医学-学士学位论文-早产儿喂养不耐受的相关因素.docVIP

早产儿喂养不耐受的相关因素 分析与护理探讨 摘 要 近年来随着围产医学技术的迅速发展，早产儿存活率逐渐提高，其中。良好的护理质量是提高早产儿成活的关键护理干预能诱发早产儿胃肠激素的分泌促进消化道动力，提高早产儿喂养耐受性，促进早产儿的生长 早产儿；喂养；不耐受；护理 ABSTRACT In recent years, with the rapid development of inland medical technology, the livability of premature infants increases gradually. Therefore, the feeding has become the important problem of the popular concern. Premature infants have special dissection, physical characteristics, nutriments demands and metabolism of their own. So how to increasingly mature and perfect their stomach and intestine’s function, avoid feeding intolerance, satisfy their special demands for nutriments, reduce the complications and promote the physical and mental development is still one of the major problems of research and exploration at present at home and abroad. This thesis introduces the current judgment standards and related factors of premature infants’ feeding intolerance and summarizes the related nursing measures: high-quality nursing is the key to increase the survival of premature infants and early nursing intervention can induce premature infants’ excretion of stomach and intestine’ hormone, increase their alimentary canal drive and feeding tolerance and promote the growth of premature infants. Key Words Premature infants；Feeding；Intolerance；Nursing 早产儿喂养不耐受的相关因素分析与护理探讨 早产儿又称未成熟儿，指胎龄＜37周（259d）的新生儿[1]。喂养不耐受是早产儿最常见的喂养问题，也称喂养困难，是一个由多种不同胃肠道症状组成的症状性诊断。若出现下列情况之一，可考虑喂养不耐受呕吐腹胀（24h 腹围增加1.5cm ，伴有肠型）； 胃残余超过上次喂养量的1/3或持续喂养时超过 1h 的量；胃残被胆汁污染；大便潜血阳性；大便稀薄，还原物质超过2（乳糖吸收不良）；呼吸暂停和心动过缓的发生明显增加奶量不增或减少，出生前，营养素的来源完全依赖母体输送出生后必须通过自己的胃肠道摄取，但早产儿的胃肠动力的发育可能还暂时不能适应这一转变。妊娠25～30周的早产儿肠蠕动的幅度较低，无规则节律、压力杂乱；妊娠35周才会形成能推进食物的复合波群，并且这种波群是随胎龄的增加而增加的。早期经口喂养可促进胃肠机能的启动、激素的形成、消化酶的分泌临床实践证明，肠蠕动开始和胎粪排出是开始喂养的指征离开母体环境发生突然变化选用母乳可以减轻早产儿的喂养不耐受对一般情况好无并发症的极低体重儿最好生后4小时开奶，低出生体重儿开奶时间根据个体情况早开奶，有宫内窘迫，窒息的早产儿禁食13天后开奶，禁食的早产儿生后24小时可静脉补充爱米特，72小时补充脂肪乳，以保证热卡的提供。开奶的奶液为母乳或早产儿配方奶，开奶量为23ml/次，每2小时1次。发生喂养不耐受（呕吐、腹胀、胃内咖啡色液等）立即停喂。早产儿容易出现低体温，体温易随环境温度变化而变化，适中的环境温度能使早产儿维持理想的体温，早产儿室的温度一般应保持在24～26℃，相对温度在55%～65%。并