早期母乳微量喂养对极低出生体重儿生长发育和喂养不耐受的影响研究  

Effects of early breast milk microfeeding on growth and feeding intolerance of very low birth weight infants

作　　者：钟学红[1] 吴旭红[1] 杨芹[1] 王红 王娟 Zhong Xuehong;Wu Xuhong;Yang Qin;Wang Hong;Wang Juan(Department of NICU,National Medical Center Beijing Children's Hospital Affiliated to Capital Medical University,Beijing 100045,China)

机构地区：[1]国家医学中心首都医科大学附属北京儿童医院NICU,100045

出　　处：《中华消化病与影像杂志（电子版）》2024年第3期222-225,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：中华医学会杂志社2022-2023年护理学科研究课题(CMAPH-NRI2022050)。

摘　　要：目的极低出生体重儿(VLBWI)需要充足的营养以满足自身快速生长发育,但同时还需要注意患儿在营养支持过程中出现喂养不耐受和相关并发症的风险。本研究探讨早期母乳微量喂养对VLBWI生长发育和喂养不耐受的影响,为今后VLBWI的营养治疗提供合理方法。方法选取2021年1月至2023年4月首都医科大学附属北京儿童医院收治的VLBWI 92例为研究对象,根据喂养方式分为观察组56例和对照组36例。两组均行静脉营养支持,观察组给予早期母乳微量喂养,对照组给予常规喂养。观察和比较两组生长发育状况及胃功能变化。结果观察组经口喂养时间[(6.8±0.4)d]、全肠内喂养达到时间[(13.7±1.2)d]以及住院时间[(38.1±3.5)d]均明显低于对照组(t=-8.572、-9.113、-6.028,P<0.05);观察组身长增长速度[(0.93±0.15)cm/周]、头围增长速度[(0.67±0.06)cm/周]、体重增长速度[(18.75±2.87)g/(kg²d)]均明显高于对照组(t=4.442、2.571、4.861,P<0.05);观察组恢复出生体重时间[(8.1±1.3)d]明显低于对照组(t=-7.522,P<0.05);观察组呕吐、胃潴留发生率(分别为8.9%、8.9%)均明显低于对照组(χ^(2)=5.705、8.664,P<0.05)。结论早期母乳微量喂养能显著提高VLBWI生长发育水平,降低胃肠道喂养不耐受发生率,缩短住院时间。Objective Very low birth weight infants(VLBWI)need adequate nutrition to meet their rapid growth and development,but also need to pay attention to the risk of feeding intolerance and related complications in the course of nutritional support.This study is investigate the effects of early breast milk microfeeding on the growth and feeding intolerance of VLBWI,so as to provide a reasonable method for nutritional treatment of VLBWI in the future.Methods A total of 92 VLBWI admitted to Beijing Children's Hospital Affiliated to Capital Medical University from January 2021 to April 2023 were selected as the research objects.According to the feeding method,they were divided into observation group(56 cases)and control group(36 cases).Both groups received intravenous nutrition support,the observation group was given early breast milk microfeeding,and the control group was given routine feeding.The growth and development status and gastrointestinal function of the two groups were observed and compared.Results The oral feeding time[(6.8±0.4)d],the total enteral feeding time[(13.7±1.2)d]and the hospitalization time[(38.1±3.5)d]in the observation group were significantly lower than those in the control group(t=-8.572,-9.113,-6.028,P<0.05).The growth rate of body length[(0.93±0.15)cm/week],head circumference[(0.67±0.06)cm/week]and body weight[(18.75±2.87)g/(kg·d)]in the observation group were significantly higher than those in the control group(t=4.442,2.571,4.861,P<0.05).The recovery time of birth weight in the observation group[(8.1±1.3)d]was significantly lower than that in the control group(t=-7.522,P<0.05).The incidence of vomiting and gastric retention in the observation group(8.9% and 8.9%,respectively)was significantly lower than that in the control group(χ^(2)=5.705,8.664,P<0.05).Conclusion Early breast milk microfeeding can significantly improve the growth and development of VLBWI,reduce the incidence of gastrointestinal feeding intolerance,and shorten the length of hospital stay.

关 键 词：极低出生体重儿 早期微量喂养 母乳 生长发育 

分 类 号：R722.6[医药卫生—儿科]