基于循证的多感官刺激对住院早产儿脑功能发育的影响

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The effect of evidence-based multisensory stimulation on brain function development in hospitalized premature infants

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doi:10.12372/jcp.2025.24e0491

Abstract:

Objective To investigate the effect of multisensory stimulation on the brain function development of hospitalized preterm infants and provide references for clinical practice. Methods preterm infants with a gestational age of 30 to 33⁺⁶ weeks were randomly divided into two groups. The control group was only given routine care for preterm infants, including close observation, creating a suitable environment, maintaining warmth, and preventing infections. The intervention group received multi-sensory stimulation daily on the basis of routine care, including playing the mother's voice, touching, red ball visual stimulation, and droplet feeding of breast milk on the anterior part of the tongue. The intervention period was 14 days. Results There was no statistically significant difference between the baseline data of preterm infants and mothers in the two groups (P >0.05), and the comparison of the NBNA scores and aEEG results before and after the intervention showed statistically significant differences (P<0.05). Conclusion Multisensory stimulation for preterm infants can effectively improve the brain function development of the infants.

Key words: multisensory stimulation, premature infants, brain function, development supportive care

LEI Qing, LEI Xiaoping, LI Na, WANG Yaxin, SHE Guifang, SUN Hongyan. The effect of evidence-based multisensory stimulation on brain function development in hospitalized premature infants[J].Journal of Clinical Pediatrics, 2025, 43(4): 257-263.

Table 1

Programs of multisensory stimulation"

干预主题	干预内容
实践者培训	1. 在干预开始前，参与人员需经过系统的培训，包括随机分组人员、干预实施者、结局指标收集者，培训结束后进行理论和操作考核，由专科护士带教老师、医师进行实践指导。
人员分工	2. 1名成员负责与家属联系，邀请家属参与并配合本研究，详细介绍研究目的、意义并签署知情同意书，指导并收集母亲的录音音频、母乳，并将母乳进行统一冷冻保存。
	3. 1名受培训的干预实施者专门负责触觉刺激，确保干预一致性。
干预时间	4. 选择12∶00喂奶前的30 min，避开护理操作，共干预14 d。
干预前准备	5. 环境准备。室内应保持安静清洁，光线柔和，室温在24~26 ℃，湿度为55%~65%，按摩时做好早产儿的保暖工作。
	6. 人员准备。干预人员放松心情，穿着清洁衣物、佩戴口罩；按摩时手部需保持温暖并消毒。
	7. 用物准备。避免交叉感染，播放设备、玩具均消毒处理。
操作方法	8. 听觉刺激。为早产儿播放母亲的录音音频（唱儿歌、讲故事或轻柔的说话声），将播放设备放于距离早产儿20 cm处，于耳处测量音量为45~55 dB，且背景噪声<45 dB，持续15 min。
	9. 触觉刺激。干预操作者手部保持温暖并消毒双手，按头面部、胸腹部、上肢、下肢和背部的顺序，每个部位持续10 s，采用中等压力（颜色由粉红轻微变白），干预8 min。
	10. 视觉刺激。早产儿安静觉醒时，用红球进行视觉追视或人脸视觉接触，距离早产儿20 cm处，间歇性引导患儿目光在水平或前后方向移动，不超过3 min。（注：视觉刺激时不会持续对患儿进行刺激，红球和目光接触交替进行）
	11. 味觉刺激。母乳使用前水浴加热至38~40℃，用无菌注射器注射1 mL缓慢滴于舌前部。
注意事项	12. 干预过程需人员在场监护，若出现呕吐或有呕吐迹象、拱背、哭闹、肤色改变等不耐受情况要及时停止干预。
	13. 音乐设备需提前测试，确保不会对监护仪和呼吸机等设备造成干扰。

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项目	对照组（n=35）	干预组（n=36）	统计量	P
男[n(%)]	20（57.14）	22（61.11）	0.12	0.734
单胎[n(%)]	26（74.29）	24（66.67）	0.50	0.482
出生胎龄( x±s)/d	221.69±6.09	220.83±7.97	0.51	0.615
出生体重( x±s)/g	1 573.80±243.93	1 569.50±262.72	0.07	0.943
入组日龄( x±s)/d	2(1,3)	2(1,3)	0.15	0.883
5分钟Apgar评分[M(P₂₅~P₇₅)]/分	9（8~9）	9（9~9）	1.31	0.191
使用PS治疗[n(%)]	23（65.71）	18（50.00）	1.80	0.180

项目	对照组（n=35）	干预组（n=36）	统计量	P
年龄( x±s)/岁	29.71±5.68	30.67±4.76	0.77	0.446
受孕方式[n(%)]			0.66	0.417
自然受孕	29（82.86）	27（75.00）
人工受孕	6（17.14）	9（25.00）
分娩方式[n(%)]			1.13	0.288
阴道分娩	17（48.57）	13（36.11）
剖宫产	18（51.43）	23（63.89）
产前使用青霉素[n(%)]			0.68	0.411
是	19（54.29）	23（63.89）
否	16（45.71）	13（36.11）
产前使用糖皮质激素[n(%)]			0.84	0.358
是	25（71.43）	22（61.11）
否	10（28.57）	14（38.89）
定期产检[n(%)]			0.13	0.717
是	28（80.00）	30（83.33）
否	7（20.00）	6（16.67）
妊娠期并发症[n(%)]	10（28.57）	8（22.22）	0.38	0.539
有	10（28.57）	8（22.22）
无	25（71.43）	28（77.78）

组别	例数	第1天	第7天	第14天
对照组	35	29.83±1.42	30.97±1.34	32.34±1.14
干预组	36	29.64±1.44	32.25±1.25	33.92±1.20
t值		0.56	4.16	5.66
P		0.578	<0.001	<0.001

组别	例数	aEEG总分	上边界/mV	下边界/mV	带宽
对照组	35	10.37±1.29	25.34±1.28	9.03±0.82	16.31±1.47
干预组	36	11.33±1.24	24.86±1.48	9.56±0.91	15.31±1.74
t值		3.21	1.47	2.56	2.64
P		0.002	0.147	0.013	0.010

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