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思连康防治早产儿喂养不耐受的临床研究

2017-08-17蔡冰冰韩丽萍兰晓云董莉

中国医药科学 2017年12期
关键词:早产儿

蔡冰冰??韩丽萍??兰晓云??董莉

[摘要] 目的 觀察思连康防治早产儿喂养不耐受的临床效果及其安全性。 方法 收集2015年1月~2016年1月于我院新生儿科住院治疗的早产儿200例,将其随机分为对照组和治疗组,各100例,对照组给予对症支持治疗,治疗组在常规治疗的基础上给予思连康(0.25g,每日两次)治疗。对比观察两组患儿胃肠耐受性、存活率、肠外营养时间、喂养并发症等指标。 结果 比较两组患儿胃肠耐受相关指标,治疗组患儿喂养不耐受11例,占比11.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组肠外营养时间(9.5±3.2)d,住院时间(12.5±1.9)d,较对照组显著缩短,差异有统计学意义(P<0.05);治疗组呕吐患儿5例,占比5.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组腹泻患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组胃出血患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组坏死性小肠结肠炎患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05)。 结论 早期服用思连康的早产儿较未服者可增加早产儿胃肠道的耐受性,降低早产儿喂养不耐受性发生率,缩短全肠道外营养使用时间达5~7d,提高早产儿存活率和生活质量,减少喂养并发症,是比较理想的治疗方法,值得临床推广。

[关键词] 思连康;早产儿;喂养不耐受

[中图分类号] R722.6 [文献标识码] A [文章编号] 2095-0616(2017)12-48-03

Clinical research on Siliankang in prevention and treatment of feeding intolerance of premature infants

CAI Bingbing HAN Liping LAN Xiaoyun DONG li

Department of Pediatrics, the Second Hospital Affiliated Hospital of Mudanjiang Medical University, Heilongjiang, Mudanjiang 157000, China

[Abstract] Objective To observe the clinical effect and safety of siliankang in prevention and treatment of feeding intolerance of premature infants. Methods 200 premature infants who were hospitalized in department of pediatrics in our hospital from January 2015 to January 2016 were collected. They were randomly divided into the control group and the treatment group, with 100 in each. The control group was given targeted treatment while the treatment group was given siliankang (0.25g, twice for every day) at basis of routine treatment. Gastrointestinal tolerance, survival rate, parenteral nutrition time, feeding complications and other indicators of premature infants in two groups were compared and observed. Results Related indicators of gastrointestinal tolerance of premature infants in two groups were compared. There were 11 cases with feeding intolerance in the treatment group accounting for 11.0%, which was significantly decreased compared with that of the control group. The difference was statistically significant, P<0.05. Survival rate and hospitalization stay of the treatment group were statistically (9.5±3.2) days and (12.5±1.9) days, which were significantly shorter compared with those of the control group. The difference was statistically significant(P<0.05). There were 5 premature infants with vomiting in the treatment group accounting for 5.0%, which was significantly decreased compared with that of the control group. The difference was statistically significant(P<0.05). There was 1 premature infant with diarrhea in the treatment group accounting for 1.0%, which was significantly decreased compared with that of the control group. The difference was statistically significant(P<0.05). There was 1 premature infant with gastric bleeding in the treatment group accounting for 1.0%, which was significantly decreased compared with that of the control group. The difference was statistically significant(P<0.05). There was 1 premature infant with necrotizing enterocolitis in the treatment group accounting for 1.0%, which was significantly decreased compared with that of the control group. The difference was statistically significant(P<0.05). Conclusion Compared with premature infants who dont take siliankang, premature infants taking siliankang in early time can increase gastrointestinal tolerance, reduce incidence of feeding intolerance, shorten parenteral nutrition time up to 5-7 days, improve survival rate and quality and reduce feeding complications. It is an ideal treatment method, which is worthy of clinical promotion.

