两种母乳低温保存方式在低出生体质量早产儿喂养中的应用  

Two different methods of cryopreservation of breast milk effects and application on feeding of low birth weight preterm infants

作　　者：韩玉珠 顾瓅[1] 刘洋[1] 张凡[1] 王学谦[1] 王婧 周慧 HAN Yuzhu;GU Li;LIU Yang;ZHANG Fan;WANG Xueqian;WANG Jing;ZHOU Hui(Department of Paediatrics,Affiliated Maternity and Child Health Care Hospital of Nantong University,Jiangsu 226018)

机构地区：[1]南通大学附属妇幼保健院儿科,江苏226018

出　　处：《南通大学学报（医学版）》2024年第2期136-140,共5页Journal of Nantong University(Medical sciences)

基　　金：南通市卫健委面上项目(MS2022073);南通大学临床基础研究专项基金项目(2019JQ014)。

摘　　要：目的:比较冷藏的新鲜母乳和冷冻母乳对低出生体质量早产儿(low birth weight infant,LBWI)喂养的影响。方法:以286例LBWI为研究对象,按家属意愿分为观察组142例,予冷藏的新鲜母乳(0~4℃,保存24 h)喂养;对照组144例,予冷冻母乳(-20~-18℃,保存3~6个月)喂养。患儿入院后即开始干预,喂养1周后,比较两组喂养不耐受的发生率、经口喂养率、全经口喂养开始时间、肠道菌群的变化,及新生儿坏死性小肠结肠炎(necrotizing enterocolitis of newborn,NEC)、院内感染等发生率。结果:观察组第8天经口喂养率高于对照组(P=0.002),喂养不耐受的发生率低于对照组(P<0.001),肠道菌群的建立优于对照组(P=0.041);观察组出院前全经口喂养开始时间较对照组提前(P<0.001),喂养不耐受和院内感染的发生率均低于对照组(P=0.041,P=0.046)。而两组新生儿坏死性小肠结肠炎、胆汁淤积症和支气管肺发育不良的发生率差异均无统计学意义(均P>0.05)。结论:与冷冻母乳相比,冷藏的新鲜母乳能提高LBWI经口喂养率,使全经口喂养开始时间提前,降低喂养不耐受和院内感染的发生率,优化肠道菌群的建立。本研究结果在一定程度上验证了新鲜母乳冷藏对LBWI干预的有效性和可行性。Objective:To compare the effects of cold storage of fresh breast milk and frozen breast milk on feeding of premature infants with low birth weight infant(LBWI).Methods:286 children with LBWI were divided into observation group(n=142)and control group(n=144)according to their families′wishes.One week after admission,the observation group was fed with chilled fresh breast milk(0-4℃,stored for less than 24 hours).The control group was fed with frozen breast milk(-20--18℃,preserved for 3-6 months).The incidence of neonatal necrotizing enterocolitis of newborn(NEC),cholestasis and bronchopulmonary dysplasia were not significantly different between the two groups(P>0.05).Results:On the 8th day,the rate of oral feeding in the observation group has higher than that in the control group(P=0.002),and the incidence of feeding intolerance in the observation group was lower than in the control group,and the differences were statistically significant(P<0.001).The establishment of intestinal flora in the observation group on day 8 was better than that in the control group,and the difference was statistically significant(P=0.041).The observation group started full oral feeding before discharge earlier than the control group,the difference was statistically significant(P<0.001).The incidence of feeding intolerance and nosocomial infection before discharge in the observation group were lower than those in the control group,with statistical significance(P=0.041,P=0.046).There was no significant difference in the incidence of necrotizing enterocolitis,cholestasis and bronchopulmonary dysplasia between the two groups(P>0.05).Conclusion:Compared with frozen breast milk,cold storage of fresh breast milk can increase the rate of low birth weight premature infants fed through the mouth,make the whole through the mouth feeding started ahead of time,reduce the incidence of feeding intolerance and nosocomial infection.The results of this study to a certain extent verified the effectiveness and feasibility of fresh breast milk refriger

关 键 词：低出生体质量早产儿 母乳 低温保存 

分 类 号：R722.6[医药卫生—儿科]