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目的:探讨经幽门喂养(TP)和经胃管喂养(IG)对极低出生体质量儿胃肠功能的影响,以制订合理的早期肠内营养(EEN)方案。方法:将60例极低出生体质量儿随机分为TP组和IG组,每组各30例。观察两组病儿呼吸暂停发生频率、体质量增长速度、达出生体质量时间、喂养不耐受时间、达TEN时间、宫外发育迟缓(EUGR)发生率以及胃动素、胃泌素、住院时间、喂养相关并发症、坏死性小肠结肠炎和肠穿孔等指标。结果:TP组病儿喂养不耐受时间和达TEN时间均明显低于IG组(P<0.05),呼吸暂停发生频率明显低于IG组(P<0.01)。两组病儿的体质量增长速度、出院时EUGR发生率、并发症坏死性小肠结肠炎和住院时间均无显著性差异(P>0.05)。两组病儿胃动素和胃泌素水平出生后第8天与喂养前比较有显著性差异(P<0.01),且胃动素水平TP组明显高于IG组,差异有显著性统计学意义(P<0.01)。结论:TP可用于胃管喂养耐受性差或反复出现呼吸暂停的极低出生体质量儿,在进行喂养时应针对不同情况制订个体化方案。
Objective: To investigate the effects of pyloric feeding (TP) and gastric tube feeding (IG) on the gastrointestinal function of very low birth weight infants to develop a reasonable early enteral nutrition (EEN) regimen. Methods: Sixty children with very low birth weight were randomly divided into TP group and IG group, with 30 cases in each group. The incidences of apnea, body mass growth, birth weight, feeding intolerance, TEN time, extrauterine growth retardation (EUGR), motilin, gastrin, hospitalization Time, feeding related complications, necrotizing enterocolitis and intestinal perforation and other indicators. Results: Intolerance and TEN of TP group were significantly lower than those of IG group (P <0.05). The incidence of apnea was significantly lower than that of IG group (P <0.01). There was no significant difference in body weight growth rate, EUGR incidence at discharge, complications of necrotizing enterocolitis and length of hospital stay between the two groups (P> 0.05). Motilin and gastrin levels in both groups were significantly different from those before feeding on the 8th day after birth (P <0.01), and motilin levels in TP group were significantly higher than those in IG group Significance (P <0.01). Conclusion: TP can be used in very low birth weight children with poor tolerance to gastric tube feeding or repeated apnea. Individuals should be formulated according to different situations during feeding.