張紅麗 蔣慧玲 高麗娟
[摘要] 目的 探討早期微量喂養(yǎng)聯(lián)合腹部按摩對(duì)早產(chǎn)兒胃腸功能及生長發(fā)育的影響。 方法 選取2016年1月~2018年7月在我院住院的早產(chǎn)兒84例,將其隨機(jī)分為觀察組與對(duì)照組,每組42例。兩組早產(chǎn)兒均予以早期微量喂養(yǎng),觀察組在此基礎(chǔ)上采用腹部按摩,兩組療程均為2周。觀察并比較兩組早產(chǎn)兒胃腸功能及生長發(fā)育指標(biāo)的變化。 結(jié)果? 觀察組早產(chǎn)兒的胎便初排時(shí)間和胎便轉(zhuǎn)黃時(shí)間明顯短于對(duì)照組,日排便頻率明顯高于對(duì)照組,喂養(yǎng)不耐受率明顯低于對(duì)照組(P<0.05)。觀察組2周內(nèi)體質(zhì)量增長速度和頭圍增長速度明顯大于對(duì)照組(P<0.05)。結(jié)論 早期微量喂養(yǎng)聯(lián)合腹部按摩用于早產(chǎn)兒不僅能改善胃腸功能,促進(jìn)胃腸蠕動(dòng),減少喂養(yǎng)不耐受率;而且能加快短期內(nèi)體質(zhì)量和頭圍的增長,促進(jìn)生長發(fā)育。
[關(guān)鍵詞] 早產(chǎn)兒;早期微量喂養(yǎng);腹部按摩;胃腸功能;生長發(fā)育
[中圖分類號(hào)] R473.72? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701(2020)04-0060-03
Effect of early micro-feeding combined with abdominal massage on gastrointestinal function, growth and development of premature infants
ZHANG Hongli? ?JIANG Huiling? ?GAO Lijuan
Department of Pediatrics, Lishui Central Hospital in Zhejiang Province, Lishui? ?323000, China
[Abstract] Objective To investigate the effect of early micro-feeding combined with abdominal massage on gastrointestinal function, growth and development of premature infants. Methods 84 premature infants admitted in our hospital from January 2016 to July 2018 were randomly divided into observation group and control group, with 42 cases in each group. Both groups were given early micro-feeding. The observation group was given abdominal massage on the above basis. The two courses were 2 weeks. The changes in gastrointestinal function and growth and development indicators in two groups were observed and compared. Results The fetal stool time and meconium turning yellow time of fetus in the observation group and the yellowing of the fetus was significantly shorter than that of the control group, and the frequency of daily defecation in the observation group was significantly higher than that of the control group. The feeding intolerance rate in the observation group was significantly lower than that of the control group(P<0.05). The growth rate of body mass and head circumference in the observation group was significantly higher than that in the control group within 2 weeks (P<0.05). Conclusion Early microfeeding combined abdominal massage for premature infants can not only improve gastrointestinal function, promote gastrointestinal motility, reduce feeding intolerance rate, but also accelerate the growth of body mass and head circumference in a short period of time and promote growth and development.
[Key words] Premature infants; Early microfeeding; Abdominal massage; Gastrointestinal function; Growth and development
總之,早期微量喂養(yǎng)聯(lián)合腹部按摩用于早產(chǎn)兒不僅能改善胃腸功能,促進(jìn)胃腸蠕動(dòng),減少喂養(yǎng)不耐受率;而且能加快短期內(nèi)體質(zhì)量和頭圍的增長,促進(jìn)生長發(fā)育。
[參考文獻(xiàn)]
[1] 黃卓健. 早產(chǎn)兒營養(yǎng)支持對(duì)早產(chǎn)兒生長的影響觀察[J]. 吉林醫(yī)學(xué),2018,39(6):1118-1119.
[2] Tekgündüz KS,Gürol A,Apay SE,et al. Effect of abdomen massage for prevention of feeding intolerance in preterm infants[J]. Ital J Pediatr,2014,40(14):89-94.
[3] De Aguilar-Nascimento JE,Kudsk KA. Early nutritional therapy:The role of enteral and pareenteral routes[J]. Curr Opin Clin Nutr Metab Care,2008,11(3):255-260.
[4] 曾雙志,楊佩,江欣. 微量喂養(yǎng)聯(lián)合益生菌思連康預(yù)防早產(chǎn)兒壞死性小腸結(jié)腸炎發(fā)生的有效性分析[J]. 中國醫(yī)學(xué)工程,2014,22(10):8-10.
[5] 陳英. 開塞露結(jié)合腹部按摩對(duì)早產(chǎn)兒胎糞排泄時(shí)間的影響研究[J]. 中國全科醫(yī)學(xué),2010,13(9A):2869-2870.
[6] 宋朝敏,楊長儀,王程毅,等. 早期營養(yǎng)支持策略對(duì)極低出生體重兒生長代謝及并發(fā)癥的影響[J]. 中國新生兒科雜志,2013,28(6):379-384.
[7] 金漢珍,黃德珉. 實(shí)用新生兒學(xué)[M]. 第3版. 北京:人民衛(wèi)生出版社,2006:73.
[8] 倪文思,張永紅,李婷,等. 早期康復(fù)介入降低早產(chǎn)兒宮外生長發(fā)育遲緩的研究[J]. 中國當(dāng)代兒科雜志,2018, 20(2):97-101.
[9] Gokmen T,Oguz SS,Bozdag S,et al. A controlled trial of erythromycin and UDCA in premature infants during parenteral nutrition in minimizing feeding intolerance and liver function abnormalities[J]. Journal of Perinatology Official Journal of the California Perinatal Association,2012,32(2):123-128.
[10] Vlaardingerbroek H,van Goudoever JB,van den Akker CH. Initial nutritional management of the preterm infants[J].Early Hum Dev,2009,85(11):691-695.
[11] Tudehope D,Vento M,Bhutta Z,et al. Nutritional requirements and feeding recommendations for small for gestational age infants[J]. J Pediatr,2013,162(3 Suppl):S81-S89.
[12] Lapillonne A,Griffin IJ. Feeding preterm infants today for later metabolic and cardiovascular outcomes[J]. J Pediatr,2013,162(3 Suppl):S7-S16.
[13] Tekgandaz KS,Garol A,Apay SE,et al. Effect of abdomen massage for prevention of feeding intolerance in preterm infants[J]. Ital J Pediatr,2014,14(1):89-92.
[14] 蔡威. 早產(chǎn)兒營養(yǎng)支持難點(diǎn)與對(duì)策[J]. 中國當(dāng)代兒科雜志,2014,7(16):661-663.
[15] Scott C Denne. Early nutritional support for extremely premature infants:What aminoacid amount should be given? [J]. AM J Clin Nutr,2016,103(8):1383-1384.
[16] Burdge GC,Lillycrop KA. Nutrition,epigenetics,and developmental plasticity:Implications for understanding human disease[J]. Annu Rev Nutr,2010,30(4):315-339.
[17] Jirapaet K,Jirapaet V,Sritipsukho S. Safety of initiating early enteral feeding with slow volume advancement in preterm infants[J]. J Med Assoc Thai,2010,93(10): 1177-1187.
[18] Rodriguez NA,Meier PP,Groer MW,et al. A pilot study to determine the safety and feasibility of oropharyngeal administration of own mother's colostrum to extremely low-birth-weight infants[J]. Adv Neonatal Care,2010,10(4):206-212.