极低出生体重儿胃肠喂养中的不耐受性相关因素

The enteral feeding intolerance in very low birthweight infants

目的总结极低出生体重儿(VLBWI)胃肠喂养不耐受的相关因素、探讨有利于喂养成熟的要点。方法对新生儿监护室收治的极低出生体重并痊愈出院的48例婴儿进行喂养相关因素和体重增长情况调查。分为喂养不耐受或耐受两组,分析喂养不耐受的相关危险因素。结果喂养不耐受的发生率为56%(27/48)。喂养耐受和不耐受两组的胎龄、出生体重、开奶日龄、达足量喂养日龄及住院天数差异有显著意义。胎龄小、脐插管、应用氨茶碱及开始胃肠喂养日龄晚是喂养不耐受的显著相关危险因素。结论如果VLBWI的生命体征平稳,在出生6d内应尽可能早地开始胃肠道喂养或非营养性吸吮。早期微量喂养、缓慢加奶、谨慎禁食、促进排便,有利于促进喂养耐受性。

Objective To investigate the enteral feeding in very low birth weight infants(VLBWI),to determine the risk factors associated with feeding intolerance,and to analysis the beneficial factors in order to improve gut motility and maturation.Methods The study was carried out in 48 VLBWI,they were devided into feeding tolerance and intolerance groups.Comparison was made between the two groups about the associate factors.Results The incidence of feeding intolerance was 56 per cent.There was a significant difference in the two groups about the clinical factors(gestational age,birth weight,the age of the first feeding,time of full enteral feeding and the hospitalized days).The significant risk factors associated with feeding intolerance were gestational age,umbilical catheterization,theophylline therapy,and delay of the time when the first feed commenced.Conclusion If vital signs are stable,trophic feeding in VLBWI should be commenced as soon as possible during the first 6 days of life.Early trophic feeding,slow volume increase,careful fast,and moving bowel are suggested and will improve the feeding tolerance and gastrointestinal maturation.