极低出生体重儿早期经口微量喂养的临床研究  

The clinical study on early minimal feeding of very low birth weight infant

作　　者：陈震[1] 陈静[1] 杨震英[1] 邵宪花 

机构地区：[1]山东省泰安市妇幼保健院新生儿科,271000

出　　处：《中华全科医师杂志》2006年第12期730-733,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨早期经口微量喂养对极低出生体重儿营养状况、喂养并发症及远期预后的影响。方法将2002年1月至2004年12月收治的90例极低出生体重儿按随机编号分为:早期经口微量喂养组30例(采用早期经口微量喂养),胃管组30例(采用常规胃管喂养),全静脉营养组30例(采用全静脉营养)。比较3组的喂养不耐受发生情况、恢复出生体重时间、平均日增长克数、达到全肠道营养时间、住院天数及并发症等。结果早期经口微量喂养组、胃管组、全静脉营养组恢复出生体重的时间分别为(14·1±4·0)d、(13·8±3·5)d、(13·5±3·8)d,差异无统计学意义(P>0·05)。早期经口微量喂养组平均每日体重增长克数、达到全肠道营养时间、住院天数、喂养不耐受发生率分别为(20·8±7·0)g/d、(24·3±2·1)d、(28·7±3·5)d、27%,与胃管组及全静脉营养组相比,差异有统计学意义(P<0·01);其血糖紊乱发生率(33%)与胃管组(32%)相比差异无统计学意义(P>0·05),与全静脉营养组(68%)相比差异有统计学意义(P<0·05);发生喂养并发症如呼吸暂停、呕吐、腹胀、胃出血与胃管组相比差异有统计学意义(P<0·01);发生窒息、吸入性肺炎、腹泻、坏死性小肠结肠炎、胃穿孔与胃管组相比,差异无统计学意义(P>0·05)。随访结果表明,1·5岁时胃管组和全静脉营养组各有1例发生脑瘫,全静脉营养组有1例发生精神发育迟滞。结论对极低出生体重儿宜提倡早吸吮、早期微量喂养,以减少喂养相关并发症的发生,缩短住院天数,减少后遗症的发生。Objective To study the effect of early minimal feeding on the nutrition, the feeding complication and the prognosis of very low birth weight infant （VLBWI）. Methods Ninety VLBWI were enrolled in this study between January 2002 and December 2004. The infants were divided into three groups in randomization, 30 cases with early minimal feeding （early minimal feeding group ）, 30 cases with gastrogavage（ gastrogavage group） and 30 cases with total parenteral nutrition（TPN group）. Compared the three groups in the incidence of feeding intolerance, days to regain birth weight, daily body weight gain, time to establish enteral nutrition, length of hospitalization and complication. Results There was no significant difference in the time to regain birth weight among the three groups [ （ 14.1 ±4.0）d, （ 13.8 ± 3.5）d and（ 13.5 ± 3.8）d, respectively] （P 〉 0.05）. The amount of daily body weight gain in early minimal feeding group [ （20.8 ± 7.0） g/d] was higher than other groups （ P 〈 0.01 ） ; time to establish enteral nutrition [ （24.3 ± 2.1 ） d ], length of hospitalization [ （ 28.7 ± 3.5 ） d ] were shorter than other groups （P〈0.01） ; the rate of feeding intolerance （27%） was lower than other groups （P 〈0.01 ） ; The incidence of blood sugar disorders （33 % ） was lower than in TPN group （68%） （P 〈 0.05 ） , but there was no significant difference than in gastrogavage group （ 32% ） （ P 〉 0.05 ） ; The incidence of complications （ apnea, vomit, abdominal distension, gastrorrhagia） was lower than in gastrogavage group （ P 〈 0.01 ）, But there was no difference in asphyxia, aspiration pneumonia, diarrhea, NEC, gastric perforation （ P 〉 0.05 ）. Following all the patients when they were eighteen months old, there was respectively one cerebral palsy in the gastrogavage group and TPN group, and one mental retardation in TPN group. Conclusions Early minimal feeding and early sucking up could reduce the occurrence of feeding comp

关 键 词：婴儿 极低出生体重 经口微量喂养 治疗结果 

分 类 号：R722[医药卫生—儿科]