经十二指肠喂养在极低体重儿中的应用探讨

To Study the Effects of Duodenal Feeding on Very Low Birth Weight Infants

目的对极低体重儿采用有效的十二指肠喂养方法，从护理学的角度研究其喂养的最佳方案。方法将32例极低体重儿（VIJRWI）随机分为观察组18例，对照组14例。观察组采用十二指肠喂养，对照组胃内喂养．两组均生后48h内开始喂养，比较两种方法在早产极低体重儿营养支持方面的差异。结果观察组在喂养过程中2例因肺出血分别于生后21h和32h死亡，存活的16例患儿3～4d时体重降至最低点，体重下降幅度占出生体重的3．6％～7．8％，7～9d恢复至出生体重．12d时体重平均增加104g。对照组1例死于重度硬肿症，1例死于肺出血，1例死于呼吸窘迫综合征．存活患儿体重降至最低点时间及体重下降幅度均与观察组相似，体重恢复至出生体重时间为9～11d，12d时体重平均增加59g。平均使用静脉营养液时间较观察组长2～3d。结论采用十二指肠喂养，能够有效地解决极低体重儿生后早期的营养问题．降低并发症。提高存活率和生存质量．

OBJECTIVES To study the effects of duodenal feeding on very low birth weight infants （VLBWI）. METHODS Thirty-two cas- es of VLBWI were randomly divided into two groups： the observing group （duodenal feeding, 18 cases） and the control group （stomach feed- ing, 14 cases）. Feeding for both groups was commenced 48 hours after birth and the different effects of both feeding methods on VLB- WIs were compared. RESULTS Of those cases in the observing group, 16 were survival（two cases died of pulmonary hemorrhage 21 and 32 hours after birth respectively）. Their weights reached the lowest range 3-4 days after birth with weight decreasing by 3.6% to 7.8% of birth weights, returned to birth weights 7 to 9 clays after birth, and gained by average of 104 gram 12 clays after birth. Of the cases in the control group, 11 cases were survival （3 cases died of severe diseases： one died of severe scleroedema, one of pulmonary hemor- rhage and another of respiratory distress syndrome.）. The time for weight to reach the lowest range and the rate of weight loss of these cases were similar to those of the observing group. It took 9 to 11 clays for weight to regain to birth weight, weight increased by an average of 59 grams 12 clays after birth. The average time of the use of intravenous nutrition in the control group was 2 - 3 clays more than in the observing group. CONCLUSIONS Duodenal feeding could increase the nutrition of VLBWIs shortly after birth, reduce medical complications and improve the survival rate as well as their quality of llfe.