早产极低出生体质量儿早期微量喂养

目的为探讨早产儿的早期营养管理,采用微量喂养方法,研究其对早产极低出生体质量儿生长发育及其并发症发生的影响。方法76例早产极低出生体质量儿,均不能完全经口哺喂,无任何疾病。其中对照组36例采用常规管饲和(或)完全静脉营养。观察组40例在常规处理、对症支持治疗、静脉营养的基础上加用微量喂养,观察体质量变化、达足量喂养时间、喂养不耐受发生率、呼吸暂停发生率、胃肠排空便秘发生率、低血糖、高胆红素血征、坏死性小肠结肠炎发生率。结果观察组低血糖12例次,对照组13例次,2组比较无显著性差异(P>0.05),在恢复出生体质量时间、达足量喂养时间及喂养不耐受、呼吸暂停、便秘、坏死性小肠结肠炎的发生率和高胆红素血症等方面,观察组与对照组比较均有显著性差异(P<0.05)。结论早期微量喂养可以有效促进早产极低出生体质量儿的胃肠发育及功能成熟,减少并发症的发生,早期喂养,缓慢加奶,谨慎禁食在早产极低出生体质量儿早期管理中具有重要意义。

Clinical study on early minimal feeding of premature infants with very low weight

Objective To explore early nutrition management of premature infants with very low weight and to study the effect of development and the appearance rate of associated complicance.Methods Seventy-six cases of premature with very low weight,who all couldn't be feed by mouth and were no any ills.Thirty-six cases in control group were given routine tube feed and total intravenous nutrition.Based on routine treatment,supporting therapy and intravenous nutrition,forty cases in observational group were given minimal feeding.Then to observe the changes of weight,time of reaching enough feeding,and the incidence of intolerance feeding,apnea,consipitision,hypoglycemia,hyperbilirubinemia and necrotizing enterocolitis.Results There was no significant difference in incidence of hypoglycemia between control group(13 cases)and observed group(12 cases)(P>0.05).There were significant difference in time of reaching normal weight and time of reaching enough feeding,and there were also significant difference in the incidence of intolerance feeding,apnea,consipitision,hyperbilirubinemia and necrotizing enterocolitis between two groups(P<0.05).Conclusion it may improve gastrointestinal development functional mature of premature infant with very low weight and reduce associated complicance.Early minimal feeding,increasing milk slowly and no-food caution play an important role in early management of very low weight infant.