低出生体重儿不同喂养方法时血清视黄醇结合蛋白的变化

CHANGES OF SERUM RETINOL-BINDING PROTEIN BETWEEN INTERMITTENT NASOGASTRIC AND INTERMITTENT NASODUODENAL FEEDINGS IN LOW BIRTH-WEIGHT INFANTS

为评估低出生体重儿生后早期间断鼻胃管喂养和鼻十二指肠喂养的效果 ,将 40例低出生体重儿 (出生体重 1 0 50～ 1 92 0g)随机分为间断鼻胃管喂养组和鼻十二指肠喂养组 ,两组出生体重、性别、胎龄无显著差异 (P >0 0 5)。用同一种配方乳喂养 ,记录入液量、热能、蛋白质摄入量、大便性状及喂养相关并发症 ,喂养前和喂养后 1周用ELISA法测血清视黄醇结合蛋白。结果显示 ,喂养后 1周鼻十二指肠喂养组较鼻胃管喂养组奶量、热能、蛋白质摄入量均显著增加 (P <0 0 0 1 ) ;肠道营养热能达 1 0 0kcal (kg·d)的时间、恢复出生体重时间均明显缩短 (P <0 0 5)。前者较后者血清视黄醇结合蛋白明显增加 (P <0 0 5)。两组均无腹泻、十二指肠穿孔、坏死性小肠结肠炎发生 ,鼻十二指肠喂养组较鼻胃管喂养组吸入性肺炎、高胆红素血症的发生显著减少 (P <0 0 1 )。提示低出生体重儿生后早期鼻十二指肠喂养优于鼻胃管喂养。

To compare and evaluate the effects of intermittent nasogastric feeding (INGF) with intermittent nasoduodenal feedings (INDF) on nutrient intake, Changes of serum retinol-binding protein, feeding-related complications in low birth-weight infants (LBWls). Using 40 LBWls (birth-weight 1 050 g to 1 920 g) were randomizedly assigned into INGF or INDF and fed with the same milk formula. There was no significant difference between the two groups in the components of gender, gestation, and birth-weight(P>0.05). Recorded intake of liquid (including intravenous and oral), caloric intake, protein intake, stool characters, and feeding related complications; Serum retinol-binding protein (RBP) was detected by ELISA before feeding and by the end of the first week of initial feeding. Results showed milk input, the calories and protein supplied by milk by the end of the first week in the INDF was significantly higher than these in INGF(P<0.001). In INDF the time of reaching the level 100 kcal/kg.d from enteral feeding and the time of birth-weight regain were significantly shorter than those in INGF (P<0.05). Serum levels of RBP were significantly higher than in INGF (P<0.05). Except the morbidity of both pneumonia caused by aspiration and hyperbilirubinemia in INDF were significantly less than in INGF (P<0.01). There was no complications such as diarrhea, duodenal perforation, and necrotizing enterocolitis in the two groups. Therefore nasoduodenal feedings is a better tolerable way while initial feeding of low birth-weight infants than nasogastric feeding.