胃肠动力药物联合微生态制剂防治早产儿喂养不耐受的疗效观察

Effects of gastrointestinal motility drug combined with microecology on preventing feeding intolerance in premature infants

目的:评价胃肠动力药物联合微生态制剂防治早产儿喂养不耐受的临床疗效。方法:将448例早产儿分为A组(常规组)104例、B组(微生态制剂组)173例、C组(微生态制剂+胃肠动力药物组)171例。A组患儿予常规护理和治疗,B组在A组的基础上于出生6 h内开始口服(或经胃管)微生态制剂酪酸梭菌-婴儿型双歧杆菌二联活菌散剂,每次0.5 g,每天2次。C组在B组治疗基础上加用胃肠动力药物莫沙必利,每次0.2 mg/kg,每天3次。观察和记录3组早产儿喂养不耐受发生率、出生后体质量下降幅度、恢复至出生体质量时间、达到全胃肠喂养时间、体质量增长速度及住院时间等情况。结果:B组和C组喂养不耐受发生率均低于A组(P<0.01),喂养不耐受持续时间均短于A组(P<0.01),出生后体质量下降幅度均低于A组(P<0.01),恢复至出生体质量时间、达到全胃肠喂养时间和住院时间均短于A组(P<0.05～P<0.01),体质量增长速度均大于A组(P<0.01);C组与B组喂养不耐受发生率差异无统计学意义(P>0.05),C组喂养不耐受持续时间、恢复至出生体质量时间、达到全胃肠喂养时间和住院时间均短于B组(P<0.05～P<0.01),体质量下降幅度低于B组(P<0.01),体质量增长速度大于B组(P<0.01)。胃肠动力药物及微生态制剂应用过程中均未见不良反应。结论:胃肠动力药物联合微生态制剂可有效防治早产儿喂养不耐受,较单一使用微生态制剂效果更好,可促进早产儿早期生长发育,缩短达到全胃肠喂养的时间。

Objective： To evaluate the clinical effects of gastrointestinal motility drug combined with microecology on preventing feeding intolerance in premature infants. Methods： Four hundred and forty-eight premature infants were divided into group A （ the conventional group, 104 cases）, group B （the microecological group, 173 cases） and group C （the microecological and gastrointestinal motility group,171 cases）. Group A were treated with routine nursing and therapy. Based on group A, group B were treated with microecological agent（ duplex live bacteria powder of clostridium butyricum and infant bifidobacterium） for 0.5 g twice a day by oral or stomach tube within 6 hours after birth. Based on group B, Mosapride（ gastrointestinal motility drug） was given to group C for O. 2 mg/ kg three times a day. The incidence of feeding intolerance, decreasing degree of body weight, time of returning to birth weight, reaching full gastrointestinal feeding and hospital stay, and weight growth speed in three groups were investigated. Results：Compared with group A, the incidence of feeding intolerance, duration of feeding intolerance, body weight decreasing extent, time of reaching the birth body weight,full enteral feeding and hospital stay were less in group B and C,their weight growth speed were greater（P 〈0.05 to 0.01 ）. There was no statistically significant difference in the incidence of feeding intolerance between group C and B（ P 〉 O. 05 ）. The time of duration of feeding intolerance, returning to birth weight and full gastrointestinal feeding and hospital stay in group C were shorter than those in group B （P 〈 0.05 to 0.01 ）. The body weight decreasing extent and weight growth speed in group C were lower and more than those in group B,respectively（P 〈 0.01 ）. No adverse reactions were observed in the application process of gastrointestinal motility drug and microecology. Conclusions ： Gastrointestinal motility drug combined with microecology can effectively prevent the feeding intolerance of premature infants, the effect is better than singly microecological agent, and can promote the early growth of premature infants and shorten the time of reaching full enteral feeding.