早产极低出生体重儿早期滴服喂养的临床研究

Clinical study on early drip feeding in premature and very low birth weight infant

目的观察早期滴服喂养对早产极低出生体重儿的喂养效果及其相关并发症的发生情况,探讨其临床应用价值。方法 2006年6月至2008年12月滨州医学院附属医院新生儿科收治的早产极低出生体重儿45例,分为观察组(早期滴服喂养组)23例,对照组(早期鼻胃管喂养组)22例。观察奶量增加速度、体重增长速度、经奶头喂养时间、达全口喂养时间、恢复出生体重时间、胎粪完全排出时间、累计光疗时间、住院时间及其相关并发症的发生情况。结果与对照组比较,观察组体重增长速度快(P<0.05),奶量增加速度明显加快(P<0.01),经奶头喂养时间、达全口喂养时间、恢复出生体重时间、胎粪完全排出时间、累计光疗时间及住院时间明显缩短(P<0.01)。吸入性肺炎、胃出血及口腔炎的发生率减少(P<0.05),呼吸暂停、呕吐及腹胀的发生率明显降低(P<0.01)。结论早期滴服喂养能较快提高胃肠道喂养的耐受性、缩短病程、减少并发症,值得临床推广应用。

Objective To observe the effect of early drip feeding and the occurrence of its correlated complications in premature and very low birth weight infants,and study its clinical application value. Methods From June 2006 to December 2008 at the Affiliated Hospital of Binzhou Medical College Hospital ,45 cases of very low birth weight babies in premature infants were randomly divided into two groups. Twenty-three cases with early drip feeding were included in study group and 22 cases with early nasogastric tube feeding in control group. Milk amount increasing speed, body weight increasing speed, the time of beginning oral feeding,total enteral feeding, recovery time of birth weight, completely meconium excretion time, all acumulative phototherapy time, hospital stay time and correlated complications were compared between the two groups. Results Compared with the control group, body weight increased faster in study group （P 〈 0.05）,and milk amount obviously increased more in study group （P 〈 0.01）.The time of beginning oral feeding, the time of total enteral feeding,recovery time of birth weight,completely meconium excretion time, all acumulative phototherapy time and hospitalization period were obviously shorter in study group than in control group（P 〈 0.01）.The incidence rates of aspirated pneumonia,gastric hemorrhage and stomatitis in study group decreased compared with control group（P 〈 0.05）.The incidence rates of apnoea,emesia and abdominal distension in study group obviously reduced compared with control group（P 〈 0.01）. Conclusion Early drip feedling can quickly boost the survivability of enteral feeding in premature very low birth weight infant, shorten the clinical course and reduce the occurrence of clinically complications. It is worthy of clinically application and extension.