早产儿间断鼻十二指肠喂养和鼻胃管喂养的对照研究

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目的 比较早产儿生后早期间断鼻十二指肠喂养和间断鼻胃管喂养营养摄入量、生长情况、肠道及胃肠道转运时间、喂养相关并发症。方法 将 4 0例早产儿 (出生体重 10 5 0g~ 192 0g) ,随机分为鼻十二指肠喂养组和鼻胃管喂养组 ,用同一种配方乳喂养。记录喂养 1周的入液量 (静脉入液量和奶量 )、热能、蛋白质摄入量 ;体格生长指标 (体重、身长、头围 )的变化 ;大便性状 ;喂养相关并发症 ;测定肠道及胃肠道转运时间。结果 喂养后 1周鼻十二指肠喂养组较鼻胃管喂养组平均进奶量、热能、蛋白质摄入量均显著增加 (P <0 0 0 1)。肠道营养热能达 4 18 4kJ/ (kg·d)的时间、恢复出生体重时间明显缩短 (P <0 0 5 ) ;喂养前及 1周后身长、头围的变化无差异 (P >0 0 5 )。鼻十二指肠喂养组的肠道转运时间较鼻胃管喂养组的胃肠道转运时间缩短 ,但两组均无腹泻发生 ;鼻十二指肠喂养组较鼻胃管喂养组呼吸暂停、吸入性肺炎、呕吐、残留的发生率减少 ;而高胆红素血症显著减少 (P <0 0 1)。结论 早产儿生后早期鼻十二指肠喂养优于鼻胃管喂养 Objective To compare nutritional intake, growth, gut transit, gastrointestinal transit time, and feeding-related complications of interrupted nasal duodenal feeding and intermittent nasogastric tube feeding in the early postnatal period. Methods Forty cases of premature infants (birth weight 10 05 ~ 192 0 g) were randomly divided into nasal duodenal feeding group and nasogastric feeding group, fed with the same formula. The volume of fluid infused (IVF and milk volume), caloric intake and protein intake during 1 week of feeding were recorded. The changes of body growth index (body weight, body length and head circumference), stool characteristics, feeding-related complications, And gastrointestinal transit time. Results The average milk intake, caloric content and protein intake of nasal duodenal feeding group were significantly higher than those of nasogastric tube feeding group 1 week after feeding (P <0.01). There was no significant difference in body length and head circumference before and after feeding (P> 0.05), but the time to recovering body weight was significantly shorter (P <0.05) 5). The intestinal transit time in nasal duodenal feeding group was shorter than that in nasogastric feeding group, but no diarrhea occurred in both groups. Nasal duodenal feeding group was shorter than that in nasogastric tube feeding group, Inhalation pneumonia, vomiting, the incidence of residual reduction; and hyperbilirubinemia was significantly reduced (P <0.01). Conclusions Nasal duodenal feeding is better than nasogastric feeding in the early postnatal period in preterm infants
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