早期微量喂养对危重症新生儿胃肠道动力的影响

Effect of Early Minimal Feeding on Neonatal Gastrointestinal Motility

摘要:

目的 在接受机械通气的新生儿中进行早期微量喂养 ,观察其对新生儿胃肠道动力的影响。方法 收集 1998年 9月至 1999年 2月间 ,机械通气的 13例患儿 ,分早期喂养组 (6例 )和常规喂养组 (7例 )。早期微量喂养组平均在生后 2 .5d开始开奶 (每 2小时 2ml/kg) ,常规喂养组为生后13 .6d ,两组均在生后第 3天开始静脉营养。当两组患儿病情稳定后 ,进行放射性核素胃食管显像和血胃泌素、胃动素测定。结果 早期微量喂养组的胃排空率 (32 .6± 12 .2 ) %快于常规喂养组 (16 .0± 5 .5 ) %、到达全量肠内营养时间为 (17.5± 8.0 )d对 (34.9± 17.7)d以及拔胃管时间 (12 .2± 8.3)d对 (31± 11.2 )d均明显缩短 (P <0 .0 5 ) ,但两组在反流指数、血胃泌素、胃动素水平、恢复出生体重时间以及住院天数等方面差异不明显。结论 早期微量喂养能促进胃肠动力成熟 ,缩短到达全量肠内营养的时间并早日建立经口喂养 ,减少喂养困难的发生。

Abstract:

Objective To study the effect of early minimal feeding on neonatal gastrointestinal motility. Methods Thirteen critically ill neonates who needed mechanical ventilation were enrolled in this study between September, 1998 and February, 1999. The infants were devided into two groups, one of which received early minimal enteral feeding while the other received all fluid requirements via total parenteral nutrition (controls). The minimal feeding group started enteral feeding (2 ml·kg -1 ·2h -1 ) at 2.5 days after birth, and the control group at 13.6 days postnatally. Results Minimal feeding promoted gastric emptying [( 32.6 ± 12.2 )% vs. (16± 5.5 )%] and shortened the time to establish complete enteral nutrition [( 17.5 ± 8.0 ) vs. ( 34.9 ± 17.7 ) days, P< 0.05 ] and the time to establish complete oral nutrition [( 12.2 ± 8.3 ) vs. (31± 11.2 ) days, P< 0.05 ]. There was no significant difference noted in the amount of gastrointestinal reflux, serum levels of gastrin and motilin, days to regain birth weight, and length of hospitalization between the two groups. Conclusions Early minimal enteral feeding could improve the neonatal gastrointestinal motility and reduce the occurrence of feeding problems in critically ill neonates.