洗胃后配合间歇胃肠减压治疗新生儿顽固性呕吐的疗效及安全性评价

目的：探讨洗胃后配合间歇胃肠减压治疗新生儿顽固性呕吐的临床疗效及安全性。方法：将2009年1月～2012年6月我院儿科收治124例顽固性呕吐的新生患儿随机分为两组,每组各62例。所有患儿均给予病因治疗、体位治疗、维持水电解质及酸碱平衡等常规综合治疗。在此基础上,对照组给予温盐水洗胃治疗,治疗组给予洗胃后配合间歇胃肠减压治疗。观察和比较两组患儿的临床疗效、体重和胃肠功能变化及不良反应。结果：治疗后,治疗组患儿总有效率为90.3%,显著高于对照组总有效率为75.8%（P〈0.05）;与对照组比较,治疗组患儿顽固性呕吐症状的缓解时间、胃肠功能完全恢复时间明显缩短,体重减轻程度较轻（P〈0.05）;两组患儿均未见坏死性肠炎、新生儿窒息等严重不良反应。结论：洗胃后配合间歇胃肠减压可提高临床疗效及促进胃肠功能恢复,简单安全,可作为新生儿顽固性呕吐理想的治疗方法。

Combined with Intermittent Decompression after Gastric Lavage for Neonatal Intractable Vomiting

Objective： To explore the clinical effect and safety of gastric lavage combined with gastrointestinal decompression in the treatment of neonatal intractable vomiting. Methods： A total of 124 newborns with intractable vomiting, admitted in traditional chinese medicine hospital of Baoshan district in shanghai between January 2009 and June 2012, were randomly divided into two groups. All the patients were given regular comprehensive treatment,including pathogeny cure, postures treatment,correct water-electrolyte and acid-base balance. On this basis, the control group （n=62） was given warm salt water and gastric lavage treatment;treatment group （n=62） was given gastric lavage combined with gastrointestinal decompression. The clinical effect, change of body weight and gastrointestinal function, and main adverse effect were observed and analyzed between the two groups. Results： The total clinical effective rate in treatment group（90.3%） was significantly higher than that in control group（75.8%）（P〈0.05） after treatment. Compared with control group, the remission time of vomiting and fully restored time of gastrointestinal function were significantly shortened, degree of body weight loss was lower （P〈0.05）. No serious adverse effect such as necrotic enteritis and asphyxia neonatorum was found in both groups. Conclusion： The gastric lavage combined with gastrointestinal decompression can improve the clinical effect and promote the recovery of gastrointestinal function,which is simple and easy, and can be used as an ideal therapy for neonatal intractable vomiting.