酪酸梭菌活菌散在迟发型母乳性黄疸中的应用

目的探讨酪酸梭菌活菌散促进迟发型母乳性黄疸消退的疗效。方法将87例迟发型母乳性黄疽患儿随机分为对照组和观察组,对照组43例和观察组44例,对照组采用常规治疗,观察组在常规治疗的基础上加服酿酸梭菌活菌散,500mg/次,3次/d,两组均不停止母乳喂养。观察两组患儿日均胆红素水平的变化及黄疽消退时间。结果观察组日均胆红素下降程度显著大于对照组（P〈0. 01）,观察组黄疸消退时间明显短于对照组（P〈0. 01）,差异有统计学意义。结论在常规治疗的基础上加用酪酸梭菌活菌散治疗迟发型母乳性黄疸,不仅可加速胆红素降低水平,缩短黄疽持续时间,而且能显著缓解茵扼黄颗粒引起的腹泻,是一种简单、安全、有效的治疗措施,并减少停喂母乳对乳母及乳儿的不利影响,值得临床推广应用。     

地衣芽孢杆菌治疗新生儿母乳性黄疸的疗效观察

目的了解地衣芽孢杆菌活菌胶囊(整肠生)治疗母乳性黄疸的疗效。方法选取2012年1月至2015年4月我院门诊治疗的新生儿母乳性黄疸69例,随机分为两组,对照组给予口服茵栀黄颗粒,观察组给予茵栀黄颗粒及整肠生治疗,观察治疗效果及两组血清胆红素值及黄疸消退时间、大便次数。结果 (1)治疗后观察组总有效率97.14%,对照组治疗总有效率82.35%,差异具有统计学意义(P0.05)。(2)治疗第5天观察组血清总胆红素值明显低于对照组,黄疸消退时间短于对照组,平均大便次数多于对照组,差异具有统计学意义(P0.01)。(3)两组患儿均无过敏及脱水等不良反应。结论整肠生治疗母乳性黄疸可缩短黄疸持续时间,显著降低血清总胆红素水平,提高治疗有效率。     

酪酸梭菌活菌散在治疗母乳性黄疸中的应用

目的观察在常规治疗的基础上加用酪酸梭菌活菌散（商品名：宝乐安）治疗新生儿母乳性黄疸的疗效。方法176例母乳性黄疸患儿随机分为治疗组和对照组,治疗组90例,对照组86例,对照组采用常规治疗,治疗组在常规治疗基础上加服酪酸梭菌活菌散,2组均不停止母乳喂养,并观察2组患儿日均总胆红素水平及黄疸消退时间的变化。结果治疗组日均胆红素下降值为（58．61±26．52）μmol／L,显著高于对照组（39．12±25．41）μmol／L（P〈0．01）;黄疸消退时间,治疗组为（4．25±2．68）d,显著短于对照组（6．42±2．74）d（P〈0．01）。结论在常规治疗的基础上加用酪酸梭菌活菌散治疗母乳性黄疸,可迅速降低胆红素水平,缩短治疗时间。     

凝结芽孢杆菌活菌片治疗母乳性黄疸的临床观察

目的探讨凝结芽孢杆菌活菌片（商品名：爽舒宝）治疗母乳性黄疸的临床疗效。方法将母乳性黄疸患儿69例随机分为观察组和对照组,观察组34例在常规治疗的同时给予口服凝结芽孢杆菌活菌片;对照组35例应用蓝光、菌栀黄颗粒等常规治疗。治疗中观察患儿黄疸消退时间并定期检测血清胆红素含量,血常规情况。结果治疗后观察组总有效率、日均胆红素下降值均明显高于对照组,治疗第5天血清胆红素值低于对照组,黄疸消退时间亦明显短于对照组,差异具有统计学意义（P〈0．05）。观察组和对照组的白细胞计数和红细胞计数均降为正常值,血红蛋白也有所降低,但仍高于正常值,差异无统计学意义（P〉0．05）。结论凝结芽孢杆菌活菌片治疗母乳性黄疸,可提高总有效率,迅速降低胆红素水平,缩短黄疸消退时间,且无不良反应发生。     