[Key words] Siliankang; Premature infant; Feeding intolerance

早产儿是指胎龄在37周以下的新生儿,其出生体重多在2500g以下,器官功能和适应能力较足月儿差,应给予早产儿特殊治疗[1-2]。早产儿各项身体机能发育不完全,包括肺部、心脏和胃肠道,随着新生儿护理的提高,早产儿的病死率显著下降,而早产儿喂养成为突出问题[3-4]。思连康是一种双歧杆菌四联活菌片,是肠道的正常菌群,可以促进正常菌群定植和优势化[5],本文旨在探讨此药在早产儿喂养不耐受的临床效果及其安全性。现报道如下。

1 资料与方法

1.1 一般资料

收集2015年1月~2016年1月于我院新生儿科住院治疗的早产儿200例,将其随机分为对照组和治疗组,各100例。其中,治疗组患儿,男54例,女46例,平均孕周(33.5±2.2)周;对照组患儿中,男55例,女45例,平均孕周(33.5±2.5)周;治疗组患儿入院时体重(1977.5±52.2)g,BMI指数(23.1±4.8)kg/m2;对照组患儿入院时体重(1938.5±55.2)g,BMI指数(22.5±5.6)kg/m2。所有患儿家属均填写知情同意书。

1.2 方法

对照组给予对症支持治疗,治疗组在常规治疗的基础上给予思连康治疗。思连康(杭州龙达新科生物制药有限公司,S20060010)0.25g,每日2次。

1.3 统计学处理

使用统计软件SPSS16.0进行数据分析,计数资料比较采用χ2检验,计量资料比较采用t检验。检测结果以()的形式表示,P<0.05为差异有统计学意义。

2 结果

2.1 两组患儿一般资料比较

比较两组患儿性别、胎龄、入院时体重、BMI等临床资料,差异无统计学意义(P>0.05),具有可比性。见表1。

2.2 两组患儿胃肠耐受相关指标比较

比较两组患儿胃肠耐受相关指标,治疗组患儿喂养不耐受11例,占比11.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组肠外营养时间(9.5±3.2)d,住院时间(12.5±1.9)d,较对照组显著缩短,差异有统计学意义(P<0.05)。

2.3 两组患儿喂养并发症比较

治疗组呕吐患儿5例,占比5.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组腹泻患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组胃出血患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05);治疗组坏死性小肠结肠炎患儿1例,占比1.0%,较对照组显著降低,差异有统计学意义(P<0.05)。见表3。

3 讨论

早产儿出生体重常常偏低,在2500g以下,称为低出生体重早产儿,其早期的喂养状况是决定其生存率和幼儿时期生存质量的重要因素[6]。喂养不耐受是早产儿早期面临的一大难题,其发生率较高,约为28%左右,严重影响患儿生长发育[7]。

母乳中含有肠道正常菌群生长所必须的生物因子,可改善早产儿的喂养不耐受[8]。因早产儿出生早期要接受住院治疗,不能及时进行母乳喂养,缺乏肠道正常菌群定植所必须的因子,导致喂养不耐受等问题,可导致严重并发症发生[9]。目前研究认为,给早产儿早期补充双歧杆菌可预防喂养不耐受的发生[10]。本文关注药物思连康,是一种双歧杆菌四联活菌片,用于治疗与肠道菌群失调相关的腹泻、便秘、功能性消化不良等病症,但其在儿童中的应用尚不明确[11-12]。本文旨在探讨此药在早产儿喂养不耐受的临床效果及其安全性。

本文收集早产儿200例,随机分为对照组和治疗组,各100例,对照组给予对症支持治疗,治疗组在常规治疗的基础上给予思连康治疗。结果显示,治疗组患儿喂养不耐受较对照组显著降低。此结果说明,思连康对早产儿喂养不耐受有临床疗效。思连康通用名为双歧杆菌四联活菌片,主要成分是婴儿双歧杆菌、嗜酸乳杆菌、粪肠球菌、蜡样芽孢杆菌,它可直接补充人体正常生理细菌,在肠道形成生物屏障,抑制肠道中某些致病菌,促进肠道蠕动,调整肠道菌群平衡,促进营养物质的消化和吸收[13-15]。

本文还关注了患儿喂养并发症的发生率,结果表明,治疗组肠外营养时间和住院时间较对照组显著缩短;治疗组呕吐、腹泻、胃出血、坏死性小肠结肠炎患儿较对照组显著降低。思连康是一种肠道有益菌微生物制剂,对人体基本无毒副作用。此结果证实,思连康治疗早产儿喂养不耐受具有安全性,可降低不良反应发生率。

综上所述,早期服用思连康的早产儿较未服者可增加早产儿胃肠道的耐受性,降低早产儿喂养不耐受性发生率,缩短全肠道外营养使用时间达5~7d,提高早产儿存活率和生活质量,减少喂养并发症,是比较理想的治疗方法,值得临床推广。

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(收稿日期:2017-04-27)

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