不同营养方式对早产儿生长和胃肠激素水平的影响

lnfluence of different nutrition ways to growth and gastrointestinal hormone in premature infants

目的研究早产儿早期不同的营养方式对出院时体重（宫外发育迟缓）和胃肠激素的影响。方法采用临床对照研究的方法，选择2011年1月-2014年12月入住宝鸡市第二人民医院新生儿重症监护室的早产儿共106例，随机分为观察组和对照组，观察组采用早期胃肠内外营养，微量喂养代替禁食，管饲的同时采取非营养性吸吮。对照组采取晚喂养，喂养不耐受时禁食，喂养过程中未采取非营养性吸吮。监测体重等生长发育指标和生后2d内、7～9d、13～15d血清胃动素和胃泌素水平。结果1）观察组患儿体重开始增长时间、达全肠道喂养时间及恢复出生体重时间均较对照组缩短[（7．28士6．25）比（10．8±5．07）d，（11．16±4．32）比（18．43±9．72）d，（8．21±3．72）d比（13．84±5．46）d]，住院天数较对照组短（16．82士2．2）d比（19．91±2．3）d，宫外发育迟缓发生率较对照组低（40．30％比65．38％），生后2d内及7～9d胃动素水平高于对照组[（348．6±177．6）pg／mL比（246．3±95．6）pg／mL，（492．3±235．8）pg／mL比（342．2±141．5）pg／mL]，13～15d胃泌素水平高于对照组[（75．2±12．9）pg／mL比（58．9±16．5）pg／mL]，差异均有统计学意义（P均〈0．05）。2）体重增长速度和生后2d内及7～9d测得的胃泌素水平差异均无统计学意义（P〉0．05）。结论早期实施胃肠内外营养可有效降低宫外生长迟缓的发生率。

Objective To study the effects of different nutrition on preterm childreffs weight （extrauterine growth re- tardation,EUGR） and gastrointestinal hormone. Methods Using the methods of control study clinical,a total of 106 pre- mature children who stay in Baoji Second People＇s hospital NICU from January 2011 to December 2014, were selected and randomly divided into observation group and control group,the observation group received enteral and parenteral nutrition, micro-feeding instead of fasting, tube feeding while taking non-nutritive sucking, the control group received evening feeding, fasting during feeding intolerance,feeding process without non-nutritive sucking. The weight and other growth indicators, the serum motilin and gastrin levels of 2 d,7～9 d,13-15 d after birth were monitored. Results 1）The increase time of weight, time reaching full enteral feeding and recovery time of birth weight of observation group were shorterE （7.28±6.25） d to（10.8±5.07）d,（11. 16±4.32）d to（18.43±9.72）d, （8.21±3.72）d to （13.84±5.46）d],the days in hospital was shorter（16.82±2.2）d to （19.91±2.3）d,and the rate of extrauterine growth retardation was lower（40.30% to 65.38%）, motilin levels of the babies who birth 2 d and 7～9 d were higherP（348.6±177.6）pg/mL to（246.3±95.6）pg/mL,（492.3 ±235.8）pg/mL to（342.2±141.5）pg/mL],gastrin levels of birth 13～15 d was higher[-（75.2±12.9） pg/rnL to（58.9± 16.5） pg/mL], differences were statistically significant （P〈0.05）. 2） The differences of growth rate, and the gastrin levels of birth 2 d and 7～9 d had no statistically significant （P〉0.05）. Conclusion Implementation of enteral and parenteral nutrition can effectively reduce incidence of extrauterine growth retardation.