早产儿喂养不耐受的因素的分析报告

论文编号:HL164  论文字数:9193.页数:20

论文题目：早产儿喂养不耐受的因素的分析报告
摘　要
 目的：总结肠道营养与肠外营养相结合的新生儿喂养效果，评价新生儿喂养不耐受对营养的影响，计算喂养不耐受的发生率，分析发生喂养不耐受的相关危险因素。
 方法：438例新生儿进行临床观察，早产儿381例。对早产儿及足月儿采用不同的喂养，母乳喂养早产儿135例,奶瓶喂养早产儿167例,胃管喂养早产儿79例。按黄瑛诊断标准即频繁呕吐≥3次/d，奶量不增或减少>3d，胃潴留（潴留量>前次喂养量的1/3）分为喂养不耐受组（feedingintolerance,FI组）和非喂养不耐受组（non-FI组）。喂养不耐受组用小剂量红霉素治疗，剂量3－5 mg/kg.次，1-2次/日，连用5-7天,部分病例疗程>7天。记录每日奶量、热卡、体重增长情况,比较喂养不耐受组与非喂养不耐受组的喂养效果，分析喂养不耐受的相关危险因素，计算喂养不耐受的发生率。
 结果：低体重(p<0.01)、宫内窘迫(p<0.05)、胃出血(p<0.01)是喂养不耐受的相关危险因素；喂养不耐受患儿有胃出血组达全肠道喂养的日龄比无胃出血组明显延长（17.63±7.97与12.29±5.34天,t=-2.121,p<0.05）；两组恢复出生体重的日龄无明显差别。
 结论：出生体重>2500g早产儿、2001-2500g早产儿、≤2000 g早产儿喂养不耐受组的发生率分别为25%、50%、73.7%。用热卡值达80Kcal/kg.d（334.4KJ/kg.d）及恢复出生体重的日龄来评价喂养不耐受的营养指标有临床意义。低体重、胎儿宫内窘迫、胃出血是喂养不耐受的相关危险因素。肠外营养与正确的喂养方案相结合，可提供满足生长所需的热卡，最终过渡到肠道营养。
 关键词：新生儿；喂养；喂养不耐受；营养；危险因素
 论文类型：研究报告
 
 Title： feeding intolerance in preterm children related factors and nursing intervention
ABSTRACT
Objectives：
 Enteral nutrition and parenteral nutrition combined effect of neonatal feeding, evaluation of neonatal feeding intolerance on nutrition, calculating the incidence of feeding intolerance, of occurrence of feeding intolerance related risk factors.Methods：
 381 cases of neonatal clinical observation.Huang Ying diagnostic criteria by the frequent vomiting ≥ 3 times / d, milk does not increase or decrease> 3d, gastric retention (retention volume of> the previous feeding of 1 / 3) is divided into feeding intolerance group (feedingintolerance, FI Group) and non-feeding intolerance group (non-FI group).Feeding intolerance group with low-dose erythromycin treatment, dose of 3-5 mg / kg. Times, 1-2 times / day, 5-7 days, in some cases treatment> 7 days.Record daily milk, calorie, weight gain, feeding intolerance group compared with non-feeding group feeding intolerance effects of feeding intolerance and the risk factors to calculate the incidence of feeding intolerance.Results：
 The low birth weight (p <0.01), fetal distress (p <0.05), bleeding (p <0.01) feeding intolerance is related risk factors; feeding intolerance in children with a group of full-intestinal bleedingday feeding was significantly longer than those without bleeding (17.63 ± 7.97 and 12.29 ± 5.34, t =- 2.121, p <0.05); two days to regain birth weight was no significant difference.
Conclusion：
 The full-term children, birth weight> 2500g premature children ,2001-2500g premature children, ≤ 2000 g group feeding intolerance in preterm children the incidence rate was 9.7%, 25%, 50%, 73.7%.Caloric value with 80Kcal/kg.d (334.4KJ/kg.d) and the days to regain birth weight to assess nutritional indicators of feeding intolerance have clinical significance.Low birth weight, fetal distress, bleeding is a risk of feeding intolerance factor.Parenteral nutrition and proper feeding programs combine to provide the necessary calories to meet growth, and ultimately the transition to enteral nutrition.KEY WORDS： newborn；feeding；feeding intolerance；nutrition；risk factors
TYPE OF THESIS： research report
目  录
目  录 III
1绪论 1
1.1背景及意义 1
1.2研究目的及目标 1
1.3关键词及定义 1
1.4文献回顾 1
2 研究设计 4
2.1 研究类型 4
2.2 研究对象 4
2.3 研究方法 4
2.4 研究步骤 4
2.5 统计方法 4
3 研究结果 5
4 讨论 7
5 推论及建议 9
致    谢 10
参考文献 11
附件： 13