极低出生体重儿胃肠喂养不耐受的相关因素研究

目的研究极低出生体重儿(VLBWI)胃肠喂养不耐受的相关因素,总结有利于胃肠喂养成熟的因素。方法对新生儿监护室收治的极低出生体重且痊愈出院的33例婴儿的喂养相关因素和体重增长等情况进行调查。分为喂养不耐受和耐受两组,分析喂养不耐受的相关因素;并根据开始胃肠喂养时间的早晚分为早胃肠喂养组和晚胃肠喂养组,比较两组胃肠喂养的不耐受率及其他相关指标。结果33例极低出生体重儿胃肠喂养总的不耐受率为48%(16/33)。胃肠喂养耐受和不耐受组患儿的胎龄、出生体重、开奶日龄、胃肠道营养达418.4kJ·kg-1·d-1的日龄、开始经口喂养日龄及氨茶碱的使用率间差别均有显著性意义(P<0.05)。结论VLBWI的胃肠喂养不耐受率与患儿的胎龄、出生体重、开奶日龄等因素密切相关。早期微量喂养、缓慢加奶、谨慎禁食,可促进胃肠功能成熟,提高喂养耐受性。

The Relative Factors about Enteral Trophic Intolerance in Very Low Birth Weight Infants

Objective To study the enteral feeding intolerance in very low birth weight infants(VLBWI) and summarize the beneficial factors of improving gut motility and maturation.Methods The study was carried out on 33 VLBWI,who were divided into feeding tolerance and intolerance groups.A comparison was made between the two groups about the associate factors.According to the beginning of enteral feeding time,the infants were divided into sooner or later enteral feeding.The intolerance rate of enteral feeding and other related signs of the two groups were compared.Results The incidence of enteral feeding intolerance was 48 percent in the 33 VLBWI.There was a significant difference in the clinical factors (gestational age,birth weight,the age of the first feeding,the time of full enteral feeding,the time of the first feed through mouth and theophylline therapy) betneen two groups(P<0.05).Conclusion The enteral feeding intolerance rate is close related with the clinical factors (gestational age,birth weight,the age of the first feeding,et al) in VLBWI.The early trophic feeding,slow volume increase and careful fast,are suggested to improve the feeding tolerance and gastrointestinal maturation.