非营养性吸吮联合小剂量红霉素对早产儿喂养不耐受的效果观察

目的评估非营养性吸吮（NNS）联合小剂量红霉素对早期预防治疗早产儿喂养不耐受的疗效。方法选择住院喂养不耐受早产儿76例，随机分为治疗组和对照组各36例，对照组给予保温、抗感染、维持水电解质平衡、营养支持和对症治疗，鼻胃管喂养，治疗组在此基础上，给予红霉素3～5mg／kg·d加入10％葡萄糖注射液20ml中静脉滴注，同时在每次喂养前15min给予吸吮未开孔橡皮奶头10min，对吸吮力欠佳者用橡皮奶头缓慢、辐轻地来回刺激口腔，或用手指轻轻刺激口角、口唇，诱发吸吮反射出现。两组疗程均为5—7d。结果治疗组早产儿喂养不耐受的临床症状明显改善，病程、奶量与对照组相比，差异有统计学意义（P〈0．01）。两组患儿体质量增长相近（P〉0．05）。治组患儿用药前后肝功能无变化。结论非营养性吸吮纪合小剂量红霉素治疗新生儿喂养不耐受能提高肠道喂养的成功率，避免完全静脉营养的弊端，安全、实用。

The combination of non-nutritive sucking and low-dose erythromycin in the treatment of feed intolerance in preterm infants

Objective To evaluate effect of the combination of non-nutritive sucking and low-dose erythromycin in the treatment of feed intolerance in preterm infants. Methods76preterm infants with feed intolerance were divided into twos groups randomly.In control group,the patients thermal insulation,antiinfection,the maintenance of water electrolyte balance,nutritional support and symptomatic treatment,tube feeding were used.In treatment group,the patients were given erythromyc intravenously at a dose of 5 mg/kg·d,and at each feeding 15 min before the opening of rubber nipple the patient sucked not less than 10 min,lighted back and forth to stimulate the mouth,or gently with fingers to stimulate the numbness of the mouth,lips,sucking reflex,the duration of treatment was 5~7 days. Results The symptom alleviation and residual milk volume were significantly improved in treatmant group,there were no significant difference in weight gain and liver function between two groups. Conclusion The combination of low dose erythromycin and non nutritive sucking can improve the success rate of enteral feeding and avoid the drawbacks of total parenteral nutrition,it is safe and practical.