【摘要】 目的探讨非营养性吸吮(NNS)对早产儿生长发育的影响。方法2004-11—2005-09对贵阳医学院附院新生儿室收治的需经间断鼻胃管喂养(INGF)早产适于胎龄儿60例,根据是否辅以非营养性吸吮随机分成无非营养性吸吮(N-NNS)组及NNS组;并以同期出生无窒息、无消化系统解剖及功能异常足月新生儿25例为对照。放射免疫法(RIA)动态监测早产儿生后第1、3、7天血、胃液中胃泌素(GAS)、胃动素(MOT)水平,同时记录胃肠道功能紊乱发生的情况(呕吐、腹胀、胃潴留、消化道出血、坏死性小肠结肠炎)、生长发育指标(体重、头围)及其它临床指标。结果①随日龄增加,各组GAS、MOT有增高趋势,NNS组增高幅度较大。第1天N-NNS组、NNS组血GAS低于对照组(P<0.01),血及胃液MOT低于对照组(P<0.05);第3天N-NNS组及NNS组血GAS、MOT低于对照组(P<0.05),N-NNS组血GAS低于NNS组(P<0.05);第7天N-NNS组血GAS、MOT均低于NNS组及对照组(P<0.05)。②N-NNS组腹胀、胃潴留发生率均高于NNS组(P<0.05);N-NNS组胃肠功能紊乱发生率为60.0%(18/30),NNS组胃肠功能紊乱发生率为26.7%(8/30),两组差异有统计学意义(χ2=6.787,P=0.018)。③NNS组睡眠时间较N-NNS组长,烦躁时间较N-NNS组短,第14天体重及头围增长幅度较N-NNS组大,差异均有统计学意义(P<0.05);N-NNS组呼吸暂停发生率为43.3%(13/30),NNS组呼吸暂停发生率为16.7%(5/30),两组差异有统计学意义(χ2=5.080,P=0.047)。结论NNS能促进GAS、MOT分泌,改善胃肠转运功能,减少胃肠功能紊乱的发生,促进胃肠功能成熟,加快早产儿体格生长。更多还原

【Abstract】 Objective To dynamically examine the levels of gastrin and motilin in blood and in gastric juice in premature infants who were 1,3,7 days old.To monitor the levels of gastrin and motilin in blood and gastric juice in all these infants after intervening with non-nutritive sucking(NNS).Discuss the effects on the growth of the premature infants with non-nutritive sucking(NNS).Methods Sixty premature infants appropriate for gestational age who accepted intermittent nasogastric feeding (INGF) were randomly assigned into a non-NNS group and NNS group according to whether they should receive the non-nutritive sucking or not.Twenty-five normal full-term infants were enrolled as controls.The levels of gastrin and motilin in blood and gastric juice were detected by radioimmunoassay (RIA).The occurence of functional disturbances of gastrointestinal tract (e.g.vomiting,abdominal distention,gastric retention,alimentary tract hemorrhage and necrotizing enterocolitis),growth standard (e.g.body weight,head circumference) and the other clinical standards were collected and recorded.Results 1.The levels of gastrin and motilin in blood and gastric juice increased with days in the three groups,and the levels of them in the three groups were increased respectively,especially in the NNS group.There were significantly statistical differences of gastrin in blood (P<0.01) and motilin in blood and gastric juice (P<0.05) between N-NNS,NNS groups and the control group on the first day.The levels of gastrin and motilin in blood in N-NNS and NNS groups were lower than those of the control group on the third day (P<0.05),and gastrin in blood of N-NNS group was lower than that of NNS group (P<0.05).The levels of gastrin and motilin in blood in N-NNS were significantly lower than those of control group and NNS group on the seventh day (P<0.05).2.The incidence rates of abdominal distention and gastric retention in N-NNS group were significantly higher than those in NNS group(P<0.05).The incidence rate of functional disturbances of gastrointestinal tract in N-NNS group was 60%(18/30),the rate was 26.7%(8/30) in the NNS group,and there was a statistical significance between the differences of two groups (χ2=6.787,P=0.018).3.The sleeping time in NNS group was longer the that in N-NNS group,and the fidget time in NNS group was shorter than that in N-NNS group.The growth of body weight and head circumference in NNS group were faster than those in N-NNS group on the fourteenth day.The differences had statistical significance (P<0.05); the incidence rate of respiration pause in N-NNS group was 43.3% (13/30),the rate in NNS group was 16.7% (5/30),and there was a statistical significance between the differences of two groups(χ2=5.080,P=0.047).Conclusion NNS can increase the secretion of gastrin and motilin,improve the function of transportation gastrointestinal tract,decrease the occurrence of functional disturbances of gastrointestinal tract,promote the functional maturity of gastrointestinal tract and quicken the growth of the premature infant.更多还原