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目的:探讨早期肠内营养与常规喂养对重度缺氧缺血性脑病(HIE)新生儿的影响。方法:将88例重度HIE新生儿按照入院顺序随机分为两组,每组各44例,其中对照组采取常规喂养,观察组实施早期肠内营养,比较两组患儿体重增长、头围增长、神经症状恢复和住院时间及各项血生化指标和免疫指标差异。结果:观察组患儿体重增长和头围增长分别为(25.74±0.72)g/d和(0.67±0.12)cm/周,显著高于对照组(P<0.05);而观察组神经症状恢复和住院时间分别为(6.10±0.61)天和(12.22±0.73)天,均显著少于对照组的(8.32±0.73)天和(17.87±1.02)天,两组比较差异具有统计学意义(P<0.05);观察组总蛋白、白蛋白、尿素氮及总胆红素水均较对照组显著改善(P<0.05);观察组治疗后CD4+显著低于对照组,CD4+/CD8+显著高于对照组,两组比较差异均具有统计学意义(P<0.05);两组CD8+水平比较差异无统计学意义(P>0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论:早期肠内营养可促进重度HIE新生儿体重增长、神经症状恢复,患儿的生化和免疫指标也显著改善,且并发症发生率低,具有良好的临床应用价值,值得推广应用。
Objective: To investigate the effect of early enteral nutrition and routine feeding on neonates with severe hypoxic-ischemic encephalopathy (HIE). Methods: Eighty-eight newborns with severe HIE were randomly divided into two groups according to the sequence of hospital admission, 44 cases in each group. The control group was fed routinely and the observation group was enrolled in early enteral nutrition. The weight gain and head circumference growth were compared between the two groups , Recovery of neurological symptoms and length of hospital stay, as well as differences in blood biochemical and immune parameters. Results: The body weight gain and head circumference growth in the observation group were (25.74 ± 0.72) g / d and (0.67 ± 0.12) cm / week respectively, which were significantly higher than those in the control group (P <0.05) The length of hospital stay was (6.10 ± 0.61) days and (12.22 ± 0.73) days respectively, which were significantly lower than those of the control group (8.32 ± 0.73) days and (17.87 ± 1.02) days respectively. There was significant difference between the two groups (P < 0.05). The total protein, albumin, urea nitrogen and total bilirubin in the observation group were significantly improved compared with the control group (P <0.05). The CD4 + and CD8 + levels in the observation group were significantly lower than those in the control group (P <0.05). There was no significant difference in the level of CD8 + between the two groups (P> 0.05). There was no significant difference in the complication rates between the two groups (P> 0.05). CONCLUSION: Early enteral nutrition can promote weight gain and neurological symptoms of neonates with severe HIE. The biochemical and immunological indexes of children with HIE are also significantly improved. The incidence of complications is low, which has good clinical value and is worth popularizing and applying.