非营养性吸吮在极低出生体重儿中的临床应用

目的 探讨非营养性吸吮（NNS）在极低出生体重儿（VLBWI）中的应用效果.方法 对2011年6月～2013年6月在儿科NICU住院的98例VLBWI患儿,根据随机数字表分为研究组和对照组各49例,研究组联合鼻胃管喂养和NNS,对照组仅用鼻胃管喂养,比较两组患儿喂养、喂养不耐受、生长发育情况与胃肠功能及血生化指标.结果 研究组患儿较对照组胎粪排尽时间、黄疸消退时间、胃管留置时间、达到全胃肠营养时间均明显短,腹胀、胃潴留、呼吸暂停及心动过缓等喂养不对受情况明显少（喂养情况）,体重增加明显快,恢复出生体重及体重到2000g时间明显短（生长发育情况）,Mot、Gas水平明显高,TBIL水平明显低,ALB水平明显高（血生化指标）,差异均有统计学意义（P＜0.05）.结论 在VLBWI鼻胃管喂养中,联合NNS安全有效,可明显改善喂养不耐受情况,促进生长及胃肠功能发育,且无相关肝功能损伤.

Clinical research of care of non-nutritive sucking in very low birth weight infant

Objective To observe the application effect of non-nutritive sucking in very low birth weight infant care.Methods The clinical materials of 98 very low birth weight infants were reviewed and analyzed.They could be divided into two groups by the table of random number.The exercise group （n =49） was in combination of nasogastric tube feeding and non-nutritive sucking and the control group （n=49） was in nasogastric tube feeding.The feeding,feeding intolerance,growth and development,gastrointestinal function and blood biochemical index were observed.Results The exercise group＇s waiting time of meconium,jaundice time,gastric tube indwelling time and time to total parenteral nutrition were obviously shorter than the control group.The feeding intolerance （abdominal distension,gastric retention,apnea,bradycardia） of exercise group was obviously less than that of the control group.The weight gain of exercise group was significantly faster than that of the control group.The recovery of birth weight and weight to the 2000g time of exercise group was significantly shorter than that of the control group.The levels of Mot and Gas of exercise group were significantly higher than that of the control group.The level of TBIL of exercise group was significantly lower that of the control group,and the level of ALB of exercise group was significantly higher that of the control group.Conclusion In the nasogastric tube feeding of very low birth weight infant,combined with non-nutritive sucking is safe and effective.It can improve feeding intolerance,promote the growth and development of gastrointestinal function,and has no damage to liver function.