初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响
Effect of colostrum enemas on meconium evacuation and immune response in very low birth weight preterm infants
王嘉莹 1林梅 2许冬梅 2黄婷 1黄芝蓉 2黄丽玲 2李玉娟2
作者信息
- 1. 右江民族医学院研究生学院(广西百色,533000)
- 2. 右江民族医学院附属医院新生儿科
- 折叠
摘要
目的 探讨初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响.方法 将128例极低出生体重儿随机分为干预组和对照组各64例.干预组采用2 mL/kg初乳灌肠;对照组采用1 mL/kg开塞露+1 mL/kg生理盐水1∶1稀释灌肠.灌肠自早产儿出生后24 h开始,至胎粪排尽时停止.结果 干预组脱落10例,对照组脱落9例.干预组胎粪排尽时间和达到完全肠内营养时间显著短于对照组,体质量增长速度显著高于对照组(均P＜0.05);干预组首次排出与排尽时的胎粪中的分泌型免疫球蛋A浓度、出生后第1次与第6天尿液中的分泌型免疫球蛋A浓度显著高于对照组(均P＜0.05);干预组坏死性小肠结肠炎、喂养不耐受发生率显著低于对照组(均P＜0.05).结论 初乳灌肠能促进极低出生体重儿胎粪排出,缩短达到完全肠内营养时间,提高体质量增长速度,提高早产儿免疫功能,降低相关并发症发生率.
Abstract
Objective To explore the effects of colostrum enemas on meconium evacuation and immune response in very low birth weight(VLBW)preterm newborns.Methods Totally,128 VLBW preterm newborns were randomly assigned into 2 groups of 64 cases each.The intervention group received enema with 2mL/kg colostrum,while the control group received enema with 1 mL/kg glycerin suppository plus 1 mL/kg saline solution diluted at a ratio of 1∶1.Enemas started 24 hours after birth and ceased upon complete meconium evacuation.Results Ten cases in the intervention group dropped out,versus 9 cases in the control group.The intervention group had significantly shorter time to complete meconium evacuation,and time to full enteral feeding,as well as fas-ter weight gain rate,than the control group(all P＜0.05);the former group also had significantly higher immunoglobulin A(sI-gA)concentration in the first and last meconium discharge sample,as well as in the first-time and sixth-day urine sample,thanthe latter group(all P＜0.05).The intervention group also had significantly lower rates of necrotizing enterocolitis and feeding into-lerance than the control group(both P＜0.05).Conclusion Colostrum enemas can facilitate meconium evacuation in VLBW pre-term newborns,expedite full enteral feeding,enhance weight gain,boost immunity,and reduce incidence of related complications.
关键词
早产儿/极低出生体重儿/初乳/灌肠/胎粪排出延迟/免疫球蛋白A/免疫反应/全肠内营养Key words
infant,premature/very low birth weight infants/colostrum/enema/delayed meconium evacuation/immuno-globulin A/immune response/total enteral nutrition引用本文复制引用
基金项目
广西壮族自治区卫生健康委西医类自筹经费科研课题(2022)(Z-L20220851)
广西医药卫生自筹经费科研课题(2019)(Z20190049)
右江民族医学院附属医院院内高层次人才计划(R20196349)
出版年
2024
NETL
NSTL
万方数据