本文選題：早產(chǎn)兒 + 莫沙必利��； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：【目的】 評價(jià)胃腸動(dòng)力藥物莫沙必利聯(lián)合不同益生菌制劑（酪酸梭菌-嬰兒型雙歧桿菌二聯(lián)活菌、枯草桿菌腸球菌二聯(lián)活菌）對早產(chǎn)兒胃腸功能以及早期生長發(fā)育影響的臨床療效。 【方法】 收集2009年1月至2012年6月在安徽省立醫(yī)院新生兒科住院的早產(chǎn)兒。入選標(biāo)準(zhǔn):（1）胎齡37周的早產(chǎn)兒（2）出生體重2500g （3）出生后24小時(shí)內(nèi)即轉(zhuǎn)入我院新生兒科（4）住院時(shí)間≥14天且治療結(jié)果為治愈或好轉(zhuǎn)。排除標(biāo)準(zhǔn):消化道畸形，新生兒重度窒息，先天性心臟病，顱內(nèi)出血，新生兒呼吸窘迫綜合癥，羊水咽下，吸入性肺炎，早期感染，消化道出血。共有421例早產(chǎn)兒符合入選標(biāo)準(zhǔn)，隨機(jī)分為A組(常規(guī)組)共計(jì)92例、B組（莫沙必利+媽咪愛組)共計(jì)156例、C組（莫沙必利+常樂康組.)共計(jì)173例。A組患兒予常規(guī)護(hù)理和治療，B組在A組的基礎(chǔ)上于出生6h內(nèi)開始口服(或經(jīng)胃管)給予益生菌制劑枯草桿菌腸球菌二聯(lián)活菌散顆粒，每次1g，每天2次和莫沙必利每次0.5mg，每天3次。C組在A組的基礎(chǔ)上于出生6h內(nèi)開始口服(或經(jīng)胃管)給予益生菌制劑酪酸梭菌-嬰兒型雙歧桿菌二聯(lián)活菌散劑，每次0.5g，每天2次和莫沙必利每次0.5mg，每天3次。觀察和記錄3組早產(chǎn)兒每天添加奶量、第14天攝入奶量、腸內(nèi)營養(yǎng)熱卡達(dá)50kcal/kg.d、80kcal/kg.d的時(shí)間、達(dá)到全胃腸喂養(yǎng)時(shí)間、體質(zhì)量增長速度、喂養(yǎng)不耐受發(fā)生率、不耐受癥狀持續(xù)時(shí)間、胎糞初排時(shí)間、黃疸消退時(shí)間、合并癥發(fā)生率等情況。采用SPSS16.0統(tǒng)計(jì)軟件包進(jìn)行處理，計(jì)量資料以均數(shù)士標(biāo)準(zhǔn)差（±S）表示，采用單因素的方差分析，兩兩比較采用Bonferroni法；計(jì)數(shù)資料采用2檢驗(yàn)，以P0.05為有統(tǒng)計(jì)學(xué)意義。 【結(jié)果】 B組和C組早產(chǎn)兒每日添加奶量、第14天攝入奶量、平均體質(zhì)量增長速度均高于A組（P0.05）；腸內(nèi)營養(yǎng)達(dá)50kcal/kg.d、80kcal/kg.d的時(shí)間、全胃腸營養(yǎng)時(shí)間、住院時(shí)間以及恢復(fù)出生體質(zhì)量時(shí)間均短于A組（p0.05）；B組和C組早產(chǎn)兒生后體質(zhì)量下降幅度、EUGR發(fā)生率、喂養(yǎng)不耐受發(fā)生率均低于A組（P0.05），喂養(yǎng)不耐受癥狀持續(xù)時(shí)間均短于A組(P0.05)；B組和C組患兒初次排便時(shí)間、胎糞排盡時(shí)間均短于A組（p0.05）。B、C兩組早產(chǎn)兒在營養(yǎng)攝取、體重增長、喂養(yǎng)不耐受發(fā)生方面的差異均無統(tǒng)計(jì)學(xué)意義（P0.05）。B組和C組患兒黃疸消退時(shí)間均短于A組（p0.05），B組比C組患兒第7天總膽紅素水平、第14天總膽紅素水平更低（p0.05）。B組和C組患兒敗血癥、壞死性小腸結(jié)腸炎、膽汁淤積的發(fā)生率均低于A組（p0.05）。C組敗血癥的發(fā)生率較B組更低（P0.05）。 【結(jié)論】 莫沙必利聯(lián)合益生菌能有效防治早產(chǎn)兒胃腸功能紊亂，促進(jìn)營養(yǎng)物質(zhì)的吸收和利用，顯著縮短達(dá)全胃腸喂養(yǎng)時(shí)間，對早期的生長發(fā)育有促進(jìn)作用；并且促進(jìn)胎糞排除，縮短黃疸消退時(shí)間；有效降低早產(chǎn)兒合并癥的發(fā)生率。媽咪愛和常樂康在促進(jìn)早產(chǎn)兒營養(yǎng)攝入、生長發(fā)育、改善喂養(yǎng)不耐受的療效方面無明顯差異，，但媽咪愛退黃作用略優(yōu)于常樂康，而后者在減少早產(chǎn)兒敗血癥的發(fā)生上略優(yōu)于媽咪愛。
[Abstract]:[Objective]
To evaluate the effect of the gastrointestinal motility drug mosapride combined with different probiotics (Clostridium butyricum - two Bifidobacterium infantile, two Bacillus subtilis Enterococcus) on the gastrointestinal function and early growth and development of preterm infants.
[method]
The preterm infants in the neonatal department of Anhui Provincial Hospital from January 2009 to June 2012 were collected. (1) 2500g (3) of premature infants (2) of 37 weeks of fetal age (3) were transferred to our hospital 24 hours after birth (4) hospitalization time for more than 14 days and the treatment results were cured or improved. Exclusion criteria: digestive malformation, severe neonatal stifles Congenital heart disease, intracranial hemorrhage, neonatal respiratory distress syndrome, amniotic fluid pharynx, inhalation pneumonia, early infection, digestive tract bleeding, 421 premature infants were randomly divided into group A (routine group) 92 cases, group B (mosapride + mommy love group) in total 156 cases, and group C (mosapride + changlekang group) in a total of 173 cases The children were given routine care and treatment. On the basis of group A, group B began to give oral (or through gastric tube) oral (or through gastric tube) to the probiotics of Bacillus subtilis Enterococcus two combined bacteria granules, each time 1g, 2 times a day and Mosapride each time 0.5mg, 3 times a day on the basis of group.C in the A group to begin oral (or through gastric tube) to give probiotics. Clostridium butyricum - two Bifidobacterium infantile Bifidobacterium, each 0.5g, 2 times a day, and Mosapride each time 0.5mg, 3 times a day. Observe and record 3 groups of preterm infants added milk per day, intake of milk in Fourteenth days, 50kcal/kg.d, 80kcal/kg.d of enteral nutrition, total gastrointestinal feeding time, body mass growth rate, and feeding intolerance. The incidence, the duration of the intolerance of the symptoms, the time of the meconium initial row, the time of the jaundice, the incidence of the complication, and so on. The data were processed with SPSS16.0 software package, the measurement data were represented by the standard deviation of the number of men (+ S), the single factor analysis of variance, and the 22 comparison of the Bonferroni method were used, and the count data were 2 test, and P0.05 was the unified system. The significance of learning.
[results]
In group B and group C, the amount of milk was added daily and milk was consumed in Fourteenth days. The average body mass growth rate was higher than that of group A (P0.05); the time of enteral nutrition 50kcal/kg.d, 80kcal/kg.d, total enteral nutrition time, time of hospitalization and recovery of birth body mass time were shorter than that of group A (P0.05), and the decrease of body mass of premature infants in group B and C group was EUG, EUG The incidence of R was lower than that of group A (P0.05), and the duration of feeding intolerance was shorter than that in group A (P0.05), and the time of initial defecation in group B and C was shorter than that of A group (P0.05).B, and there was no significant difference in nutrition intake, weight growth, and feeding intolerance between the two groups of C group (P0.05). The regression time of jaundice in group B and group C was shorter than that in group A (P0.05). The total bilirubin level in group B was lower than that of group C, and the rate of total bilirubin in group.B and C group was lower (P0.05), necrotizing enterocolitis, and cholestasis was lower than that of group C, and the incidence of cholestasis was lower than that of group A group (P0.05), and the incidence of sepsis in.C group was lower than that of group A.
[Conclusion]
The combined probiotics of Mosapride can effectively prevent and control the gastrointestinal dysfunction in preterm infants, promote the absorption and utilization of nutrients, shorten the feeding time of the whole gastrointestinal tract, promote the early growth and development, promote the removal of meconium, shorten the time of the jaundice to decline, and reduce the incidence of complication in premature infants. Mommy love and Changle There is no obvious difference in the effect of promoting nutrition intake, growth and development and improving feeding intolerance in preterm infants, but Mommy is slightly better than Changle Kang, and the latter is slightly better than mommy love in reducing the incidence of sepsis in premature infants.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R722.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃瑛,邵肖梅,曾紀(jì)驊,趙瑞芳,季志英,袁紅;早期微量喂養(yǎng)對危重癥新生兒胃腸道動(dòng)力的影響[J];中國當(dāng)代兒科雜志;2000年03期

