不同重力喂养高度及卧位在预防早产儿胃食管反流中的效果分析

Effect of different gravity feeding heights and lying position in preventing gastroesophageal reflux in premature infants

  • 摘要:
    目的 探讨不同重力喂养高度及卧位预防早产儿胃食管反流的效果。
    方法 选取中国医科大学附属盛京医院新生儿科2022年6—12月出生的早产儿138例为研究对象, 按照随机数字表法分为对照组、观察1组、观察2组,每组46例。对照组采用常规仰卧位重力喂养; 观察1组采取右侧卧位,确认无残留奶量后,抬高针筒至距离早产儿嘴唇上方20 cm处; 观察2组采取俯卧位,其他步骤同观察1组。比较3组呕吐、溢奶、呼吸暂停、血氧饱和度下降、胃残留、减量喂养次数、停喂次数、体质量增长、排便次数、排便量、胎便排尽用时、潴留量及喂养2周后食管24 h反流监测等指标。
    结果 3组早产儿人均喂养次数均为112次; 观察1组和观察2组呕吐、溢奶、呼吸暂停、血氧浓度下降等发生率均低于对照组,差异有统计学意义(P<0.05); 观察1组和观察2组胃残留比率低于对照组,体质量增长大于对照组,差异均有统计学意义(P<0.05); 观察1组和观察2组减量喂养次数、停喂次数均少于对照组,差异有统计学意义(P<0.05); 观察1组和观察2组排便次数、排便量均大于对照组,胎便排尽用时、潴留量均小于对照组,差异有统计学意义(P<0.05); 观察1组和观察2组食管pH<4次数、反流超过5 min次数、最长单次反流持续时间及反流指数均小于对照组,差异有统计学意义(P<0.05)。
    结论 重力喂养高度及体位改变可降低呕吐、溢奶、呼吸暂停和血氧浓度下降等发生率,预防胃食管反流,有利于早产儿生长发育。

     

    Abstract:
    Objective To explore the effect of different gravity feeding heights and lying position in preventing gastroesophageal reflux in premature infants.
    Methods A total of 138 premature infants in the Department of Neonatology in Shengjing Hospital of China Medical University from June to December 2022 were selected as the research objects, and they were randomly divided into control group, the first observation group and the second observation group, with 46 cases in each group. The control group received conventional supine gravity feeding; the first observation group adopted a right lateral position, and raised the syringe to a distance of 20 cm above the lips of the premature infant after confirming there was no residual milk; the second observation group adopted a prone position, and the other measures were the same as the first observation group. Vomiting, milk spilling, apnea, decrease of blood oxygen saturation, gastric residue, times of reduced feeding, times of stopping feeding, growth of body mass, times of defecation, amount of defecation, time of exhausted fetal stool, amount of retention, and esophageal reflux monitoring in 24 hours after 2 weeks of feeding were compared among the three groups.
    Results The average number of feedings per capita for premature infants in the three groups was 112 times; the incidence rates of vomiting, milk spilling, apnea and decreased blood oxygen concentration in the first observation group and the second observation group were significantly lower than those in the control group (P < 0.05); the gastric residue ratios in the first observation group and the second observation group were significantly lower than that in the control group, while the body weight growth was significantly greater than that in the control group (P < 0.05); the first observation group and the second observationgroup had fewer times of reduced feeding and stopped feeding thanthe control group, and the differences were statistically significant (P < 0.05); the number and amount of defecation in the first observation group and the second observation group were significantly greater than those in the control group, while the time and retention of exhausted fetal stool were significantly less than those in the control group (P < 0.05); the number of times of esophageal pH < 4 and reflux exceeding 5 minutes, the longest single reflux duration, and reflux index in the first observation group and the second observation group were significantly lower than those in the control group (P < 0.05).
    Conclusion Changes in gravity feeding heights and postures can reduce the incidence rates of vomiting, milk spilling, apnea and decreased blood oxygen concentration, prevent gastroesophageal reflux, and promote the growth and development of premature infants.

     

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