早产儿的早期微量喂养

Early trace feeding for premature infant

目的研究早期微量喂养对早产儿的影响。方法 70例早产儿分为观察组(36例)和对照组(34例)。2组早产儿出生后均用微量输液泵经外周静脉匀速输入配置的营养液,观察组于早产儿出生后24 h内采用配方奶粉经口或鼻饲喂养,对照组于早产儿出生后48 h开始采用配方奶粉喂养。观察2组早产儿喂养耐受情况、恢复至出生体质量的时间以及出生后3 d胆汁酸及胆红素的情况。结果观察组喂养不耐受、坏死性小肠炎、高胆红素血症的发生率明显低于对照组(P<0.05);观察组每日体质量增长速度高于对照组(P<0.05);观察组恢复至出生体质量所需时间短于对照组(P<0.05);观察组胆汁酸和胆红素均值低于对照组(P<0.05)。结论静脉营养支持疗法辅以早期肠内微量喂养可改善早产儿喂养的耐受性,缩短恢复至出生体质量的时间,促进肠蠕动,减少肠肝循环,减轻血清胆红素水平,有利于出生低体质量婴儿的生长发育。

Objective To study the effects of the early trace feeding on premature infants.Methods Seventy cases of premature infants were randomly divided into two groups,with 36 cases as the observation group and 34 cases as the control group.The premature infants in both groups were injected with liquid nutrient formulation via peripheral vein at a constant rate using a minimal infusion pump right after birth.The infants in the observation group were fed with baby diary formula via mouths or noses within 24 hours after birth.In contrast,the babies in the control group were not fed with baby diary formula until 48 hours after birth.The tolerance to feeding,the time took to resume their birth weights,and the serum bile acid and bilirubin concentration about 3 days after birth were examined between the two groups.Results The incidence of feeding intolerance,necrotizing enterocolitis and hyperbilirubinemia were significantly lower in the observation group than those in the control group（P0.05）.The average daily weight gain in the observation group was significantly higher than that in the control group（P0.05）.The average time took to resume their birth weights in the observation group was shorter than that in the control group（P0.05）.The average concentrations of serum bile acid and bilirubin in observation group were significantly lower than those in control group（P0.05）.Conclusion The parenteral nutrition support therapy supplemented with early trace feeding can improve tolerance to feeding,shorten the time that take to resume their birth weights,stimulate gastric movement,reduce the enterohepatic circulation and the serum bilirubin concentration.This method is benefitial for the growth of low birth weight infants and can be recommended in clinic.