酪酸梭菌活菌散联合光疗治疗新生儿母乳性黄疸临床观察

目的探讨酪酸梭菌活菌散（商品名：宝乐安）联合光疗治疗母乳性黄疸的临床疗效。方法将母乳性黄疸患儿116例随机分为观察组和对照组,观察组59例在光疗、补液等常规治疗的同时给予口服酪酸梭菌活菌散;对照组57例应用光疗、补液等常规治疗。治疗中观察患儿黄疸消退时间并定期检测血清胆红素含量,比较胆红素日均下降速度及治愈时间。结果观察组治愈时间短于对照组（P〈0．05）,观察组日均胆红素下降值高于对照组（P〈0．01）,差异具有非常显著性。结论酪酸梭菌活菌散联合光疗治疗母乳性黄疸能够缩短光疗时间和快速降低血清胆红素,值得临床推广应用。     

新生儿高胆红素血症血清TNF-α表达水平的研究

目的:通过检测新生儿高胆红素血症时血清TNF-α的水平,探讨新生儿高胆红素血症时炎性细胞因子TNF-α的变化情况。方法:收集我院诊断为新生儿高胆红素血症的患儿共116例,根据黄疸原因分为感染性黄疸组、母乳性黄疸组等,用ELISA方法检测其血清TNF-α的表达水平。结果:感染性黄疸组TNF-α最高,其次为早产低体重组。结论:感染和早产低体重是新生儿高胆红素血症的主要原因,在临床工作中应注意做好抗感染抗炎工作。     

微生态制剂"妈咪爱"治疗母乳性黄疸的临床观察

为探讨微生态制剂“妈咪爱”对母乳性黄疸的影响,对30例临床诊断的母乳性黄疸患儿随机分为治疗组和对照组,观察“妈咪爱”对母乳性黄疸血清胆红素影响,对十二指肠液胆红素影响,对胆汁和粪便中β-葡萄糖醛酸苷酶活性影响。结果显示,微生态制剂“妈咪爱”能降低血清胆红素值,减少十二指肠液和粪便中β-葡萄糖醛酸苷酶量。对母乳性黄疸患儿继续母乳喂养具有退黄治疗作用。     

加强对母乳性黄疸认识,促进小儿健康成长

母乳性黄疸发病率逐年提高,严重母乳性黄疸可以导致小儿发生高胆红素血症,一旦引起胆红素脑病,会给小儿带来致死、致残的代价,然而如果治疗、护理及时得当,黄疸最终可完全消退,预后良好。因此临床医师应对此病有充足的认识,争取做到早发现,早诊断,适当干预治疗和护理,保证小儿健康、聪明的成长。     

金双歧联合茵桅黄口服液治疗母乳性黄疸疗效观察

目的探讨治疗新生儿母乳性黄疸的有效方法。方法将185例新生儿母乳性黄疸分为治疗组和对照组,治疗组的新生儿在出生后24 h内开始口服金双歧(0.5 g/次,3次/d,温水冲服),同时口服茵桅黄口服液(5 mL/次,2次/d),疗程5～7 d。对照组不采取任何干预措施。结果治疗组胆红素日均下降值为(42.31±16.12)μmol/L显著高于对照组的(22.26±11.25)μmol/L(P<0.05);观察组胆红素下降至119.5μmol/L以下的天数为(4.2±1.9)d,显著短于对照组的(7.8±3.5)d(P<0.05)。结论金双歧联合茵桅黄口服液应用于母乳性黄疸,可迅速降低胆红素水平,缩短治疗时间,无副作用,值得临床推广应用。     

茵栀黄口服液联合布拉酵母 对新生儿黄疸的治疗

目的探讨茵栀黄口服液联合布拉酵母治疗新生儿黄疸的效果。方法回顾性分析2012年5月至2016年2月我院收治的108例新生儿黄疸患儿的临床资料,根据治疗方法的不同将患儿分为对照组(50例)和观察组(58例)。两组患儿均给予蓝光处理,对照组同时给予布拉酵母治疗,观察组在对照组的基础上联用茵栀黄口服液进行治疗。比较两组患儿凝血指数、血气指标、生化指标及治疗效果。结果观察组患儿治疗后有效率高于对照组(98.28%vs 90.00%,χ~2=24.92,P0.05)。观察组患儿治疗后PaCO_2、pH、BE及Ca~(2+)和Mg~(2+)水平均低于对照组,差异有统计学意义(均P0.05)。观察组患儿治疗后PT、APTT、FIB、TT异常发生率与对照组比较差异无统计学意义(均P0.05)。观察组患儿治疗后血清总胆红素水平低于对照组,住院时间及黄疸消退时间均短于对照组,差异有统计学意义(均P0.05)。结论茵栀黄口服液联合布拉酵母治疗新生儿黄疸效果显著,能够明显缩短黄疸消退时间,改善血气分析指标及生化指标水平,安全有效。     

Improvement of Expressed Breast Milk in Mothers of Preterm Infants by Recording Breast Milk Pumping Diaries in a Neonatal Center in China

Objectives

Because inadequate expression of human milk (EBM) in mothers of hospitalized infants were noticed in a neonatal center of our hospital, family education program was carried out to increase the EBM.

