早产极低体重儿早期喂养及护理体会.docVIP

早产极低体重儿早期喂养及护理体会【摘要】目的：探讨极低出生体重儿早期喂养对疾病恢复的效果。方法：对48例极低出生体重儿进行随机分组,观察组27例,采用早期喂养联合静脉营养;对照组21例,采用静脉高营养。观察2组患儿体重增加及达全胃肠道喂养情况。结果早期喂养患儿体重增加较明显,可缩短静脉营养时间,较快过渡到全胃肠道喂养,缩短住院时间。结论对极低出生体重儿早期喂养安全有效,可大大提高极低出生体重儿的生存率及生命质量,值得推广。 【关键词】极低出生体重儿;静脉高营养;全胃肠道喂养;新生儿 Early Feeding and Nursing for Premature Very Low Birth Weight Infants HAO xianglan LIUFengli 【Abstract】Objective To discuss the effects of early feeding in very low birth weight infants(VLBWI).Methods Forty-eight VLBWI were randomly divided into two groups.Twenty-seven infants were provided with early feeding and intravenous nutrition in the observation group and twenty-one infants with intravenous hyperalimentation(IVH)in the control group.The body weight and full gastrointestinal feeding were compared between two groups.Results The body weight of early feeding infants increased significantly and turned to full gastrointestinal feeding rapidly.The time of intravenous nutrition and in hospital was shortened.Conclusions Early feeding in very low birth weight infants was safety and effective,which could significantly elevated the survival rate and life quality of VLBWI.It was worth to spread in clinical work.. 【Keywords】Very low birth weight infants;Intravenous hyperalimentation;Full gastrointestinal feeding;Newborn infant . 【中图分类号】R452【文献标识码】A【文章编号】1005-0515(2011)02-0004-02 对我院2008年1月~2011年1月收治的48例极低出生体重儿的其中27例进行早期喂养联合静脉营养,取得满意效果,现报道如下。? 1 资料与方法 1.1 临床资料：2008年1月~2011年1月收入我院NICU的48例极低出生体重儿随机分为早期喂养联合静脉营养组27例(观察组)和静脉高营养组21例(对照组)。入院时间均为10min-1d，实验组男18例，女9例，胎龄（30.2±2.5）周，出生体重(1.22±0.12)Kg,Apgar评分≥8分14例，4~7分10例，≤3分3例.对照组男15例，女6例，胎龄（30.4±2.5）周，出生体重（1.24 ±0.11）Kg,Apgar评分≥8分者12例，4~7分者7例，≤3分者2例。两组各项指标比较均无统计学意义（P＞0.05），具有可比性。 1.2 护理方法：对照组患儿采用静脉高营养，其营养液均经周围静脉输入。前3天仅静滴葡萄糖及电解质，3天后开始静脉营养。成分包括葡萄糖、小儿复方氨基酸、20%中长链脂肪乳剂、电解质、多种维生素、白蛋白及血浆等，液体量100~120ml/(kg.d),总热量250.78~334.72KJ/(kg.d),每日总液体量经微量泵控制24小时均匀滴入，至反应好转、能自行吸吮、吞咽反射正常后开始胃肠道喂养。观察组在患儿出生后尽早给予胃肠道营养，选择合适的喂养方法，从小剂量开始，再根据患儿有无呕吐、腹胀、大便等情况，逐步加量至全胃肠道喂养。乳类选择：23例应用母乳，4例无母乳者应用了早