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目的探究早期不同喂养方式对危重新生儿胃肠功能的影响。方法选取106例危重新生儿为研究对象,按照随机数字表法分为观察组和对照组,每组各53例。观察组采用早期微量喂养,于出生后6~12 h内开奶,奶量从0.4~4.0 ml·kg~(-1)·d~(-1)开始,对照组则采用晚期常规喂养,于出生后48~72 h内或病情平稳后开奶,奶量从10~20 ml·kg~(-1)·d~(-1)开始;比较两组的胃动素、胃泌素、监测资料以及临床症状。结果观察组静脉营养时间、恢复出生体重时间、达全肠道喂养时间和住院时间均显著低于对照组(P<0.05);观察组黄疸、喂养不耐受的发生率均显著低于对照组(P<0.05);观察组出生后第2天及第9天的胃动素水平均显著高于对照组(P<0.05),且出生后第15天的胃泌素水平也显著高于对照组(P<0.05);观察组出生后第9天、第15天的胃动素及出生后第15天胃泌素水平,相比第2天均有所上升,且均高于同期对照组,差异均有统计学意义(P<0.05)。结论早期微量喂养能够有效促进危重新生儿胃肠功能的成熟,提高其喂养耐受性,同时减少并发症发生。
Objective To explore the effect of early different feeding methods on the gastrointestinal function of critically ill newborns. Methods A total of 106 cases of critically ill newborn infants were selected as the research object and divided into observation group and control group according to random number table method, with 53 cases in each group. In the observation group, early micro-feeding was used to start milk within 6-12 hrs after birth, and the milk volume was started from 0.4-4.0 ml · kg -1 · d -1. In the control group, After 48 ~ 72 hrs after birth or when the disease was stable, the milk amount was started from 10 to 20 ml · kg -1 · d -1. Motilin and gastrin were compared between the two groups Information and clinical symptoms. Results The duration of intravenous nutrition, the time of recovery of birth weight, the time of reaching full intestine feeding and the length of hospital stay in observation group were significantly lower than those in control group (P <0.05). The incidence of jaundice and feeding intolerance in observation group was significantly lower than that in control group (P <0.05). The level of motilin in the second day and the ninth day after birth in the observation group was significantly higher than that in the control group (P <0.05), and the gastrin level on the 15th day after birth was also significantly higher than that of the control (P <0.05). The levels of motilin in the observation group on the 9th and 15th days after birth and the gastrin level on the 15th day after birth in the observation group increased compared with those on the 2nd day, and both were higher than those in the control group , The differences were statistically significant (P <0.05). Conclusion Early micronutrient feeding can effectively promote the maturation of gastrointestinal function in critically ill newborn infants, improve their feeding tolerance and reduce the incidence of complications.