早期微量喂养对新生儿肺透明膜病临床康复的影响

Effect of Early Minimal Feeding on Clinical Rehabilitation in Children with Hyaline Membrane Disease

目的观察早期微量喂养在新生儿肺透明膜病(HMD)治疗中的效果。方法收集2009年1月-2010年12月在本院NICU住院的HMD新生儿的临床喂养情况,分别统计实行早期微量喂养(早期微量喂养组)和常规喂养(常规喂养组)新生儿的一般资料,观察2组患儿达全量胃肠道营养时间、恢复出生体质量时间、胃肠功能紊乱发生率、血胆红素峰值、并发胆汁淤积比例等。采用t检验和χ2检验进行统计学分析。结果常规喂养组56例,早期微量喂养组48例,2组一般资料比较均无统计学差异。在达全量胃肠道营养时间、恢复出生体质量时间、血胆红素峰值、并发胆汁淤积等方面早期微量喂养组明显优于常规喂养组,差异均有统计学意义;2组患儿在住院天数及胃肠功能紊乱、吸入性肺炎、坏死性小肠结肠炎发生率方面差异均无统计学意义。结论新生儿HMD实行早期微量喂养有利于患儿更早地过渡到全量胃肠道喂养,更好地恢复、增长体质量,减少胃肠外营养相关胆汁淤积的发生,无明显不良反应。

Objective To observe the effects of early minimal feeding on neonates with hyaline membrane disease（HMD）. Methods Clinical data of neonates with HMD in NICU from Jan.2009 to Dec.2010 were retrospectively reviewed.In the patients who received early minimal feeding（n=48）,general informations,over the whole volume of enteral nutrition time,time to regain birth weight,incidence of gas-trointestinal disorders,blood bilirubin peak performance ratio with cholestasis were compared to those who received routine practice neonates（n=56）.Data were analyzed with t test and Chi-square test. Results Fifty-six cases of neonates in normal diet group,48 patients in early feedings group,between two groups,neonates had no significant difference of the general information.There were no significant differences in the general information between early minimal feeding and routine practice groups.The amount of enteral nutrition to full time,time to regain birth weight,blood bilirubin peak concurrent aspects of cholestasis in neonates with early feedings were higher than those in routine practice neonates,respectively.There were no differences in the hospital stay time,gastrointestinal disorders,aspiration pneumonia,necrotizing enterocolitis incidence between 2 groups. Conclusion The neonates with HMD benefit the implementation of early feedings over to the full amount feeding by the gastrointestinal tract,better recovery,growth weight,reduce parenteral nutrition associated cholestasis occurred,no side effect.