母乳喂养在早产儿坏死性小肠结肠炎中的预防作用

Preventive Effect of Breast-feeding on Necrotizing Enterocolitis in Premature Infants

目的分析母乳喂养在早产儿坏死性小肠结肠炎预防中预防作用分析。方法2016年1月—2021年10月期间选取扬州大学医学院附属连云港市妇幼保健院坏死性小肠结肠炎早产儿62例,依照喂养方式不同分为对照组与观察组,各31例。对照组实施配方奶喂养,观察组实施母乳喂养,对比两组早产儿干预前、干预1个月后生长发育情况、肠道菌群情况,干预2、3、4周坏死性小肠结肠炎发生率。结果干预前,对照组与观察组早产儿体质量(1.74±0.32)kg vs(1.78±0.30)kg、身长(40.21±3.12)cm vs(41.01±2.98)cm、头围(26.89±2.12)cm vs(27.01±2.14)cm等生长发育情况对比,差异无统计学意义(t=0.508、1.032、0.222,P>0.05);干预1个月后,观察组体质量(3.22±0.30)kg、身长(56.99±3.10)cm、头围(38.78±2.80)cm优于对照组(2.35±0.26)kg、(50.43±3.02)cm、(34.67±2.78)cm,差异有统计学意义(t=12.202、8.439、5.800,P<0.05)。干预前,对照组与观察组细菌总数(103.00±13.00)×10^(3)/L vs(103.00±14.00)×10^(3)/L、杆菌总数(91.00±9.00)×10^(3)/L vs(90.00±10.00)×10^(3)/L、球菌总数(12.00±2.00)×10^(3)/L vs(12.00±3.00)×10^(3)/L对比,差异无统计学意义(t=0.000、0.414、0.000,P>0.05);干预1个月后,观察组肠道菌群情况[(253.00±11.00)×10^(3)/L、(237.00±12.00)×10^(3)/L、(16.00±1.00)×10^(3)/L]均优于对照组[(192.00±10.00)×10^(3)/L、(177.00±11.00)×10^(3)/L、(14.00±1.00)×10^(3)/L],差异有统计学意义(t=22.846、20.522、7.874,P<0.05)。干预2、3、4周后,观察组坏死性小肠结肠炎发生率(6.45%、3.23%、0.00%)明显低于对照组(32.26%、29.03%、25.81%),差异有统计学意义(χ2=6.613、7.630、7.032,P<0.05)。结论对早产儿采用母乳喂养,可有效预防/降低坏死性小肠结肠炎发生风险,改善患儿生长发育情况与肠道菌群。

Objective To analyze the preventive effect of breastfeeding in the prevention of necrotizing enterocolitis in premature infants.Methods 62 premature infants with necrotizing enterocolitis from January 2016 to October 2021 in Lianyungang Maternal and Child Health Care Hospital were selected and divided into control group and observation group according to different feeding methods,with 31 cases in each group.The control group implemented formula feeding and the observation group implemented breastfeeding.The growth and development,intestinal flora and the incidence of necrotizing enterocolitis at 2,3 and 4 weeks of intervention were compared between the two groups before and after 1 month of intervention.Results Before the intervention,the growth and development of premature infants in the control and observation groups were compared in terms of weight(1.74±0.32)kg vs(1.78±0.30)kg,length(40.21±3.12)cm vs(41.01±2.98)cm,and head circumference(26.89±2.12)cm vs(27.01±2.14)cm,the difference was not statistically significant(t=0.508,1.032,0.222,P>0.05);after 1 month of intervention,the growth and development of the observation group weight(3.22±0.30)kg,length(56.99±3.10)cm,head circumference(38.78±2.80)cm were better than that of the control group(2.35±0.26)kg,(50.43±3.02)cm,(34.67±2.78)cm,the difference was statistically significant(t=12.202,8.439,5.800,P<0.05).Before intervention,total bacterial count(103.00±13.00)×10^(3)/L vs(103.00±14.00)×10^(3)/L,total bacilli(91.00±9.00)×10^(3)/L vs(90.00±10.00)×10^(3)/L,and total cocci(12.00±2.00)×10^(3)/L vs(12.00±3.00)×10^(3)/L in the control group compared with the observation group,the difference was not statistically significant(t=0.000,0.414,0.000,P>0.05);after 1 month of intervention,the intestinal flora profile of the observation group[(253.00±11.00)×10^(3)/L,(237.00±12.00)×10^(3)/L,(16.00±1.00)×10^(3)/L]were better than that of the control group[(192.00±10.00)×10^(3)/L,(177.00±11.00)×10^(3)/L,(14.00±1.00)×10^(3)/L],the difference was statistically significant(t=22.846,20.522,7.874,P<0.05).After 2,3 and 4 weeks of intervention,the incidence of necrotizing enterocolitis was significantly lower in the observation group(6.45%,3.23%,0.00%)than in the control group(32.26%,29.03%,25.81%),the difference was statistically significant(χ^(2)=6.613,7.630,7.032,P<0.05).Conclusion Breastfeeding of preterm infants can effectively prevent/reduce the risk of necrotizing enterocolitis rotizing small bowel colitis and improve the growth and intestinal flora of the children.