Liang Zhiqiang, Lu Lu, Zhou Yingchun, Chen Shangqin, Huang Yumei, Lin Zhenlang
Department of Neonatology, Wenzhou Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Department of Neonatology, Wenzhou Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China. Email:
Zhonghua Er Ke Za Zhi. 2014 Jan;52(1):51-6.
To explore the relationship between gastric retention and full enteral feeding during the course of feeding in extremely low birth weight (ELBW, birth weight <1 000 g) infants.
A total of 43 ELBW infants were fed with formula according to the strategy for premature infants feeding of Canadian Society of Neonatology. The information such as gastric retention, the time they finish full enteral feeding and sucking spontaneously and complication were recorded. These infants had transition to full enteral feeding step by step since initiating formula feeding on the second day of life. The volume of gastric retention and the duration of gastric retention was analyzed with the time of attaining full enteral feeding and sucking spontaneously by linear regression.
Forty-one infants finished the course, the remaining 2 infants got necrotizing enterocolitis (NEC) and were rescued by surgery. The incidence was 4.6%. In 18 infants full enteral feeding could not be initiated successfully on the second day of life, the incidence was 43.9%. The peak duration of gastric retention was the first week of feeding. The average time of attaining enteral feeding was (26.71 ± 12.24) days. The proportion of different residual contents was simlar, the major content was milky content after 3 weeks of feeding. The gastric retention time had a significant effect of on the time of attaining full enteral feeding (β = 1.045, P = 0.001) and sucking well (β = 0.787, P = 0.034) .
The course of formula feeding ELBW infants to attaining full enteral feeding was a long period, in the early stage of formula feeding the occurrence of gastric retention was high; the amount of formula during the first week of feeding should be slowly increased as compared to the second week; the present strategy and aggressive strategy should be done 2 weeks later. The time of attaining full enteral feeding can be predicted by the duration of gastric retention.
探讨极低出生体重（ELBW，出生体重<1000g）婴儿喂养过程中胃潴留与完全肠内喂养之间的关系。
按照加拿大儿科学会早产儿喂养策略，对43例ELBW婴儿进行配方奶喂养。记录胃潴留情况、完全肠内喂养时间、自主吸吮时间及并发症等信息。这些婴儿自出生后第二天开始配方奶喂养，逐步过渡到完全肠内喂养。采用线性回归分析胃潴留量和胃潴留持续时间与完全肠内喂养及自主吸吮时间的关系。
41例婴儿完成整个过程，其余2例发生坏死性小肠结肠炎（NEC）并接受手术治疗，发病率为4.6%。18例婴儿在出生后第二天未能成功开始完全肠内喂养，发病率为43.9%。胃潴留的高峰持续时间为喂养的第一周。达到肠内喂养的平均时间为（26.71±12.24）天。不同残留内容物的比例相似，喂养3周后主要内容物为乳状物质。胃潴留时间对完全肠内喂养时间（β=1.045，P=0.001）和良好吸吮时间（β=0.787，P=0.034）有显著影响。
ELBW婴儿配方奶喂养至完全肠内喂养的过程较长，配方奶喂养早期胃潴留发生率较高；与第二周相比，喂养第一周的配方奶量应缓慢增加；当前策略和积极策略应在2周后实施。胃潴留持续时间可预测完全肠内喂养时间。
