早期不同喂养方式对危重新生儿胃肠功能的影响

Effect of early different feeeding patterns on gastrointestinal function of critically ill neonates

目的探究早期不同喂养方式对危重新生儿胃肠功能的影响。方法选取106例危重新生儿为研究对象,按照随机数字表法分为观察组和对照组,每组各53例。观察组采用早期微量喂养,于出生后6~12 h内开奶,奶量从0.4~4.0 ml·kg^(-1)·d^(-1)开始,对照组则采用晚期常规喂养,于出生后48~72 h内或病情平稳后开奶,奶量从10~20 ml·kg^(-1)·d^(-1)开始;比较两组的胃动素、胃泌素、监测资料以及临床症状。结果观察组静脉营养时间、恢复出生体重时间、达全肠道喂养时间和住院时间均显著低于对照组(P<0.05);观察组黄疸、喂养不耐受的发生率均显著低于对照组(P<0.05);观察组出生后第2天及第9天的胃动素水平均显著高于对照组(P<0.05),且出生后第15天的胃泌素水平也显著高于对照组(P<0.05);观察组出生后第9天、第15天的胃动素及出生后第15天胃泌素水平,相比第2天均有所上升,且均高于同期对照组,差异均有统计学意义(P<0.05)。结论早期微量喂养能够有效促进危重新生儿胃肠功能的成熟,提高其喂养耐受性,同时减少并发症发生。

Objective To explore the effect of early different feeding patterns on gastrointestinal function of critically ill neonates.Methods A total of 106 critically ill neonates were selected and divided into observation group and control group according to random number table,53 neonates in each group.The neonates in observation group were fed within 6- 12 hours after birth according to early minimal feeding pattern,the amount of milk started from 0.4-4.0 ml·kg^-1·d^-1 the neonates in control group were fed within 48-72 hours after birth or the condition was steady,the amount of milk started from 10-20 ml·kg^-1·d^-1The levels of motilin,gastrin,monitoring data and clinical symptoms in the two groups were compared.Results The time of intravenous nutrition,the time of recovery of birth weight,the time achieving full enteral feeding and hospitalization time in observation group were statistically significantly shorter than those in control group（ P〈0.05）; the incidence rates of jaundice and feeding intolerance in observation group were statistically significantly lower than those in control group（ P〈0.05）; the levels of motilin on the second day and the ninth day after birth in observation group were statistically significantly higher than those in control group（ P〈0.05）,the level of gastrin on the fifteenth day after birth in observation group were statistically significantly higher than that in control group（ P〈0.05）; the levels of motilin on the ninth day and the fifteenth day after birth and the level of gastrin on the fifteenth day after birth in observation group were statistically significantly higher than those on the second day after birth（ P〈0.05）,which were also statistically significantly higher than those in control group（ P〈0.05）.Conclusion Early minimal feeding can effectively promote the maturity of gastrointestinal function of critically ill neonates,improve feeding tolerance,and reduce the incidence rate of complications.