2 蔡威;陶曄璇;湯慶婭;馮一;;《中國新生兒營養(yǎng)支持臨床應(yīng)用指南》解讀[J];中國當(dāng)代兒科雜志;2006年05期

3 蔡威;湯慶婭;陶曄璇;馮一;;中國新生兒營養(yǎng)支持臨床應(yīng)用指南[J];中國當(dāng)代兒科雜志;2006年05期

4 向建文;楊琳琳;楊杰;;口服益生菌對早產(chǎn)兒胃腸動(dòng)力影響的臨床研究[J];兒科藥學(xué)雜志;2009年05期

5 蔡俊偉,賁曉明;中長鏈脂肪乳劑在早產(chǎn)兒臨床應(yīng)用的研究[J];臨床兒科雜志;2002年10期

6 李曉東;田青;何中倩;楊俏文;郭婧;葉軍;;小劑量紅霉素治療早產(chǎn)兒喂養(yǎng)不耐受的療效[J];實(shí)用兒科臨床雜志;2006年19期

7 陳艷娟;謝潤華;余文霞;周偉;;微生態(tài)制劑對早產(chǎn)兒喂養(yǎng)不耐受及早期生長發(fā)育的影響[J];實(shí)用兒科臨床雜志;2008年14期

8 陽勇;錢新華;郭麗珊;陳佳;黃為民;;新生兒長期胃腸外營養(yǎng)相關(guān)性膽汁淤積的發(fā)生率及其影響因素[J];實(shí)用兒科臨床雜志;2010年02期

9 程衛(wèi)光;邱培全;;微生態(tài)制劑防治小兒肺炎繼發(fā)性腹瀉療效觀察[J];新鄉(xiāng)醫(yī)學(xué)院學(xué)報(bào);2007年04期

10 潘云芳;;酪酸梭菌治療小兒腹瀉療效觀察[J];當(dāng)代醫(yī)學(xué)(學(xué)術(shù)版);2007年11期

本文編號(hào)：2064145