莫沙必利联合不同益生菌对早产儿胃肠功能及早期生长发育的影响

发布时间：2018-06-25 02:37

本文选题：早产儿 + 莫沙必利　；参考：《安徽医科大学》2014年硕士论文

【摘要】：【目的】评价胃肠动力药物莫沙必利联合不同益生菌制剂（酪酸梭菌-婴儿型双歧杆菌二联活菌、枯草杆菌肠球菌二联活菌）对早产儿胃肠功能以及早期生长发育影响的临床疗效。【方法】收集2009年1月至2012年6月在安徽省立医院新生儿科住院的早产儿。入选标准:（1）胎龄37周的早产儿（2）出生体重2500g （3）出生后24小时内即转入我院新生儿科（4）住院时间≥14天且治疗结果为治愈或好转。排除标准:消化道畸形，新生儿重度窒息，先天性心脏病，颅内出血，新生儿呼吸窘迫综合症，羊水咽下，吸入性肺炎，早期感染，消化道出血。共有421例早产儿符合入选标准，随机分为A组(常规组)共计92例、B组（莫沙必利+妈咪爱组)共计156例、C组（莫沙必利+常乐康组.)共计173例。A组患儿予常规护理和治疗，B组在A组的基础上于出生6h内开始口服(或经胃管)给予益生菌制剂枯草杆菌肠球菌二联活菌散颗粒，每次1g，每天2次和莫沙必利每次0.5mg，每天3次。C组在A组的基础上于出生6h内开始口服(或经胃管)给予益生菌制剂酪酸梭菌-婴儿型双歧杆菌二联活菌散剂，每次0.5g，每天2次和莫沙必利每次0.5mg，每天3次。观察和记录3组早产儿每天添加奶量、第14天摄入奶量、肠内营养热卡达50kcal/kg.d、80kcal/kg.d的时间、达到全胃肠喂养时间、体质量增长速度、喂养不耐受发生率、不耐受症状持续时间、胎粪初排时间、黄疸消退时间、合并症发生率等情况。采用SPSS16.0统计软件包进行处理，计量资料以均数士标准差（±S）表示，采用单因素的方差分析，两两比较采用Bonferroni法；计数资料采用2检验，以P0.05为有统计学意义。【结果】 B组和C组早产儿每日添加奶量、第14天摄入奶量、平均体质量增长速度均高于A组（P0.05）；肠内营养达50kcal/kg.d、80kcal/kg.d的时间、全胃肠营养时间、住院时间以及恢复出生体质量时间均短于A组（p0.05）；B组和C组早产儿生后体质量下降幅度、EUGR发生率、喂养不耐受发生率均低于A组（P0.05），喂养不耐受症状持续时间均短于A组(P0.05)；B组和C组患儿初次排便时间、胎粪排尽时间均短于A组（p0.05）。B、C两组早产儿在营养摄取、体重增长、喂养不耐受发生方面的差异均无统计学意义（P0.05）。B组和C组患儿黄疸消退时间均短于A组（p0.05），B组比C组患儿第7天总胆红素水平、第14天总胆红素水平更低（p0.05）。B组和C组患儿败血症、坏死性小肠结肠炎、胆汁淤积的发生率均低于A组（p0.05）。C组败血症的发生率较B组更低（P0.05）。【结论】莫沙必利联合益生菌能有效防治早产儿胃肠功能紊乱，促进营养物质的吸收和利用，显著缩短达全胃肠喂养时间，对早期的生长发育有促进作用；并且促进胎粪排除，缩短黄疸消退时间；有效降低早产儿合并症的发生率。妈咪爱和常乐康在促进早产儿营养摄入、生长发育、改善喂养不耐受的疗效方面无明显差异，，但妈咪爱退黄作用略优于常乐康，而后者在减少早产儿败血症的发生上略优于妈咪爱。
[Abstract]:[Objective]
To evaluate the effect of the gastrointestinal motility drug mosapride combined with different probiotics (Clostridium butyricum - two Bifidobacterium infantile, two Bacillus subtilis Enterococcus) on the gastrointestinal function and early growth and development of preterm infants.
[method]
The preterm infants in the neonatal department of Anhui Provincial Hospital from January 2009 to June 2012 were collected. (1) 2500g (3) of premature infants (2) of 37 weeks of fetal age (3) were transferred to our hospital 24 hours after birth (4) hospitalization time for more than 14 days and the treatment results were cured or improved. Exclusion criteria: digestive malformation, severe neonatal stifles Congenital heart disease, intracranial hemorrhage, neonatal respiratory distress syndrome, amniotic fluid pharynx, inhalation pneumonia, early infection, digestive tract bleeding, 421 premature infants were randomly divided into group A (routine group) 92 cases, group B (mosapride + mommy love group) in total 156 cases, and group C (mosapride + changlekang group) in a total of 173 cases The children were given routine care and treatment. On the basis of group A, group B began to give oral (or through gastric tube) oral (or through gastric tube) to the probiotics of Bacillus subtilis Enterococcus two combined bacteria granules, each time 1g, 2 times a day and Mosapride each time 0.5mg, 3 times a day on the basis of group.C in the A group to begin oral (or through gastric tube) to give probiotics. Clostridium butyricum - two Bifidobacterium infantile