洗胃及微量喂养对重症新生儿缺氧缺血性脑病胃肠功能紊乱的影响分析

Effect of lavage and micro-quantity feeding on severe gastrointestinal dysfunction in patients with severe hypoxic-ischemic encephalopathy

目的分析洗胃及微量喂养对重症新生儿缺氧缺血性脑病(HIE)胃肠功能紊乱的影响。方法选取本科2012年7月—2014年6月足月重症HIE患儿88例,随机分为实验组和对照组。对照组予以常规喂养及综合护理,实验组入院时予以1%碳酸氢钠洗胃,禁食6 h后,给予微量喂养。对比2组患儿临床状况改善、生长发育指标、不同时间点血清胃泌素水平和胃肠功能紊乱发生率。结果实验组出生后体质量下降幅度、恢复至出生体质量所需时间、达到全胃肠道喂养所需时间和血清总胆红素水平高峰值显著低于对照组,体质量增长速度显著高于对照组(P<0.05)。实验组患儿第7、14天体质量增长和头围增长显著高于对照组(P<0.05)。实验组出生后第1天、第3天和第7天的血清胃泌素水平均显著高于对照组(P<0.05)。实验组胃肠功能紊乱发生率显著低于对照组(P<0.05)。结论对于重症HIE患儿及时予以洗胃和微量喂养可以改善其营养状况,促进新生儿早期发育,避免胃肠道紊乱的发生。

Objective To analyze the impact of gastric lavage and micro-quantity feeding on severe gastrointestinal dysfunction in patients with severe hypoxic-ischemic encephalopathy （HIE）. Methods A total of 88 children with severe HIE in our department from July 2012 to June 2014 were randomly divided into experimental and control groups. The control group received routine feeding and comprehensive care, while the experimental group was given 1% sodium bicarbonate lavage, and mi- cro-quantity feeding after fasting for 6 h. The improved clinical status, growth and development indica- tors, serum gastrin levels and the incidence of gastrointestinal disorders were compared in two groups. Results The body mass declined after birth, the time returning to birth weight, time to full enteral feeding and peak serum total bilirubin level in the experimental group were significantly lower than in the control group, body mass growth rate was significantly higher （ P 〈 0.05 ）. Weight gain and head circumference growth at 7 and 14 days in the experimental group were significantly higher（P 〈0.05）. Serum gastrin levels in experimental group on the first day, the third day and 7 days were significantly higher（ P 〈 0.05 ）. Gastrointestinal dysfunction in experimental group was significantly lower than the control group （ P 〈 0.05 ）. Conclusion For children with severe HIE, timely lavage and micro-quan- tity feeding can improve their nutritional status, promote early neonatal development and avoid the oc- currence of gastrointestinal disorders.