早产低出生体重儿的早期喂养方法和喂养不耐受的相关性

目的探讨不同的早期喂养方法在早产低出生体重儿中的临床应用以及与喂养不耐受性（FI）的相关性，寻找早产低出生体重儿尤其是极低出生体重儿（VLBW）的最合适喂养方法。方法对本院2007年5月-2009年12月期间在新生儿病房住院的早产低出生体重儿150例（VLBW112例）随机进行分组，分别给予早期经口微量喂养、饲管内直接人工推注间断喂养、微量输液泵间断喂养（IBG）、微量输液泵持续喂养（CNG）等四种喂养方法，同时进行部分静脉营养，观察不同组患儿喂养不耐受性及达到完全胃肠道喂养时间（FEF）。结果不同喂养方法中FI发生率差异有统计学意义（P〈0．05）；早期经口微量喂养FI发生率27．8％（VLBW为28％），管饲持续喂养FI发生率24．3％（VLBW为28．1％），均较间断喂养低（P〈0．05）；VLBW中，不同喂养方法达到FEF时间的差异有统计学意义（P〈0．01）；CNG（15．6±2．1）d较IBG（19．8±2．2）d、（18．8±2．0）d达到FEF早（P〈0.01）。结论早期微量喂养可增加喂养耐受性，经口微量喂养发生喂养不耐受低；管饲法中，早产低出生体重儿更耐受CNG喂养，且达到FEF早。

The Relationship between Early Feeding Methods and Feeding Intolerance in Premature and Low Birth Weight Infants

Objective To explore the clinical application of different early feeding method in premature and low birth weight infants and the relationship between feeding intolerance （FI）,looking for the most suitable feeding method for very low birth weight infants （VLBW）. Methods 150 premature and low birth weight infants （VLBW 112 cases） hospitalized in our newborn ward from May 2007 to December 2009,they were randomized into four kinds of feeding groups,including early minimal feeding,intermittent bolus garage （IBG） by artificial pushing or using minipump,and continuous nasogastric gavage （CNG）. All cases received partial parenteral nutrition simultaneously. Observe the FI and the days of reaching full enteral feeding （FEF） in different groups. Resulta There was significant difference in the incidence of FI between four feeding methods （P〈0.05）,the incidence of FI in early minimal feeding group was 27.8%（VLBW 28%）, in CNG group was 24.3%（VLBW 28.1%）,all lower than IBG （P〈0.05）. There was significant difference in reaching FEF between four feeding methods of VLBW（P〈0.01 ）, CNG infants reached FEF （ 15.6 ± 2.1 ）days earlier than IBG （ 19.8 ± 2.2）days,（18.8 ±2.0）days （P〈0.01）. Conclusion Early minimal feeding can increase feeding tolerance,minimal feeding occurs FI lower,the premature and low birth weight infants can tolerate CNG better than IBG and can reach FEF earlier.