Bifidobacterium, each 0.5g, 2 times a day, and Mosapride each time 0.5mg, 3 times a day. Observe and record 3 groups of preterm infants added milk per day, intake of milk in Fourteenth days, 50kcal/kg.d, 80kcal/kg.d of enteral nutrition, total gastrointestinal feeding time, body mass growth rate, and feeding intolerance. The incidence, the duration of the intolerance of the symptoms, the time of the meconium initial row, the time of the jaundice, the incidence of the complication, and so on. The data were processed with SPSS16.0 software package, the measurement data were represented by the standard deviation of the number of men (+ S), the single factor analysis of variance, and the 22 comparison of the Bonferroni method were used, and the count data were 2 test, and P0.05 was the unified system. The significance of learning.
[results]
In group B and group C, the amount of milk was added daily and milk was consumed in Fourteenth days. The average body mass growth rate was higher than that of group A (P0.05); the time of enteral nutrition 50kcal/kg.d, 80kcal/kg.d, total enteral nutrition time, time of hospitalization and recovery of birth body mass time were shorter than that of group A (P0.05), and the decrease of body mass of premature infants in group B and C group was EUG, EUG The incidence of R was lower than that of group A (P0.05), and the duration of feeding intolerance was shorter than that in group A (P0.05), and the time of initial defecation in group B and C was shorter than that of A group (P0.05).B, and there was no significant difference in nutrition intake, weight growth, and feeding intolerance between the two groups of C group (P0.05). The regression time of jaundice in group B and group C was shorter than that in group A (P0.05). The total bilirubin level in group B was lower than that of group C, and the rate of total bilirubin in group.B and C group was lower (P0.05), necrotizing enterocolitis, and cholestasis was lower than that of group C, and the incidence of cholestasis was lower than that of group A group (P0.05), and the incidence of sepsis in.C group was lower than that of group A.
[Conclusion]
The combined probiotics of Mosapride can effectively prevent and control the gastrointestinal dysfunction in preterm infants, promote the absorption and utilization of nutrients, shorten the feeding time of the whole gastrointestinal tract, promote the early growth and development, promote the removal of meconium, shorten the time of the jaundice to decline, and reduce the incidence of complication in premature infants. Mommy love and Changle There is no obvious difference in the effect of promoting nutrition intake, growth and development and improving feeding intolerance in preterm infants, but Mommy is slightly better than Changle Kang, and the latter is slightly better than mommy love in reducing the incidence of sepsis in premature infants.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R722.6

【参考文献】