极低出生体重儿十二指肠喂养的应用及效果观察

目的探讨极低出生体重儿（VLBW I）生后早期合理的营养方法。方法 40例极低体重儿（VLBW I）分为对照组和观察组各20例,对照组采用间断鼻胃管喂养,观察组采用间断鼻十二指肠喂养。用同一种配方乳喂养,观察两组患儿喂养1周的进奶量、胃储留、胃食管返流、误吸、呼吸暂停、腹胀、血糖、体重下降幅度、恢复出生体重时间、平均每日体重增长、平均使用静脉营养液的时间。结果观察组患儿2例因肺出血分别于21h和35h放弃治疗,对照组2例因肺出血放弃治疗,1例死于呼吸窘迫综合征,其余患儿喂养后1周鼻十二指肠喂养组较鼻胃管喂养组平均进奶量显著增加（P〈0.001）,体重下降幅度、恢复出生体重时间、每日体重增长、胃储留、胃食管返流、平均使用静脉营养液的时间有统计学意义（P〈0.001）,腹胀发生有统计学意义（P〈0.05）,误吸、呼吸暂停和低血糖发生无统计学意义（P〉0.05）。结论十二指肠喂养为极低出生体重儿生后早期提供了合理肠内营养,减少了并发症。

Effect observation of duodenal feeding on very low birth weight infants

Objective To establish reasonable nutrition-providing approaches so as to deal with very low birth weight infants（VLBWI） at early stage after birth.Methods 40 cases of very low birth weight infants（VLBWI） were divided into control group and study group,20 cases in each group.The infants in control group were given intermittent nasogastric feeding,while those in study group were treated with nasal intermittent duodenal feeding.By using the same formula milk for feeding,the infants＇ parameters were observed including one-week milk volume,stomach retention,gastric reflux,aspiration,apnea,abdominal distension,blood glucose,body weight decrease,time to regain birth weight,average daily weight gain and average parenteral nutrition the time.Results 2 infants in the study group gave up treatment due to pulmonary hemorrhage at 21h and 35h after treatment,2 cases in the control group gave up treatment because of pulmonary hemorrhage,and 1 infant died of respiratory distress syndrome.The other infants through nasoduodenal nasogastric tube feeding in study group significantly increased milk volume 1 week later compared with control group（P0.001）,and the parameters of weight decrease,time to regain birth weight,daily weight gain,stomach storage stay,gastroesophageal reflux and the average time to use parenteral nutrition were significantly different as well（P0.001）,while abdominal distention occurs was different（P0.05）.However,aspiration,apnea,and hypoglycemia were showed no significant difference（P0.05）.Conclusion Duodenal feeding on the very low birth weight infants provides a reasonable early postnatal nutrition and reduces complications.