极低出生体重儿不同喂养方式的临床分析

目的 探讨不同喂养方式对极低出生体重儿的喂养耐受性及喂养效果的优劣性.方法 将45例极低出生体重儿随机分为两组,A组:23例,间歇经口管饲+非营养性吸吮,B组:22例,经口喂养;两组起始奶量均从10～20mL·kg-1·d-1、从每3小时喂1次开始,每次持续时间为10～15分钟,每天增加20mL/kg.所有的极低出生体重儿均同时进行部分静脉营养,直至达到完全肠道内营养.比较两组极低出生体重儿的喂养耐受、胃食道返流、乳汁吸入性肺炎的发生率以及达到完全肠道喂养的时间.结果 A组胃食道返流、乳汁吸入性肺炎发生率较B组低(χ2=3.74,P=0.04;χ2=5.14,P=0.02),达到完全肠道营养时间短(t=6.41,P=0.00).喂养不耐受的发生率两组间比较无显著性差异(χ2=0.25,P=0.40).结论 极低出生体重儿采用间歇经口管饲+非营养性吸吮有利于其生长发育和胃肠功能的完善.

A clinical analysis of different feeding patterns for very low birth weight infants

Objective To investigate feeding tolerances and effects of different feeding patterns for very low birth weight infants. Methods 45 very low birth weight infants were randomly divided into two groups: group A and group B. 23 infants in group A were given intermittent per os tube feeding+non-nutrition sucking (NNS) and 22 infants in group B were given per os feeding. At beginning, milk intake started from 10~20 mL/Kg per day and once per 3 hours for all infants. The feeding persisting time was 10~15 min. Thereafter, the milk intake increased by 20mL. All the infants were also given partly parenteral nutrition to meet the caloric needs till complete enteral nutrition. The incidence rates of feeding intolerance, gastroesophageal reflux, milk aspiratory pneumonia and time to reach full enteral nutrition in the two groups were compared. Results The incidence rates of gastroesophageal reflux (χ2=3.74,P=0.04), milk aspiratory pneumonia (χ2=5.14,P=0.02) of infants in group A were lower than those in group B, the differences were statistically significant. And the time to reach complete enteral nutrition in group A was shorter than that in group B (t=6.41,P=0.00). There was no statistically difference in incidence rate of feeding intolerance between the two groups (χ2=0.25,P=0.40). Conclusion Intermittent per os tube feeding+NNS is contributive to growth and development of the very low birth weight infants and perfect of their gastrointestinal functions.