口咽初乳滴注对早产儿喂养不耐受的影响探究

Effects of oropharyngeal administration of colostrum on feeding intolerance in preterm infants

目的探究口咽初乳滴注对新生儿ICU早产儿喂养不耐受情况的影响。方法选取2016年12月至2017年12月入住温州医科大学附属第二医院新生儿ICU的87例患儿为研究对象。采用随机数字表法将87例患儿分为对照组46例和试验组41例。试验组用初乳进行口咽滴注,每次滴注量为0.4 ml,3次/d,持续5 d。对照组用无菌注射用水进行口咽滴注,评估2组肠内营养早期(第1~14天)胃潴留量、次数、呕吐次数和肠内营养进程。结果对照组早产儿在开始肠内营养后的第8、11、12天的胃潴留量分别为8.5(0,18.25)、0(0,13.50)、2.5(0,5.00)ml,试验组分别为0(0,9.00)、0(0,1.00)、0(0,2.50)ml,2组比较差异有统计学意义(t值为-2.001、-1.987、-2.061,P<0.05)。对照组在第8天和第11天胃潴留次数分别为1.5(0,4.0)、0(0,2.0)次,试验组分别为0(0,1.0)、0(0,0.5)次,2组比较差异有统计学意义(t值为-1.984、-2.267,P<0.05)。对照组在第10天和第12天呕吐次数分别为0(0,1.0)、0(0,1.0)次,试验组为0(0,0.0)、0(0,0.0)次,2组比较差异有统计学意义(t值为-3.149、-2.098,P<0.01或0.05)。试验组达全胃肠道营养时间为(17.45±10.44)d,对照组为(21.62±5.52)d,2组比较差异有统计学意义(t值为-2.022,P<0.05)。结论口咽初乳滴注能改善早产儿胃潴留和呕吐状况,缓解喂养不耐受,帮助其尽早实现全胃肠道营养。

Objective To evaluate the effects of oropharyngeal administration of colostrum on feeding intolerance in preterm infants.Methods A total of 87 preterm infants from December 2016 to December 2017 in the Second Affiliated Hospital of Wenzhou Medical University were distributed to the study group(41 cases)and the control group(46 cases)by random digits table method.The study group got oropharyngeal administration of 0.4 ml of own mother’s colostrum three times a day for 5 days.The control group got sterile water.The research data included early gastric residual volumes(the first to fourteenth day),gastric residual times and feeding status.Results The gastric residual volumes on the eighth day,the eleventh day,the twelfth day were 8.5(0,18.25),0(0,13.50),2.5(0,5.00)ml in the control group and 0(0,9.00),0(0,1.00),0(0,2.50)ml in the study group,the differences were statistically significant(t values were-2.001,-1.987,-2.061,all P<0.05).The gastric residual times on the eighth day,the eleventh day were 1.5(0,4.0),0(0,2.0)times in the control group,and 0(0,1.0),0(0,0.5)times in the study group,the differences were statistically significant(t values were-1.984,-2.267,all P<0.05).The vomiting times on the tenth day,the twelfth day were 0(0,1.0),0(0,1.0)times in the control group and 0(0,0.0),0(0,0.0)times in the study group,the differences were statistically significant(t values were-3.149,-2.098,P<0.01 or 0.05).The time reaching full enteral feeding was(17.45±10.44)d in the study group,and(21.62±5.52)d in the control group,the difference was statistically significant(t value was-2.022,P<0.05).Conclusions Oropharyngeal administration of colostrum can better the condition of feeding intolerance.