吴淑芬 张秋萍

【摘要】目的：探讨重力喂养辅以非营养性吸吮对早产儿喂养不耐受的临床效果。方法：将76例早产儿随机分为对观察组和对照组，每组38例。两组其他治疗方法均相同，观察组采用重力喂养并在喂养时给予非营养性吸吮，对照组采用鼻饲。比较两组在喂养不耐受并发症的发生情况。结果：观察组早产儿喂养不耐受的临床症状明显改善，每天增加奶量，残奶量与对照组相比差异有统计学意义（P<005）。两组早产儿体重增长比较差异有统计学意义（P<005）。结论：重力喂养结合非营养性吸吮能降低早产儿喂养不耐受的发生率，达到早日全肠内营养。

【关键词】早产儿；喂养不耐受；重力喂养

【中图分类号】

R365【文献标志码】

B【文章编号】1005-0019（2018）09-236-01

Abstract Objective：To explore the clinical effect of gravity feeding combined with non nutritive sucking on feeding intolerance in premature infants.Methods 76 premature infants were randomly divided into the observation group and the control group， 38 cases in each group.The two groups of other treatments were the same，the observation group was fed with gravity and was given non nutritive sucking while feeding，the control group was fed with nasal feeding.The incidence of complications in feeding intolerance was compared between the two groups.Results The clinical symptoms of feeding intolerance in the observation group were significantly improved， and the milk volume was increased daily，the difference between the amount of residual milk and the control group was statistically significant （P<005）.There was a significant difference in weight gain between two groups of premature infants （P<005）.Conclusion Gravity feeding combined with non nutritive sucking can reduce the incidence of feeding intolerance in premature infants and achieve early enteral nutrition.

Key words：Premature infant；Feeding intolerance；Gravity feeding

由于早产儿胃肠道动力不足，消化酶和激素分泌减少，细菌定值异常和局部免疫力的不成熟，使得早产儿喂养不耐受成为新生儿医学中的常见问题[1]。临床主要表现为过量的胃残余量。腹胀或呕吐，或两者皆有，导致肠内营养中断。针对这一状况，我科改变喂养方法，使用重力喂养，用10ml注射器的活塞拔出后针筒接胃管，再将配好奶液注入，利用重力作用经胃管流入患儿胃内的方法。现报告如下：

1资料与方法

11一般资料将2016年1月至2017年10月住院的76例发生喂养不耐受的早产儿随机分为两组.男40例，女36例，胎龄（32-36）周，体重（1180-2870）g，顺产28例，钳产3例，剖宫产45例。两组一般资料比较差异无统计学意义（P>005），具有可比性。

12喂养不耐受的判断按照黄瑛等[2]的判断标准，呕吐≥3次/天奶量不增加或减少>3天，胃残余量是前一次喂养的1/3。

13方法两组均给予常规治疗，对照组采用常规鼻饲喂养，用注射器抽取喂养奶量，连接胃管后将奶液缓慢注入，每个3h鼻饲一次。……