初乳口腔免疫疗法对早产儿的影响分析

Effects of colostrum oral immunotherapy on premature infants

目的为解决早产儿喂养难题,评估初乳口腔免疫疗法对早产儿喂养、胃肠激素和神经发育的影响。方法选取2021-03-12-2023-03-12郑州市妇幼保健院早产儿90例,按照随机数字表法分组,对照组45例给予袋鼠式护理,观察组45例在对照组基础上联合初乳口腔免疫疗法。记录并对比2组早产儿首次经口喂养时间、完全经口喂养时间,计算喂养效率;于干预前和干预30 d后,采集2组早产儿静脉血2 mL,温室内静置1 h,3000 r/min离心15 min,取上层血清,采用放射免疫法测定血清胃泌素(GAS)、胃蛋白酶原(PG)水平;采用新生儿行为神经测定评分(NBNA)评估早产儿神经发育情况;记录并发症情况。采用SPSS 23.0对数据进行统计学分析。计数资料用n(%)表示,采用χ^(2)校验;等级资料采用秩和检验,计量资料采用X±S表示,数据分析采用单因素协方差分析。检验水准α=0.05(双尾)。结果观察组干预后,首次经口喂养时间为(5.15±0.59)d,短于对照组(6.23±0.65)d,差异有统计学意义,t=8.253,P<0.001;全经口喂养时间为(9.56±0.98)d,短于对照组(11.25±1.39)d,差异有统计学意义,t=6.666,P<0.001;喂养效率为(10.09±1.26)mL/min,高于对照组(8.52±0.86)mL/min,差异有统计学意义,t=6.904,P<0.001;GAS水平为(240.23±8.67)ng/L,高于对照组(235.64±9.55)ng/L,差异有统计学意义,F=2.387,P=0.019;PG水平为(38.33±4.36)μg/L,高于对照组(35.49±4.62)μg/L,差异有统计学意义,F=2.999,P=0.004;一般状态评分为(5.37±0.50)分,高于对照组(5.07±0.46)分,差异有统计学意义,F=2.962,P=0.004;原始反射评分为(5.41±0.44)分,高于对照组(5.09±0.49)分,差异有统计学意义,F=3.260,P=0.002;主动肌张力评分为(7.36±0.50)分,高于对照组(7.01±0.63)分,差异有统计学意义,F=2.919,P=0.005;被动肌张力评分为(7.40±0.51)分,高于对照组(6.93±0.68)分,差异有统计学意义,F=3.709,P<0.001;行为能力评分为(11.13±0.75)分,高于对照组(10.12±1.01)分,差异有统计学意义,F=5.386,P<0.001。2组早产儿并发症发生率比较,差异无统计学意义,χ^(2)=0.090,P=0.764。结论初乳口腔免疫疗法对早产儿效果确切,能够有效改善早产儿喂养情况,调节胃肠激素水平,促进神经发育,安全性高。

Objective To address the feeding challenges of preterm infants,the objective of this study was to evaluate the effects of colostrum oral immunotherapy on feeding,gastrointestinal hormones,and neurodevelopment of preterm infants.Methods A total of 90 premature infants were selected from Zhengzhou Maternal and Child Health Hospital from March12,2021,to March 12,2023,and divided into groups according to random number table method.Forty-five cases in the control group were given kangaroo nursing,and 45 cases in the observation group were given colostrum oral immunotherapy on the basis of the control group.The first and complete oral feeding time of the two groups was recorded and compared,and the feeding efficiency was calculated.Before intervention and 30 days after intervention,2 mL of venous blood was collected from 2 groups of preterm infants,kept in the greenhouse for 1 h,centrifuged at 3000 r/min for 15 min,upper serum was taken,and serum gastrin(GAS)and pepsinogen(PG)levels were determined by radioimmunoassay.Neonatal behavioral neuroassay score(NBNA)was used to evaluate the neurodevelopment of preterm infants.Complications were recorded.Statistical analysis was performed using SPSS 23.0.Count data were expressed as n(%),and chi-square tests were used.Rank data were analyzed with the rank sum test,and continuous data were expressed as mean±standard deviation,and univariate covariance analysis was used for data analysis.Test levelα=0.05(two-tailed).Results After intervention,the first feeding time of observation group was(5.15±0.59)d,which was shorter than that of control group(6.23±0.65)d,and the difference was statistically significant(t=8.253,P<0.001).After intervention,the total feeding time of the observation group was(9.56±0.98)d,which was shorter than that of the control group(11.25±1.39)d,and the difference was statistically significant(t=6.666,P<0.001).After intervention,the feeding efficiency of the observation group was(10.09±1.26)ml/min,which was higher than that of the control group(8.52±0.86)ml/min,with statistical significance(t=6.904,P<0.001).After intervention,GAS level in observation group was(240.23±8.67)ng/L,higher than that in control group(235.64±9.55)ng/L,the difference was statistically significant(F=2.387,P=0.019).After intervention,the PG level in the observation group was(38.33±4.36)μg/L,higher than that in the control group(35.49±4.62)μg/L,the difference was statistically significant(F=2.999,P=0.004).After intervention,the general status score of the observation group was(5.37±0.50)points,higher than that of the control group(5.07±0.46)points,and the difference was statistically significant(F=2.962,P=0.004),After intervention,the original reflex score of the observation group was(5.41±0.44)points,higher than that of the control group(5.09±0.49)points,and the difference was statistically significant(F=3.260,P=0.002).After intervention,the score of active muscle tension in the observation group was(7.36±0.50)points,higher than that in the control group(7.01±0.63)points,and the difference was statistically significant(F=2.919,P=0.005).After intervention,the score of passive muscle tension in the observation group was(7.40±0.51)points,higher than that in the control group(6.93±0.68)points,and the difference was statistically significant(F=3.709,P<0.001).After intervention,the behavioral ability score of the observation group was(11.13±0.75)points,higher than that of the control group(10.12±1.01)points,and the difference was statistically significant(F=5.386,P<0.001).There was no significant difference in the incidence of complications between the two groups(χ^(2)=0.090,P=0.764).Conclusion Colostrum oral immunotherapy has a definite effect on premature infants,can effectively improve the feeding condition of premature infants,regulate the level of gastrointestinal hormones,promote neurodevelopment,and has high safety.