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目的探讨早期综合喂养对减少窒息早产儿发生喂养不耐受的可行性和有效性。方法选择2007年6月至2010年6月我院新生儿科收治的窒息早产儿,2008年12月前为常规喂养组(对照组),2009年1月后为早期综合喂养组(干预组)。对照组于生后24～72h出现肠鸣音后常规喂母乳,干预组于生后6～24h予早期微量喂养、非营养性吸吮及腹部抚触,病情稳定后逐步加奶。观察两组患儿喂养不耐受发生情况、恢复出生体重时间、达全量肠内营养时间、拔胃管时间、光疗情况以及住院天数。结果干预组90例,对照组72例。干预组喂养不耐受发生率低于对照组(22.2%比55.6%,P<0.01),恢复出生体重和达全量肠内营养时间明显短于对照组[(9.5±1.8)天比(12.2±2.1)天,(7.7±3.1)天比(11.8±4.1)天,P<0.01],拔胃管时间、光疗时间和住院时间亦短于对照组[(7.4±4.8)天比(10.6±7.9)天,(6.7±3.8)天比(9.6±3.8)天,(21.3±9.7)天比(26.6±10.4)天,P<0.05]。结论早期综合喂养能促进胃肠动力成熟,缩短恢复出生体重和达全量肠内营养的时间,减少喂养不耐受的发生,对窒息早产儿安全有效。
Objective To investigate the feasibility and effectiveness of early comprehensive feeding to reduce intolerance in feeding premature infants with asphyxia. Methods From June 2007 to June 2010, neonatal asphyxia premature infants admitted to our hospital were treated as normal feeding group (control group) before December 2008 and early comprehensive feeding group after January 2009 (intervention group). The control group received routine bowel sounds after 24 to 72 hours of life, and the intervention group received early micronutrient feeding, non-nutritive sucking and abdominal touching 6 to 24 hours after birth, and gradually added milk after the condition was stabilized. Observe the incidence of feeding intolerance in both groups, restoring birth weight time, up to full enteral nutrition time, gastric tube withdrawal time, phototherapy and hospitalization days. Results Intervention group 90 cases, control group 72 cases. The incidence of feeding intolerance in the intervention group was lower than that in the control group (22.2% vs. 55.6%, P <0.01), and the time to recovering birth weight and reaching full enteral nutrition was significantly shorter than that in the control group [(9.5 ± 1.8) days vs (12.2 ± (7.4 ± 4.8) days than the control group (10.6 ± 7.9 days), (7.7 ± 3.1) day (11.8 ± 4.1) days, P <0.01] ) Days, (6.7 ± 3.8) days vs (9.6 ± 3.8) days, (21.3 ± 9.7) days vs. (26.6 ± 10.4) days, P <0.05]. Conclusion Early comprehensive feeding can promote gastrointestinal motility maturation, shorten the time of restoring birth weight and up to total enteral nutrition, reduce the incidence of feeding intolerance, safe and effective for asphyxiated premature babies.