目的 分析强化母乳喂养在预防极低出生体重儿感染中的作用。方法 2015年1月-2016年8月本院新生儿科的极低出生体重儿(1 000 g≤出生体重<1 500 g)80例根据入选标准纳入研究,根据喂养方式不同分为强化母乳实验组40例[住院期间母乳量占喂养总量的75%以上,母乳均来自患儿自己的母亲,母乳喂养量达80 ml/(kg·d)时,添加母乳强化剂(母乳不足部分由早产配方奶补充)],早产配方奶对照组40例(住院期间全部早产配方奶喂养)。比较两组患儿达到全肠道喂养的时间、喂养不耐受情况、院内感染以及新生儿坏死性小肠结肠炎的发生率。结果 两组早产儿在胎龄、性别、体重等方面差异无统计学意义(P>0.05),具有可比性。实验组达到全肠道喂养的时间为(15.22±4.37) d,对照组达到全肠道喂养的时间为(17.38±5.44) d,实验组显著低于对照组(P<0.05)。实验组喂养不耐受发生例数为7例,对照组喂养不耐受发生例数为15例,实验组显著少于对照组(P<0.05)。实验组院内感染2例,对照组院内感染7例,实验组显著少于对照组(P<0.05)。实验组坏死性小肠结肠炎1例,对照组坏死性小肠结肠炎3例,两组差异无统计学意义(P>0.05)。结论 极低出生体重儿实行强化母乳喂养可缩短达到全肠道喂养的时间,减少喂养不耐受的发生,降低院内感染的发生率,同时不增加坏死性小肠结肠炎的发生率。

Objective To investigate the effect of strengthening of breastfeeding on the prevention of infection in very low birth weight infants. Methods 80 preterm infants whose birth weight between 1 000 g and 1 500 g were involved in this study.According to the feeding mode,the infants were divided into two groups.The reinforcement of breastfeeding group (experimental group,n=40,The proportion of breast milk during hospitalization accounted for more than 75% of the total feeding,breast milk was from the children's own mother.When the feeding amount was more than 80 ml/ (kg·d),human milk fortifier was added).Formula milk feeding group (control group,n=40,all preterm infants were fed with formula during hospitalization).The time of reaching total enteral feeding,feeding intolerance,nosocomial infection,and the incidence rate of neonatal necrotizing enterocolitisin of the two groups were compared. Results Two groups had no diffences in gestational age or gender or birth weight(P>0.05).The time of reaching total enteral feeding of experimental group was(15.22±4.37)d,while the control group was (17.38±5.44)d.Statistically significant difference was demonstrated in time of reaching total enteral feeding between the two groups(P<0.05).The cases of feeding intolerance in the experimental group were 7,and in the control group were 15,statistically significant difference was demonstrated in feeding intolerance between the two groups(P<0.05).The nosocomial infection cases in the experimental group were 2,and in the control group were 7,statistically significant difference was demonstrated in nosocomial infection between the two groups(P<0.05).The incidence rate of neonatal necrotizing enterocolitis of the two groups had no significant differences (P>0.05). Conclusions Strengthening of breastfeeding in very low birth weight infants can shorten the time of reaching total enteral feeding,decrease the incidence of feeding intolerance and nosocomial infection,meanwhile do not influence the occurrence of neonatal necrotizing enterocolitis.