危重新生儿胃肠喂养方式与胃肠损害发生的临床分析  

Analysis of feeding methode and gastrointestinal injury neonates with critically ill

作　　者：廖忠敬[1] 丘小汕[2] 张巧玲[1] 詹国媛[1] 唐雯[1] 文序[1] 麦文英[1] 刘艳薇[1] 

机构地区：[1]中山大学附属第一医院黄埔院区儿科,广东广州510700 [2]中山大学附属第一医院儿科,广东广州510180

出　　处：《中国实用儿科杂志》2008年第1期18-20,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨危重新生儿早期喂养方式对胃肠功能的影响及与胃肠损害发生的关系。方法2001年6月至2004年6月对中山大学附属第一医院黄埔院区收治的56例危重新生儿开展前瞻性研究并对其临床资料进行分析。随机将早产儿和足月儿分为按需喂养组和微量喂养组，其中24例早产儿中，按需喂养组和微量喂养组各12例；32例足月儿中，按需喂养组和微量喂养组各16例。所有新生儿在生后6h内开奶，按微量喂养[0．1～4．0mL／（kg·d）]和按需喂养[开始10～20mL／（kg·d），以后每天每次增加10～15mL]分成两组，观察比较两种不同喂养方式新生儿发生胃肠损害的情况。结果（1）无论早产或足月儿，微量喂养儿胃肠损害发生率明显低于按需喂养儿（P〈0、05）。（2）早产儿胃肠损害发生率明显高于足月儿（P〈0．05）。（3）生后24h内胃肠损害发生率明显高于24～48h胃肠损害发生率（P〈0．05）。（4）出生48h内极危重患儿胃肠损害发生率显著高于危重组患儿（P〈0．05）。结论危重新生儿出生后不宜过早全奶按需喂养，生后24h内尤应慎重；提倡出生后6h从1：1稀释奶开始，微量喂养，缓慢加奶，至生后48h才逐渐过渡至全奶，以减少胃肠损害的发生。Objective To investigate the influence of the early feeding on the gastrointestinal function of the critically ill neonates and the relationship between the start point of feeding time and the occurrence of gastrointestinal injury. Methods The clinical information of 56 neonates in our department was analyzed. All neonates started to be fed 6 hours later after birth following different ways of feeding： either feeding in microdosis （0. 1 - 4mL/kg ·d） or feeding according to the required volume （start from 10 -20mL/kg · d, then added 10 - 15mL/kg per time per day） , The incidence of the gastrointestinal damage was compared with two feeding methods. Results （ 1 ） The incidence of the gastrointestinal damage was significantly lower in the neonates of microdosis group than the required feeding group（ P 〈0.05） （2） The incidence of the gastrointestinal damage was significantly higher in the premature infant group than the nomal term infant group（ P 〈 0. 05 ）. （ 3 ） The incidence of gastrointestinal damage of 24th hour after birth group was higher than 48th hour after birth group. （ P 〈 0. 05 ）. （4）The incidence was significantly higher in the seriously critically ill neonates than the critically ill ones. Conclusion To reduce the incidence of the gastrointestinal damage, the Critically ill neonates should not be fed according to the required volume early after birth, especially in the first 24 hours of birth. It will suggested that the feeding should be started to use a microdosis manner using 1：1 diluted mild at the first 6 hours followed by a slowly manner to increase the volume till the whole milk after 48 hours.

关 键 词：危重新生儿 喂养 胃肠系统 

分 类 号：R72[医药卫生—儿科]