微生态制剂在新生儿窒息后喂养不耐受的应用及其对胃动素的影响

Probiotics application on feeding intolerance after asphyxia of newborn and influence of plasma motilin

目的探讨微生态制剂治疗新生儿窒息后喂养不耐受的疗效及其对胃动素(MOT)的影响。方法选择2009年9月～2012年8月华北石油总医院收治的窒息后喂养不耐受患儿58例,随机分成双歧杆菌治疗组和全胃肠外营养对照组,每组各29例,两组患儿均给予常规洗胃及防治感染,维持水、电解质平衡,静脉营养、对症支持治疗,双歧杆菌治疗组在此基础上口服或经鼻饲微生态制剂双歧杆菌;观察两组患儿呕吐、腹胀症状消失时间、恢复至出生体重时间、达全胃肠喂养时间,监测患儿血浆MOT的变化。结果双歧杆菌治疗组呕吐、腹胀症状消失时间[(3.03±1.14)d]优于全胃肠外营养对照组[(4.65±1.11)d],差异有统计学意义(P<0.05);双歧杆菌治疗组恢复出生体质量时间[(7.68±1.73)d]优于全胃肠外营养对照组[(9.72±2.78)d],差异有统计学意义(P<0.05);双歧杆菌治疗组达全量肠内营养时间[(9.03±1.84)d]优于全胃肠外营养对照[(10.79±2.19)d],差异均有统计学意义(P<0.05)。双歧杆菌治疗组总有效率(93.11%)显著高于全胃肠外营养对照组(72.41%),差异有统计学意义(P<0.05)。治疗后3 d双歧杆菌治疗组血MOT水平[(259.20±23.35)ng/L]高于全胃肠外营养对照组血MOT水平[(221.37±18.51)ng/L],治疗后4 d治疗组血MOT水平[(324.72±14.53)ng/L]高于对照组血浆MOT水平[(298.10±15.55)ng/L],差异均有统计学意义(均P<0.05)。结论新生儿窒息喂养不耐受后,采用微生态制剂恢复微生态平衡,缩短全胃肠喂营养时间,同时对胃肠道激索分泌水平恢复正常起到促进作用,值得临床推广。

Objective To study the curative effect of probiotics on feeding intolerance after asphyxia of newborn and influence of plasma motilin （MOT）. Methods 58 cases of feeding intolerance after asphyxia of newborn from September 2009 to August 2012 in North China Petroleum General Hospital were selected and randomly divided into Bifidobacterium treatment group and total parenteral nutrition control group with 29 cases in each group. Routine gastric lavage and^infection control, maintenance of water, electrolyte balance, parenteral nutrition, symptomatic and supportive therapy were all given to the two groups, the treatment group was treated with oral or nasal feeding probiotics Bifidobacterium. Vomiting, abdominal distension symptoms disappear time, back to the time of birth weight, total enteral nutrition time, changes of plasma MOT were observed in the two groups. Results Vomiting, abdominal distension symptoms disappear time in Bifidobacterium treatment group [（3.03±1.14） d] was better than that in total parenteral nutrition control group [（4.65±1,11） d], the difference was statistically significant （P 〈 0.05）; back to the time of birth weight in Bifidobacterium treatment group [（7.68±1.73） d] was better than that in total parenteral nutrition control group [（9.72± 2.78） d], the difference was statistically significant （P 〈 0.05）; total enteral nutrition time in Bifidobacterium treatment group [（9.03±1.84） d] was better than that in total parenteral nutrition control group [（10.79±2.19） d], the difference was statistically significant （P 〈 0.05）. Total effective rate in Bifidobacterium treatment group （93.11%） was higher than that in total parenteral nutrition control group （72.41%）, difference was statistically significant （P 〈 0.05）. The MOT level of Bifidobacterium treatment group [（259.20±23.35） ng/L] 3 days after treatment was higher than that of total parenteral nutrition control group [（221.37±18.51） ng/L], the difference was statistically significant （P 〈 0.05 ）; the MOT level of Bifidobacterium treatment group [（324.72±14.53） ng/L] 4 days after treatment was higher than that of total parenteral nutrition control group [（298.10±15.55） ng/L], the difference was statistically significant （P 〈 0.05 ）. Conclusion Probiotics can restore the ecological balance, reduce total parenteral feeding time for newborn of feeding intolerance after asphyxia, it also can promote the gastrointestinal shock cord secretion level back to normal, it is worthy of clinical promotion.