首页|初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响

初乳灌肠对极低出生体重儿胎粪排出和免疫反应的影响

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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.
Effect of colostrum enemas on meconium evacuation and immune response in very low birth weight preterm infants
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.

infant,prematurevery low birth weight infantscolostrumenemadelayed meconium evacuationimmuno-globulin Aimmune responsetotal enteral nutrition

王嘉莹、林梅、许冬梅、黄婷、黄芝蓉、黄丽玲、李玉娟

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右江民族医学院研究生学院(广西百色,533000)

右江民族医学院附属医院新生儿科

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

广西壮族自治区卫生健康委西医类自筹经费科研课题(2022)广西医药卫生自筹经费科研课题(2019)右江民族医学院附属医院院内高层次人才计划

Z-L20220851Z20190049R20196349

2024

10.3870/j.issn.1001-4152.2024.12.031

护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCD北大核心
影响因子：2.062
ISSN：1001-4152
年,卷(期)：2024.39(12)
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