房中的吞咽和喂养问题——对言语-语言病理学服务的分析

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中文摘要

背景： 早产儿和患病新生儿发生吞咽和喂养问题的风险增加。在德国，新生儿护理中言语-语言病理学（SLP）服务的结构标准尚缺乏，针对该情境的经过验证的评估工具也同样缺乏。本研究旨在使用临床可行的工具系统描述喂养问题。
方法： 在一项前瞻性观察研究中，在一所德国大学医院的新生儿病房实施了SLP服务。对因喂养困难转诊的婴儿数据进行了分析。使用德语版FOIS-p评估营养状况，并使用新开发的问卷S&F 0-6评估父母的感知和负担。
结果： 共纳入148名婴儿进行分析，平均经后年龄为41周（±7.0；33-68），其中58.8%为早产。最常见的诊断是吸吮无力及/或吸吮-吞咽-呼吸不协调（70%），其次是吞咽困难（15%）和喂养障碍（6%）。FOIS-p显示大多数婴儿为部分经口喂养。父母报告负担评分最高的领域是对茁壮成长和体重增加的担忧。
结论： 早产儿和患病婴儿的吞咽和喂养困难在住院环境中很常见，需要差异化的SLP评估和干预。诸如FOIS-p之类的简单措施未来可为整个住院期间提供稳健数据基础。

英文摘要

BACKGROUND: Preterm and sick neonates are at increased risk for swallowing and feeding problems. In Germany, structural standards for speech-language pathology (SLP) services in neonatal care are lacking, as are validated assessment tools for this context. The aim of this study was to systematically describe feeding problems using clinically feasible instruments.
METHODS: In a prospective observational study, a SLP service was implemented in neonatal units at a German university hospital. Data were analyzed from infants referred due to feeding difficulties. Nutritional status was assessed using the German version of the FOIS-p, and parental perception and burden were evaluated using the newly developed questionnaire S&F 0-6.
RESULTS: A total of 148 infants with a mean postmenstrual age of 41 weeks (±7.0; 33-68) were included in the analysis, of whom 58.8% were born preterm. The most common diagnosis was weak suck and/or suck-swallow-breathe discoordination (70%), followed by dysphagia (15%) and feeding disorder (6%). The FOIS-p indicated partial oral feeding for the majority of infants. Parents reported the highest burden scores in the domain of concerns about thriving and weight gain.
CONCLUSION: Swallowing and feeding difficulties in preterm and sick infants are common in the inpatient setting and require differentiated SLP assessment and intervention. Simple measures such as the FOIS-p could in future provide the basis for a robust data foundation across the inpatient stay.