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目的通过研究不同方式鼻饲喂养方法对极低出生体重早产儿(VLBW)喂养耐受性及喂养效果,探讨最适合极低出生体重早产儿的鼻饲喂养方式。方法将77例胎龄在29~33周,出生体重在1000~1400g活产极低出生体重儿,男婴38例,女婴39例,随机分为ABC组。A组:间歇鼻饲注入喂养,起始每次奶量2ml/kg,持续时间3~5min,2h1次,每天递增2ml/kg;B组:持续鼻饲输注喂养,使用电子微量输液泵持续鼻饲输注,奶量1ml/(kg.h),持续时间24h,每天递增1ml/(kg.h);C组:间歇持续鼻饲输注喂养,先采用电子输液泵持续鼻饲喂养2h,奶量2ml/(kg.h),间歇2h后,再继续交替进行,每天递增2ml/kg;所有VLBW均同时进行部分外周静脉营养,逐渐过渡到完全肠道内营养,观察3组患儿喂养过程中体重增长,喂养耐受情况以及黄疸持续时间。结果间歇持续鼻饲输注喂养组喂养不耐受例数最少,黄疸持续时间短,达到完全胃肠道营养时间最少。结论极低出生体重早产儿采用间歇持续鼻饲输注喂养,喂养不耐受发生率最低,达到完全胃肠喂养时间最短,有利于极低出生体重儿的生长发育和胃肠功能完善,优于单纯的间歇或持续鼻饲喂养,值得临床推广。
Objective To study the feeding tolerance and feeding effect of different ways of nasal feeding on very low birth weight premature infants (VLBW) and to explore the nasal feeding method most suitable for very low birth weight premature infants. Methods Seventy-seven gestational age at 29-33 weeks, with birth weight of 1000-1400g, very low birth weight children, 38 males and 39 females were randomly assigned to ABC group. Group A: fed with intermittent nasal feeding, the initial milk volume 2ml / kg, duration 3 ~ 5min, 2h1 times, increasing 2ml / kg per day; Group B: continuous feeding nasal feeding, continuous use of electronic micro infusion pump nasal feeding Note: Milk volume 1ml / (kg.h), duration of 24 hours, increasing 1ml / (kg.h) daily; Group C: intermittent continuous nasal feeding, first use of electronic infusion pump feeding nasal feeding 2h, milk 2ml / (kg.h), intermittent 2h, and then continue alternately, increasing 2ml / kg every day; all VLBW at the same time part of the peripheral vein nutrition, gradual transition to complete enteral nutrition, observation of three groups of children during feeding weight gain, Feeding tolerance and duration of jaundice. Results Intermittent continuous nasal feeding infusion group Feeding intolerance at least the number of cases, jaundice duration is short, to achieve the least complete gastrointestinal nutrition time. Conclusions Infants with very low birth weight and infants fed intermittent continuous nasal feeding have the lowest incidence of feeding intolerance and the shortest period of complete gastrointestinal feeding, which is beneficial to the growth and development of gastrointestinal function and the improvement of gastrointestinal function in very low birth weight infants. Intermittent or continuous nasal feeding, it is worth clinical promotion.