非营养性吸吮在早产儿胃食管返流中的临床应用

目的观察非营养性吸吮治疗早产儿胃食管返流的疗效，评估对胃食管返流早产儿血胃泌素、胃动素及胃排空的影响。方法将早产儿胃食管返流患儿145例随机分为治疗组（74例）和对照组（71例），两组均根据体重和出生日龄计算热卡，用同一种配方乳喂养，喂养不足的部分给予静脉营养补足，治疗组加用非营养性吸吮（NNS）。通过食管复方泛影葡胺（compound meglumine diatrizoate）造影，观察患儿7～14d后呕吐症状及食管复方泛影葡胺造影返流情况，记录胃残留率的变化，同时放免法测定血胃泌素、胃动素水平，实时超声测定胃排空。结果治疗组7d，14d胃残留发生率低于对照组，差异有统计学意义（P〈0．05）；胃半排空时间短于对照组，差异有统计学意义（P〈0．01）；胃泌素水平高于对照组，差异有统计学意义（P〈0．05）。两组早产儿7d，14d胃动素水平无差异（P〉0．05）。结论NNS治疗早产儿胃食管返流疗效显著、安全、有效，可促进胃泌素分泌，加快胃排空，有利于早产儿生后胃肠功能的发育，值得临床推广应用。

Clinical Study of Non-Nutrition Sucking on Gastroesophageal Reflux in Premature Infants

Objective To evaluate the non-nutrition sucking（NSS） effecton gastroesophageal reflux and plasma gastrin,motilin levels and gastric emptying in premature infants. Methods The 145 cases gastroesophageal reflux premature infants were randomly divided into study group （74 cases ） and control group （71 cases）, receiving the same feeding pattern ,only in the study group NSS were employed. According to the esophageal compound megluminediatrizoate visualization results,to evaluate the NSS effect after 7 -14 Ireatment;at the same time, the plasma gastrin, motilin level were measured by radioimmunoassay,gastric emptying were measured by ultrasonic in live. Results Compared with control group,in study group, the gastric residue were significantly reduced（ P 〈 0.05） , the gastric half-emptying time were significantly faster（ P 〈0.01 ） ,the plasma gastrin level were significantly higher（ P 〈0.05） ,but no diference in motilin level （ P 〉 0.05 ） , after 7 - 14 days treatment. Conclusions NSS is a safe, effective method to premature infants gastroesophageal reflux,which can stimulate the gastrin secretion,promote the gastric emptying,has great clinical value.