早产儿喂养不耐受临床研究及治疗策略.docVIP

早产儿喂养不耐受临床研究及治疗策略[摘要]目的：针对早产儿喂养不耐受问题，探讨治疗早产儿喂养困难的方法。方法：将120例早产儿分成ABCD组，A组为常量早期喂养+非常营养性吸吮；B组微量早期喂养+非营养性吸吮；C组为微量早期喂养+非营养性吸吮+温盐水与开塞露灌肠；D组在C组基础上+多潘立酮。结果：发现C组与A组比较有显著性差异P＜0.05；D组与B组比较有显著差异P＜0.01。结论：早产儿早期小剂量喂养，结合非营养性吸吮，温盐水与开塞露灌肠加多潘立酮口服能减少喂养不耐受问题，拔除胃管时间早加奶顺利，静脉营养时间短. [关键词]早产儿；喂养不耐受；早期微量喂养；灌肠；多潘立酮 [Abstracts]PurposeTo do the examination aimed at the the problem of prematures feeding intolerance, probe into the methods of curing the premature’s feeding problem. Methods:Divide the 120 cases of premature into ABCD group. A group is carried out constant forepart feeding and unnutritional absorbing; B group is carried out minim forepart feeding and unnutritional absorbing; C group is carried out minim forepart feeding, unnutritional absorbing and clyster using brine and enema; D group is carried out the method of C and plus domperidone.Then found the results that there was more distinct differnces compared with A group and C group, P＜0.05; And there was more distinct differnces compared with D group and B group, P＜0.01. Conclusion: Premature forepart feeding in little dosage, combine with unnutritional absorbing, clyster using warm brine and enema and plus Domperidone, can greatly minish the problem of feeding untolerance, and can remove the stomach tube earlier, smoothing the procedure of feeding milk; The time for vena nutrition is short. [Keyword]PrematureFeeding Untolerance Forepart Minim Feeding Unnutritional Absorbing ClysterDomperidone 随着现代围产医学和新生儿急救医学的不断发展，越来越多的早产儿被成功能地救活，早产儿的存活率逐渐提高。早产儿能活下来，需经过五关六将，如呼吸关、感染关、喂养关等等。由于早产儿的消化系统的器官功能不成熟，喂养不耐受是广大新生儿科医生天天碰到的问题，许多新生儿专家做了大量研究如早期小剂量喂养、非营养性吸吮、小剂量红霉素等等。本文拟对120例早产儿进行不同喂养方式的探究，以发现更适合早产儿的喂养方 式，减少早产儿喂养不耐受症状，尽早拔除胃管，缩短静脉营养和住院时间。现将结果报告如下：” 一、研究对象： 我院自2003年5月至2010年5月收治的早产儿，胎龄30～34w，体重1.0～1.9kg，男75例，女45例，所有患儿均为我院产科分娩后1小时内转入。将其分成4组： A组：常量24小时内喂养+非营养性吸吮； B组：微量24小时内喂养+非营养性吸吮； C组：微量24小时内喂养+非营养性吸吮+温盐水与开塞露灌肠； D组：微量24小时内喂养+非营养性吸吮+温盐水与开塞露灌肠+多潘立酮口服。 4组在性别、胎龄、体重方面大体一致，所有病例均除外围生因素、溶血因素、感染因素、无影响生长发育的先天性遗传性代谢病、先心、胃肠道先