按摩對早產兒的體重生長及神經功能發展影響之探討

隨著新生兒醫學的進步及護理照顧技術的提高，早產兒有較高的存活機會，伴隨這樣的存活率將合併有神經功能發展缺損的危險；而新生兒科護理人員是促進早產兒生長與發展的重要角色。本研究目的是探討按摩對早產兒的體重生長及神經功能發展之影響。藉此研究結果，期能使早產兒體重增加，提早出院，降低院內感染的機會，增加成本效益；且能促進神經功能發展，提供發展性、支持性的照護。 本研究採類實驗法，依早產兒出生先後次序及選案條件選取32位早產兒隨機分派至實驗組與對照組各16人。兩組均接受一般常規護理，而研究者針對實驗組早產兒施行每天三次，每次15分鐘的按摩，包括觸覺刺激與運動刺激，持續10天，每天監測體重變化，且於實驗前後評估神經功能狀況。 本研究採用pair-t-test、two sample-t-test、McNemar多元變數檢定、pearson correlation等方法來分析比較前後測之差異及相關性。研究結果顯示：(1)實驗組較對照組體重有顯著增加。(2)實驗組較對照組神經功能明顯進步。(3) 早產兒體重與神經功能呈正相關。 本研究發現按摩確能增加早產兒體重生長及促進神經功能發展。此有效、經濟、方便的護理措施值得推廣與應用，期望能提供更專業化、高品質的早產兒護理。 關鍵詞：早產兒、按摩、體重、神經功能

The survival rates of the prematurity have been increased because of the progress in neonatology and improvement in nursing skills. However, this is related to risk for neurodevelopmental deficit in these infants. Nursing staffs of neonatal intensive care unit and intermediate care unit have played very important roles in promoting the growth and development of premature infants. The purpose of the study is to find influences of massage on the increase of weight and neural function development in premature infants. Through the result of this study, we expect to provide information, which helps to increase the weight of a premature infant, to shorten the hospital stay, to avoid nosocomial infections, to raise the cost-benefit, to promote the development of neural function, as well as to provide supportive nursing care. The study used the quasi-experimental design. The premature infants were chosen based on the birth order and sampling conditions. Thirty-two infants were randomly assigned to experimental and control groups. General nursing care was offered to both groups, while only the premature infants in experimental group received massage, 3 times a day, and each time took 15 minutes, including tactile and exercise stimulations for consecutively 10 days. The changes of weights were recorded, while the neural conditions were evaluated before and after the study. Data were analyzed using the Pair-t-test, Two sample-t-test, Marginal homogeneity test, and Pearson correlation. The results indicated that : (1) The experimental group had a better weights. (2) The experimental group had a better neurodevelopment. (3)The increase of weights and neural development of the premature infants are positive associated with massage. The findings of this study imply that a massage maybe improve weight and neurodevelopment. This effective, economic, and convenient nursing skill is worth advocating, and through which, the nursing of premature would be more professional and with higher quality. Key words: premature, massage, weights, neurodevelopment