酚妥拉明联合四磨汤治疗早产儿喂养不耐受43例效果观察

Effect of phentolamine and Simo Decoction on feeding intolerance in 43 premature infants

目的探讨酚妥拉明微量泵维持泵注联合四磨汤口服液治疗早产儿喂养不耐受（feeding intolerance，FI）的效果和安全性。方法84例FI早产儿随机分为观察组43例和对照组41例，对照组给予常规综合治疗；观察组在对照组治疗基础上给予酚妥拉明1．8～2．4mg／kg＋质量分数5％葡萄糖注射液50mL，2．5mL／h持续微量泵注，并给予四磨汤口服液1．0～1．5mL／kg，1次／8h。比较2组FI症状、体征消失时间，恢复出生体质量、达足量胃肠喂养时间及住院时间，以及药物不良反应发生情况。结果观察组呕吐消失时间E（2．92±1．32）d]、胃潴留消失时间E（3．53±1.36）d]、恢复出生体质量时间[（8．72±1．35）d]、达足量胃肠喂养时间[（13．37±1．93）d3、住院时间[（17．80±3．51）d]均较对照组[（3．83±2．45）、（4．28±1．43）、（9．83±1．47）、（15．28±1．88）、（19．76±3．86）d]短，差异均有统计学意义（P〈0．05）；观察组无酚妥拉明、四磨汤口服液相关药物不良反应发生。结论酚妥拉明微量泵维持联合四磨汤口服液治疗早产儿FI可缩短症状消失及住院时间，尽早达到全胃肠喂养，且无不良反应。

Objective To observe the effect and safety of micropump infusion of phentolamine and oral administration of Simo Decoction on feeding intolerance in premature infants. Methods Eighty-one premature infants with feeding intolerance were randomly divided into observation group （n=43） and control group （n±41）. Control group received routine treatment, besides which observation group received micropump of 1.8 to 2.4 mg/kg phentolamine in 50 mL glucose injection at a speed of 2.5 mL/h combined with oral administration of 1.0 to 1.5 mL/kg Simo Decoction once per 8 h. The disappearance time of signs and symptoms, the time of body mass regaining to birth mass, the time to get sufficient amount of enteral feeding, hospitalization stay, and adverse reactions were observed and compared between two groups. Results The disappearing time of vomiting （（2.92±1.32） d）, gastric retention （（3.53±1.36） d）, the time of body bass regaining birth mass （（8. 72 ± 1.35） d）, the time to get sufficient enteral feeding （（13. 37 ± 1.93） d） and hospitalization stay （（17. 80 ± 1. 36） d） in observation group were significantly shorter than those in control group （（3.83±2.45）, （4.28±1.43）, （9.83±1. 47）, （15.28±1.88）, （19.76±3.86） d） （P〈0.05）. No phentolamine or oral simotang related adverse reactions occurred in observation group. Conclusion The micropump infusion of phentolamine combined with oral administration of Simo Decoction can shorten the disappearing time of symptoms and hospitalization stay, and realize sufficient enteral feeding faster, with no adverse reactions.