Methods

A breast milk pumping diary was introduced to the mothers with preterm infant(s) admitted in the NICU. The ratios of EBM (days of EBM to NICU/hospitalized days), breast milk feeding (BMF) (days of infants fed with exclusive human milk/hospitalized days), mixed feeding (MF) (days of infants fed with partial breast milk and partial formula/hospitalized days), and formula feeding (FF) (days of infants fed with preterm formula/hospitalized days) were evaluated.

Results

During January to April, 2014, the ratios of EBM to the NICU, BMF, MF and FF were 28.11%, 6.6%, 32.8% and 60.6%, respectively. After the introduction of breast milk pumping diary to the mothers from May 2014, the ratio of EBM to the NICU increased significantly to 53.3% (p<0.01) within the following eight months. Both the ratios of BMF and MF also rose to 23.8% and MF 55.3%, respectively. Consequently, the ratio of FF was reduced to 20.9%. Exclusive breast milk feeding also significantly reduce the duration of nil per oral (NPO) of the very low birth weight infants during hospital stay as compared to those fed with mixed feeding and formula feeding.

Conclusion

The introduction of a breast milk pumping diary was associated with a significant increase in the intake of EBM of the hospitalized preterm newborns.     

酪酸梭菌活菌散治疗母乳性黄疸疗效观察

目的观察酪酸梭菌活菌散（商品名：宝乐安）治疗母乳性黄疸的临床疗效。方法将60例母乳性黄疸的足月儿随机分为观察组30例和对照组30例。观察组在常规治疗的同时给予酪酸梭菌活菌散口服,0．5g／次,2次／d,加水2-5ml溶解口服;对照组仅常规治疗。2组均不停止母乳喂养。结果观察组胆红素日均下降值为（42．1±16．2）μmol／L,显著高于对照组的（22．6±11．2）μmol／L（P〈0．05）;观察组胆红素下降至119．5μmol／L以下的天数为（4．6±1．6）d,显著短于对照组的（9．6±2．5）d（P〈0．05）。结论酪酸梭菌活菌散治疗母乳性黄疸,可迅速降低胆红素水平,缩短治疗时间。     

Metabolic acidosis and infant feeding.

Most cows'' milk based formulae for infant feeding present a greater acid load to the infant than breast milk. To determine the effect of this difference the acid base state of 180 healthy term infants was measured on the sixth day of life and related to the type of feed. Those infants fed on cows'' milk formula (SMA) had a mean pH of 7-34 +/- 0-05 and a base deficit of 8-8 +/- 3-1, while those fed on breast milk had a mean pH of 7-38 +/- 0-05 and a base deficit of 5-6 +/- 3-1. The difference between the two groups of infants was significant for both these measurements. Metabolic acidosis was defined as a base deficit greater than 10 mmol/l. Seventy-four per cent of the 34 infants who were acidotic at six days were bottle-fed. There was a significant correlation between the pH of the feed and the degree of acidosis in the infant as measured by the base deficit. The findings suggest that when breast milk is not available a pH-adjusted milk formula would be desirable for preventing and treating neonatal metabolic acidosis.     

Characterization of gut microbiota and short-chain fatty acid in breastfed infants with or without breast milk jaundice

This study aims to investigate the gut microbiota and metabolites in breastfed infants with breast milk jaundice (BMJ) using gut microbiome–metabolomics. Breastfed newborns diagnosed with BMJ and those without BMJ (control group) were enrolled. Faecal samples were collected from the participants and subjected to high-throughput sequencing of the 16s rDNA V3 and V4 regions of the gut flora and metabolomics of short-chain fatty acids (SCFAs). Proteobacteria, Fimicutes and Actinobacteria were the main bacteria at the phylum level. Eshcerichia-Shigella and Enterobacteriacea were the main bacteria at the genus level. The difference between the two groups was compared. Compared to the control group, the amount of Streptococcus was significantly increased while the amount of Enterococcus was significantly decreased in the faeces from infants with BMJ. Functional prediction analysis of 16S found that biosynthesis of penicillin and cephalosporin significantly increased in the BMJ group. Gas chromatography–mass spectrometry detection of SCFAs revealed that levels of acetic acid and propionic acid were significantly lower in the BMJ group than in the control group. The reduced levels of acetic acid and propionic acid may be related to the increase in Streptococcus and decrease in Enterococcus, both of which may contribute to BMJ.     

