CAJ | 학술논문

目的探讨小剂量红霉素联合非营养性吸吮治疗早产儿喂养不耐受的疗效。方法选择120例符合早产儿喂养不耐受的患儿，随机分为治疗1组（n1＝40）、治疗2组（n2＝40）和对照组（n＝40）。对3组均给予综合治疗，治疗1组在综合治疗基础上给予小剂量红霉素1～3mg· kg-1· d-1加入5％葡萄糖液中，以微泵静脉输入，1次/日，连用7天；治疗2组在综合治疗及小剂量红霉素治疗基础上给予非营养性吸吮；对照组仅进行综合治疗。观察3组胃潴留消失时间、腹胀消失时间、恢复出生体重时间、日体重增长值、全部达经口喂养时间、住院时间等，并监测用药前后肝功能，用药期间观察患儿大便次数及有无哭闹。结果治疗1组和2组患儿在胃潴留消失时间（3．92±1．05/3．16±0．92）、腹胀消失时间（3．65±0．82/3．08±0．95）、恢复至出生体重时间（9．51±2．12/8．12±2．61）、全部达经口喂养时间（17．91±8．13/14．62±6．22）、住院时间（23．82±8．13/20．73±5．34）均短于对照组，差异均有统计学意义（t值分别为2．23/6．19、4．31/5．47、5．28/7．29、2．01/4．54、4．07/6．64，均P＜0．05），每日体重增长速度高于对照组，差异均有统计学意义（t值为2．00/3．76，P＜0．05）。治疗2组患儿在胃潴留消失时间、腹胀消失时间、恢复至出生体重时间、全部达经口喂养时间、住院时间均短于治疗1组，差异均有统计学意义（t值分别为2．92、2．29、2．69、2．05、2．43，均P＜0．05），每日体重增长速度比较差异无统计学意义（P＞0．05）。结论应用小剂量红霉素联合非营养性吸吮治疗早产儿喂养不耐受能更好地促进胃肠运动，具有协同作用。
목적탐토소제량홍매소연합비영양성흡전치료조산인위양불내수적료효。방법선택120례부합조산인위양불내수적환인，수궤분위치료1조（n1＝40）、치료2조（n2＝40）화대조조（n＝40）。대3조균급여종합치료，치료1조재종합치료기출상급여소제량홍매소1～3mg· kg-1· d-1가입5％포도당액중，이미빙정맥수입，1차/일，련용7천；치료2조재종합치료급소제량홍매소치료기출상급여비영양성흡전；대조조부진행종합치료。관찰3조위저류소실시간、복창소실시간、회복출생체중시간、일체중증장치、전부체경구위양시간、주원시간등，병감측용약전후간공능，용약기간관찰환인대편차수급유무곡료。결과치료1조화2조환인재위저류소실시간（3．92±1．05/3．16±0．92）、복창소실시간（3．65±0．82/3．08±0．95）、회복지출생체중시간（9．51±2．12/8．12±2．61）、전부체경구위양시간（17．91±8．13/14．62±6．22）、주원시간（23．82±8．13/20．73±5．34）균단우대조조，차이균유통계학의의（t치분별위2．23/6．19、4．31/5．47、5．28/7．29、2．01/4．54、4．07/6．64，균P＜0．05），매일체중증장속도고우대조조，차이균유통계학의의（t치위2．00/3．76，P＜0．05）。치료2조환인재위저류소실시간、복창소실시간、회복지출생체중시간、전부체경구위양시간、주원시간균단우치료1조，차이균유통계학의의（t치분별위2．92、2．29、2．69、2．05、2．43，균P＜0．05），매일체중증장속도비교차이무통계학의의（P＞0．05）。결론응용소제량홍매소연합비영양성흡전치료조산인위양불내수능경호지촉진위장운동，구유협동작용。
Objective To study the curative effect of small dose of erythromycin and non-nutritive sucking for premature infants with feeding intolerance .Methods Totally 120 cases of premature infants with feeding intolerance were selected , and they were randomly divided into treatment group 1(n1 =40), treatment group 2(n2 =40) and control group(n=40).All of the three groups were given comprehensive treatment .On the basis of the comprehensive treatment , the treatment group 1 was given a small dose of erythromycin 1-3mg· kg-1 · d-1 in 5%glucose solution.It was given by micro pump infusion , 1 time/d, 7d.The treatment group 2 was provided with non-nutritive sucking based on comprehensive treatment and small dose of erythromycin treatment . The control group was given comprehensive treatment only .The gastric retention disappear time , abdominal distention disappearance time , the time birth weight recovery, daily weight gain, all oral feeding time and the length of stay of three groups were observed .Liver function was monitored before and after medication , and the frequency of stool and crying were observed during medication .Results Compared with the control group , the gastric retention disappear time (3.92 ±1.05/3.16 ±0.92), abdominal distention disappearance time (3.65 ±0.82/3.08 ±0.95), the time birth weight recovery(9.51 ±2.12/8.12 ±2.61), all oral feeding time(17.91 ±8.13/14.62 ±6.22) and hospitalization stay (23.82 ±8.13/20.73 ±5.34)in the treatment group 1 and group 2 were shorter, and the differences were statistically significant (t value was 2.23/6.19, 4.31/5.47, 5.28/7.29, 2.01/4.54 and 4.07/6.64, respectively, all P<0.05).The daily weight gain was more in treatment group 1 and group 2 than in the control group, and the difference was significant(t=2.00/3.76,P<0.05).In the treatment group 2 the gastric retention disappear time , abdominal distention disappearance time , the time birth weight recover , all oral feeding time and hospitalization stay were shorter than in treatment group 1, and there were significant differences (t value was 2.92, 2.29, 2.69, 2.05 and 2.43, respectively, all P<0.05).However, there was no significant difference in daily weight gain (P>0.05).Conclusion Application of small dose of erythromycin and non-nutritive sucking on feeding intolerance in preterm infants can promote gastrointestinal motility with synergistic action .