郑旭新+杨烁+黄丽丽+梁国祝

【摘要】 目的 探索早期微量喂养对于肺透明膜病新生儿体重和血胆红素的影响。方法 80例肺透明膜病新生儿， 根据喂养方法的不同分为观察组和对照组， 每组40例。对照组采用常规喂养， 观察组采用早期微量喂养， 比较分析两组出生体重恢复时间、血胆红素水平、胃肠道功能、并发症发生率。结果 观察组出生7 d的胃泌素水平、血浆胃动素水平及达全量肠道喂养时间分别为（132.7±23.1）ng/L、

（365.0±32.1）ng/L、（14.87±2.32）d， 优于对照组的（110.3±20.5）ng/L、（321.6±28.6）ng/L、（18.59±3.21）d， 差异有统计学意义（P<0.05）。观察组并发症发生率为7.5%， 与对照组的15.0%比较， 差异无统计学意义（P>0.05）。观察组出生体重恢复时间、住院时间及血胆红素峰值分别为（11.27±2.36）d、（16.58±4.32）d、（237.4±43.2）μmol/L， 优于对照组的（14.38±2.76）d、（20.27±4.19）d、（275.8±52.1）μmol/L， 差异有统计学意义（P<0.05）。结论 将早期微量喂养用于肺透明膜病新生儿中是可行的， 有助于体重的恢复， 降低血胆红素水平， 促进胃肠道功能的恢复， 值得推广应用。

【关键词】 早期微量喂养；肺透明膜病；新生儿；体重；血胆红素；并发症；胃腸道功能

DOI：10.14163/j.cnki.11-5547/r.2017.01.092

Research on effect of early minimal feeding on body weight and hemobilirubin for newborns with hyaline membrane disease ZHENG Xu-xin， YANG Shuo， HUANG Li-li， et al. Department of Pediatrics， Shenzhen City Pingshan New District Peoples Hospital， Shenzhen 518118， China

【Abstract】 Objective To explore effect of early minimal feeding on body weight and hemobilirubin for newborns with hyaline membrane disease. Methods A total of 80 newborns with hyaline membrane disease were divided by different feeding methods into observation group and control group， with 40 cases in each group. The control group received conventional feeding， and the observation group received early minimal feeding. Comparison and analysis were made on birth weight recovery time， hemobilirubin level， gastroenteric function and incidence of complications in two groups. Results The observation group had gastrin level， plasma motilin level on postnatal 7 d

and full amount of enteral feeding time respectively as （132.7±23.1）ng/L， （365.0±32.1）ng/L and（14.87±2.32）d，

which were all better than （110.3±20.5）ng/L， （321.6±28.6）ng/L and （18.59±3.21）d in the control group， and their differences had statistical significance （P<0.05）. The observation group had incidence of complications as 7.5%， while 15.0% in the control group， and the difference had no statistical significance （P>0.05）. The observation group had birth weight recovery time， hospital stay time and peak hemobilirubin respectively as （11.27±2.36）d，

（16.58±4.32）d and （237.4±43.2）μmol/L， which were all better than （14.38±2.76）d， （20.27±4.19）d and （275.8±52.1）μmol/L in the control group， and their differences had statistical significance （P<0.05）. Conclusion Implement of early minimal feeding is feasible for newborns with hyaline membrane disease， which is helpful for recovery of body weight， reduction of hemobilirubin level and promoting recovery of gastroenteric function. So this method is worth promoting and applying.

【Key words】 Early minimal feeding； Hyaline membrane disease； Newborns； Body weight； Hemobilirubin； Complications； Gastroenteric function

新生儿肺透明膜病是由于肺表面活性物质缺乏以及肺结构发育不成熟而导致的一种新生儿期重症肺部疾病， 呼吸窘迫、发绀、呻吟等均属于肺透明膜病的范畴， 病情危重， 若不及时对症治疗将会对患儿的生命健康造成不良影响[1， 2]， 在临床治疗上主要采用机械通气、药物治疗。而关于肠内营养开始时间上， 早期的肠内营养有助于胃肠道结构的发育， 但是也可能引发吸入性肺炎等并发症[3]。WHO提出对于肺透明膜病新生儿应实施早期微量喂养， 为探索早期微量喂养的重要价值， 特开展本次对照研究， 汇报如下。……