非营养吸吮和金双歧预防早产儿喂养不耐受115例分析

目的评价比较非营养吸吮和金双歧对促进早产儿胃肠功能成熟度，预防早产儿喂养不耐受的效果。方法回顾分析我院2004年6月至2008年3月收治的符合标准的115例早产儿，根据喂养干预措施分成非营养吸吮（NNS）组（38例）、金双歧组（42例）和对照组（35例），组间胎龄、出生体重及Apgar评分均衡。NNS组常规干预外，生后6～12h开始NNS，在每次喂养前给予吸吮无孔橡皮奶头10min，7—8次／24h。金双歧组常规干预外，生后6—12h开始口服金双歧，每次0．5g，每Et3次。对照组常规干预。临床观察喂养不耐受发生情况，生后10d评价结果。结果各组喂养不耐受的发生率比较，NNS组明显低于对照组，差异有显著性（χ^2=6．510，P〈0．05）；金双歧组也明显低于对照组，差异有显著性（χ^2=5．840，P〈0．05）；NNS组比金双歧组发生率略低，但差异元显著性（χ^2=0．066，P〉0．05）。结论早期NNS或早期使用金双歧都可以明显降低喂养不耐受的发生，均可作为预防喂养不耐受的有效措施，两者效果相当。对于吸吮极差的极低或超低体重儿，早期NNS并不具有可操作性或不能达到足够的操作时间，而使用金双歧灌喂更具有操作性。

Analysis of nonnutritive sucking and "Golden bifid" in preventing feeding intolerance of 115 premature infants

Objective To evaluate the effect of nonnutritive sucking （NNS） and ＂Golden bifid＂ in preventing the feeding intolerance and promoting the gastrointestinal maturity of premature infants. Method Retrospective analysis was performed on 115 premature infants who were admitted in our hospital from June 2004 to November 2007. The infants were assigned into three groups based on feeding intervention： 38 in NNS group, 42 in ＂ Golden bifid ＂group, and 35 in control group, with the gestational age, birth weight and Apgar score between groups being in equilibrium. Besides the routine intervention, the infants in NNS group were allowed to suck baby soothers for 10 minutes ,7 - 8 times per day in 6 - 12 hours after birth,while the infants in ＂Golden bifid＂ group were give Golden bifid orally 0.5 g a time,three times a day. The control group was given routine intervene only. Then the phenomena of feeding intolerance was observed and the results evaluated after 10 days. Result The incidence of feeding intolerance in NNS group was lower than that of the control group and the difference was significant in statistics （χ^2=6.510, P〈0.05）. There was no significant difference between the control group and Golden bifid group, although the latter showed a lower incidence（ χ^2 = 5. 840, P 〈 0.05 ）. The incidence of NNS group was lower than that of the Golden bifid group, but the difference had no statistical significance （χ^2= 0.066, P 〉 0.05）. Conclusion Using NNS or Golden bifid in early stage could promote the gastrointestinal maturity and reduce the incidence of feeding intolerance in premature infants. The effect of the two ways is equivalent. The use ＂Golden bifid＂ is easier to the infants with very or ultra low birth weight and poor or even no sucking ability