Does opening a milk bank in a neonatal unit change infant feeding practices? A before and after study

Background

Donor human milk banks are much more than simple centers for collection, storage, processing, and distribution of donor human milk, as they cover other aspects and represent a real opportunity to promote and support breastfeeding. The aim of our study is to assess the impact that opening a human milk bank has had on the proportion of infants receiving exclusive breast milk at discharge and other aspects related to feeding children with birth weight < or = 1500 g or < 32 weeks gestation admitted to the neonatal unit.

Methods

The study included babies of < or = 1500 g or < 32 weeks gestation. Fifty infants born from February to July in 2006, before the opening of the human milk bank, and 54 born from February to July in 2008, after its opening, met inclusive criteria. We collected data about days of hospital stay, hours of life when feeding was started, hours of life when full enteral feeding was attained, the type of milk received during admission, and the type of feeding on discharge.

Results

Children born in 2008 commenced feeding 16 hours earlier than those born in 2006 (p = 0.00). The proportion of infants receiving exclusive breast milk at discharge was 54% in 2006 and 56% in 2008 (p = 0.87). The number of days they received their mother's own milk during the first 28 days of life was 24.2 days in 2006, compared to 23.7 days in 2008 (p = 0.70). In 2006, 60% of infants received infant formula at least once in the first 28 days of life, compared to 37% in 2008 (p = 0.01).

Conclusions

The opening of a donor human milk bank in a neonatal unit did not reduce the proportion of infants exclusively fed with breast milk at discharge, but did reduce the proportion of infants that received infant formula during the first four weeks of life. Also, having donor human milk available enables commencement of enteral feeding earlier.     

母乳联合鼠李糖乳杆菌预防早产儿喂养不耐受的疗效观察

目的观察母乳联合鼠李糖乳杆菌预防早产儿喂养不耐受的临床疗效。方法选取2016年2月至2017年2月武汉大学人民医院收治的80例生后24h内入住本院儿科新生儿病房的早产儿,随机分配成2组,其中研究组40例,对照组40例。研究组以新鲜母乳联合鼠李糖乳杆菌早期开奶喂养,对照组以早产儿配方奶早期开奶喂养,比较2组早产儿喂养不耐受症的发生率及其恢复出生体重时间、达全胃肠道喂养时间、体重增长速度和住院时间的差异。结果研究组患儿喂养不耐受发生率低于对照组,研究组恢复出生体重时间、达全胃肠道喂养时间及住院时间均短于对照组(P0.05),研究组患儿体重增加速度快于对照组(P0.05)。结论早产儿早期喂养母乳联合鼠李糖乳杆菌能够较早建立全胃肠道营养,减少早产儿喂养不耐受症的发生率,促进患儿体重增长,缩短恢复出生体重时间及达全胃肠道喂养时间,降低住院天数。     

S-腺苷蛋氨酸对梗阻性黄疸患者术后肝功能及营养状况影响的临床研究

目的：探讨S-腺苷蛋氨酸对梗阻性黄疸患者术后肝功能及营养状况的影响。方法：选择2010年8月至2012年7月我院肝胆病区收治的90例梗阻性黄疸患者为研究对象,随机分为S-腺苷蛋氨酸治疗组（48例）和对照组（42例）,比较和分析静脉滴注S-腺苷蛋氨酸对梗阻性黄疸患者术后第5d、10d肝功能及营养指标的影响。结果：术后5d、10d,两组患者血总胆红素、直接胆红素、谷丙转氨酶、1．谷氨酰转肽酶、碱性磷酸酶水平较术前1d显著降低,且组内比较差异有统计学意义（P〈0．05）,治疗组以上指标的下降程度较对照组更明显,差异有统计学意义（P〈0．05）。术后第10d,两组患者的血白蛋白、前白蛋白、转铁蛋白水平较术后第5d显著改善（P〈0．05）;术后第5、10d,两组组间血白蛋白、前白蛋白、转铁蛋白水平比较差异有统计学意义（P〈0．05）。结论：梗阻性黄疸患者术后应用腺苷蛋氨酸能促进黄疸消退,加快胆红素的排泄和肝功能的恢复,有利于患者营养状况的改善。