摘要
目的探讨早期初乳口腔内滴注对极低出生体重早产儿喂养管理的影响。方法 42例出生体重<1500 g、胎龄<34周的早产儿,随机分成干预组与对照组,每组21例。对照组早产儿给予母乳胃肠内营养,干预组在对照组的基础上使用初乳口腔滴注,观察并比较两组早产儿喂养不耐受发生情况、喂养不耐受症状消失时间及喂养中断、新生儿坏死性小肠结肠炎(NEC)发生情况,比较两组早产儿喂养情况[恢复至出生体重时间、体重开始增长时间、全肠内营养时间、全肠外营养(TPN)时间、住院时间、院外母乳喂养情况]。结果干预组喂养不耐受发生率19.05%低于对照组的71.43%,喂养不耐受症状消失时间(1.75±0.48)d短于对照组的(5.25±1.03)d,喂养中断发生率0低于对照组的23.81%,差异均具有统计学意义(P<0.05)。对照组中发生NEC 1例(4.76%),干预组中无NEC发生,比较差异无统计学意义(P>0.05)。干预组恢复至出生体重时间、体重开始增长时间、全肠内营养时间、TPN时间、住院时间均短于对照组,院外母乳喂养率高于对照组,差异均具有统计学意义(P<0.05)。结论早期初乳口腔内滴注可减少极低出生体重早产儿喂养不耐受的发生、降低喂养中断发生率,能更好地建立全肠内营养,并且能使此类早产儿在住院期间和出院后持续获得母乳喂养。
Objective To discuss the effect of early oropharyngeal colostrum administration on feeding management of very low birth weight premature infants. Methods A total of 42 premature infants with birth weight <1500 g and gestational age <34 weeks were randomly divided into intervention group and control group, with 21 cases in each group. The control group received breast milk for enteral nutrition, and the intervention group received oropharyngeal colostrum administration on the basis of the control group. Observation and comparison were made on occurrence of feeding intolerance, symptom disappearance time, feeding interruptions, neonatal necrotizing enterocolitis (NEC), feeding condition[ time to regain birth weight, time to start weight gain, time to total enteral nutrition, total parenteral nutrition (TPN) time, hospitalization time, number of out-ofhospital breastfeeding] between the two groups. Results The intervention group had lower incidence of feeding intolerance as 19.05% than 71.43% in the control group, shorter disappearance time of feeding intolerance symptom (gastric retention and abdominal distension) as (1.75±0.48) d than (5.25±1.03) d in the control group, and lower incidence of feeding interruptions as 0 than 23.81% in the control group. Their difference was statistically significant (P<0.05). There was 1 case of NEC in control group and 0 case in intervention group, and the difference was not statistically significant (P>0.05). The intervention group had shorter time to regain birth weight, time to start weight gain, time to total enteral nutrition, TPN time, hospitalization time than those of the control group, and higher rate of out-of-hospital breastfeeding than that of the control group. Their difference was statistically significant (P<0.05). Conclusion Early colostrum administration can reduce the incidence of feeding intolerance and feeding interruptions in very low birth weight premature infants, better establish total enteral nutrition, and enable such premature infants to continue breastfeeding during hospitalization and after discharge.
作者
巫雪芬
李晓玲
陈咏鸽
刘志娟
WU Xue-fen;LI Xiao-ling;CHEN Yong-ge(Department of Neonatology, Yingde People’s Hospital, Yingde 513000, China)
出处
《中国现代药物应用》
2019年第15期9-11,共3页
Chinese Journal of Modern Drug Application
关键词
极低出生体重早产儿
初乳滴注
喂养管理
Very low birth weight premature infants
Colostrum administration
Feeding management