母乳喂养预防极低出生体重儿坏死性小肠结肠炎作用分析

Effect of Breast Feeding in Prevention of Necrotizing Enterocolitis in Very Low Birth Weight Infants

目的探讨母乳喂养对极低出生体重儿的新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)发生率的影响。方法对2014年1月—2015年11月治疗的120例极低出生体重儿资料进行回顾性分析。根据喂养方式的不同分为观察组和对照组,每组60例。观察组采用人乳喂养,对照组采用配方奶喂养。比较并分析两组NEC发生率及NEC严重程度、喂养不耐受性、住院时间、肝内胆汁淤积症发生率及胃动素和胃泌素水平。结果观察组NEC发生率、BellⅢ期和喂养不耐受比例均明显低于对照组(P<0.05)。两组出生第1、7和14天胃动素和胃泌素水平比较差异无统计学意义(P>0.05)。结论极低出生体重儿早期应用母乳喂养,可有效地降低喂养不耐受性、NEC发生率及其严重程度,且不会对胃动素和胃泌素造成影响。

Objective To investigate effect of breast feeding on incidence rate of neonatal necrotizing enterocoli- tis （NEC） in very low birth weight infants. Methods Clinical data of 120 very low birth weight infants admitted during January 2014 and November 2015 was retrospectively analyzed, and the infants were divided into observation group and control group （n = 60 for each group） according to different feeding methods. Observation group was fed with breast, while control group was fed with formula milk. Incidence rate and severe degree of NEC, feeding intolerance, hospital stay, incidence rate of intrahepatic cholestasis and levels motilin and gastrin were compared and analyzed in two groups. Results Values of incidence rate of NEC and percentages of Bell-Ⅲ period and feeding intolerance in observation group were significantly lower than those in control group （ P 〈 0. 05 ）. There were no significant differences in motilin and gas- trin levels on the 1st, 7,h and 14th d after birth between the two groups （P 〉 0. 05）. Conclusion Early breast feeding for very low birth weight infants can effectively reduce incidence rates of feeding intolerance and NEC , and severe degree of NEC, and it can not affect motilin and gastrin levels.