论文部分内容阅读
目的 反复呼吸暂停和心率减慢是超出生体重儿 (ELBWI)特别是有患有慢性肺部疾病的ELBWI的常见问题。胃食道返流是反复呼吸暂停和心动过缓的诱因。本研究的目的是评价持续经幽门喂养对不能耐受胃管喂养的超低出生体重儿的治疗意义 ,并与间歇经胃管喂养作比较。方法 回顾性分析 81例ELBWI的临床资料。分两组 :经幽门喂养 (TP)组 (n =30 )及经胃管喂养组 (IG组 ) (n =4 9)。TP组 :比较TP前 ,与TP期间呼吸暂停及心率减慢的发生情况 ,喂养耐受性 ,营养摄入及体重增长速度 ,并与NG组的患儿做比较。TP组 :患儿TP期间与TP前比较 ,每日呼吸暂停 (0 .6 6次vs 1.6 4次 )及心率减慢次数 (B12 .0 6次vs3.32次、B2 1.6 6次vs 3.18次 )明显减少 (P <0 .0 5 ) ,未再出现呕吐及腹胀 ,在摄入蛋白及能量相似的情况下 ,每日体重增长速度比TP前慢 (13.3±2 .6 g/kgvs 15 .3± 3.9g/kg) (P <0 .0 5 )。TP组在TP期间与IG组蛋白能量摄入和体重增长速度无显著差异。TP组ELBWI均未发生坏死性小肠结肠炎和肠穿孔。结论 对于不能耐受胃管喂养的超低出生体重儿 ,经幽门喂养能显著减少呼吸暂停及心率减慢的发生率及改善喂养的耐受性。
PURPOSE Repeated apnea and slow heart rate are common problems in ELBWI beyond birth weight children (ELBWI), especially those with chronic lung disease. Gastroesophageal reflux is the cause of repeated apnea and bradycardia. The purpose of this study was to evaluate the therapeutic effect of sustained pyloric feeding on very low birth weight infants who can not tolerate gastric tube feeding compared with intermittent transabdominal feeding. Methods The clinical data of 81 cases of ELBWI were retrospectively analyzed. The rats were divided into two groups: fed with pyloric (TP) group (n = 30) and fed with gastric tube (IG group) (n = 49). TP group: Comparison of the occurrence of apnea and heart rate slowdown, feeding tolerance, nutritional intake and body weight growth rate before and during TP was compared with those in NG group. In the TP group, the daily apnea (0.666 vs 1.6.4) and the number of heartbeat slowing (B12.06 vs 3.32, B2 1.6 6 vs 3.18 ) (P <0.05). No vomiting and abdominal distension occurred again. The daily weight gain was slower than that before TP (13.3 ± 2.6 g / kg vs 15) with similar intake of protein and energy. 3 ± 3.9 g / kg) (P <0.05). There was no significant difference in energy intake and body weight gain between group TP and group IG during TP. TP group ELBWI necrotizing enterocolitis and intestinal perforation did not occur. Conclusions For the ultra-low birthweight children who can not tolerate gastric tube feeding, pyloric feeding can significantly reduce the incidence of apnea and heart rate slowdown and improve feeding tolerance.