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目的探讨早产儿GER/GERD有效治疗手段,改善早产儿整体预后。方法选取210例NICU GER/GERD早产儿分别给予红霉素、吗叮啉、雷尼替丁、奥美拉唑、30°俯卧体位、仰卧平躺体位处理(阴性对照组)并随机分为相应6组各35例,疗程为10 d,观察临床指标。结果红霉素、吗叮啉、雷尼替丁、奥美拉唑、30°俯卧位、仰卧位组GER/GERD患儿各种症状出现的例数:呼吸暂停130例、不安/激惹/烦躁118例、溢奶90例、呕吐/恶心80例;各组症状治疗前与后评分:(3.51±1.34)与(2.91±1.58)分、(3.80±1.64)与(2.63±1.37)分、(3.60±1.17)与(2.60±1.38)分、(3.49±1.56)与(2.49±1.44)分、(3.40±1.44)与(1.46±1.07)分、(3.31±1.43)与(1.20±0.97)分,各组间治疗前比较差异无统计学意义(P>0.05),治疗后比较差异有统计学意义(P<0.01),治疗前、后比较除红霉素组外差异均有统计学意义(P<0.05),各组疗效(痊愈、好转、有效)差异有统计学意义(P<0.01)。观察期间各组脓毒血症、颅内出血、胆汁郁积症等差异均无统计学意义(P>0.05),6组患儿住院天数差异无统计学意义(P>0.05),矫正胎龄6月龄时各组婴儿体重与同月龄婴儿平均体重相比的达标率组间差异无统计学意义(P>0.05)。结论体位治疗较抗反流药物改善GER/GERD效果好,针对该病的治疗手段不能改善其预后。
Objective To explore the effective treatment of GER / GERD in preterm infants and to improve the overall prognosis of preterm infants. Methods 210 cases of NICU GER / GERD preterm infants were given erythromycin, domitidine, ranitidine, omeprazole, 30 ° prone position, supine position (negative control group) and were randomly divided into the corresponding 35 patients in each group were treated with 6 courses of treatment for 10 days. Clinical indexes were observed. Results Erythromycin, domperidone, ranitidine, omeprazole, 30 ° prone position, supine position GER / GERD children with various symptoms of the number of cases: apnea 130 cases, irritability / irritability / Irritability in 118 cases, overflowing milk in 90 cases and vomiting / nausea in 80 cases. Symptoms before and after treatment in each group were (3.51 ± 1.34) and (2.91 ± 1.58), (3.80 ± 1.64) and (2.63 ± 1.37) (3.60 ± 1.17) and (2.60 ± 1.38) points, (3.49 ± 1.56) and (2.49 ± 1.44) points, (3.40 ± 1.44) and (1.46 ± 1.07) points, (3.31 ± 1.43) and (1.20 ± 0.97) There was no significant difference between the three groups before treatment (P> 0.05), but the difference was statistically significant after treatment (P <0.01). There were significant differences between before and after treatment except erythromycin group (P <0.05). The curative effect (recovery, improvement and effective) in each group had significant difference (P <0.01). There were no significant differences in sepsis, intracranial hemorrhage and cholestasis between the two groups during the observation period (P> 0.05). There was no significant difference in the days of hospitalization between the 6 groups (P> 0.05) There was no significant difference between the infants ’weight and infants’ average body weight at the same age (P> 0.05). Conclusion Body position treatment is more effective than anti-reflux drug in improving GER / GERD. The treatment of this disease can not improve its prognosis.