初乳口腔涂抹对新生儿重症监护室小于34周早产儿营养进程的影响  

The effects of administration of oropharyngeal colostrum on nutrition of preterm infants less than 34 weeks in NICU

作　　者：何婧[1] 罗碧如[2] 张勇[1] 何敏[1] 王肜 李翔宇 杨文爽 钱淑华 HE Jing;LUO Bi ru;ZHANG Yong;HE Min;WANG Rong;LI Xiang yu;YANG Wen shuang;QIAN Shu hua(Sichuan Provincial Hospital for Women and Children,Chengdu 610045,China;West China Second University Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川省妇幼保健院新生儿科,四川成都610045 [2]四川大学华西第二医院护理部,四川成都610041

出　　处：《实用医院临床杂志》2019年第6期96-99,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫计委科研基金资助项目(编号:17PJYY0817)

摘　　要：目的探究口腔涂抹初乳对小于34周早产儿营养进程的影响。方法选取2017年5月至2018年5月在我科住院的小于34周早产儿170例,按随机数字表法分为试验组(n=86)和对照组(n=84)。试验组使用母亲初乳进行口腔涂抹,每3 h涂抹1次,每次总量02 ml,连续7 d。对照组使用生理盐水进行口腔涂抹,其余干预措施与试验组一致。收集并记录两组患儿住院期间营养指标,比较两组早产儿的禁食天数、开始肠内营养时间、达全胃肠道营养时间、静脉营养时间、喂养不耐受率、恢复出生体重时间、住院期间纯母乳喂养率、坏死性小肠结肠炎(NEC)发生率、住院天数的差异。结果试验组达到全肠胃道营养时间及静脉营养时间均明显低于对照组(P<0.05),恢复出生体重天数早于对照组(P<0.05),患儿喂养不耐受例数明显低于对照组(P<0.05)。试验组纯母乳喂养天数、出院时纯母乳喂养率均高于对照组(P<0.05)。试验组发生坏死性小肠结肠炎1例,对照组7例,差异有统计学意义(P<0.05)。结论初乳口腔涂抹可改善小于34周早产儿的营养进程,缩短患儿静脉营养时间和达到全胃肠道营养的时间,缩短恢复出生体重时间,减少喂养不耐受的发生,降低NEC的发生,住院期间纯母乳喂养天数更长,出院时纯母乳率更高。Objective To explore the effects of administration of oropharyngeal colostrum on nutrition of premature infants less than 34 weeks in Neonatal Intensive Care Unit(NICU).Methods We selected 170 premature infants less than 34 weeks in our hospital between May 2017 and May 2018 and divided them into experimental group(n=86)and control group(n=84)by random num ber table method.The experimental group accepted administration of oropharyngeal colostrum once every 3 hours with a total amount of 0.2 ml each time for 7 days.The control group accepted oropharyngeal administration of normal saline and other interventions were consistent with the experimental group.The nutritional indicators were collected and the differences in fasting days,enteral nutrition,time to total gastrointestinal nutrition,intravenous nutrition time,feeding intolerance rate,time to regain birth weight,exclusive breastfeeding rate,incidence of necrotizing enterocolitis(NEC)and the length of hospital stay were compared between the two groups during hospitalization.Results Compared with the control group,the time to total gastrointestinal nutrition and intravenous nutrition were shorter(P<0.05),days to regain birth weight was earlier(P<0.05),number of feeding intolerance was less(P<0.05),mean days of exclusive breastfeeding and exclusive breastfeeding rate at discharge in the experimental group were higher(P<0.05).NEC was found in one case in the experimental group and 7 cases in the control group,which was statistically significant(P<0.05).Conclusion Adminis tration of oropharyngeal colostrum can improve the nutritional process of premature infants less than 34 weeks,shorten the time for intra venous nutrition and total gastrointestinal nutrition,shorten the time for the recovery of birth weight,and reduce the incidence of feeding intolerance and NEC.The days of exclusive breastfeeding of premature infants are extending during hospitalization,and the rate of exclusive breastfeeding is increased when discharged.

关 键 词：早产儿 初乳 口腔涂抹 营养 纯母乳喂养 新生儿重症监护室 

分 类 号：R248.4[医药卫生—中医临床基础]