Meetze W H, Palazzolo V L, Bowling D, Behnke M, Burchfield D J, Neu J
University of Florida College of Medicine, Gainesville.
JPEN J Parenter Enteral Nutr. 1993 Nov-Dec;17(6):537-40. doi: 10.1177/0148607193017006537.
The timing of the first meconium stool has been considered a marker for proper gastrointestinal functioning in the term infant. There is limited information on the meconium passage patterns of very-low-birth-weight infants of less than 32 weeks' gestation. It is unknown whether feeding practices influence the timing of the first stool in these infants. We retrospectively studied 47 very-low-birth-weight infants with birth weights of 1250 g or less who were previously enrolled in a study of gastrointestinal (GI) priming. Infants whose mothers desired to breast feed (n = 7) were given GI priming with their own mother's milk. The remaining infants had been randomly assigned to receive total parenteral nutrition alone (n = 21) or GI priming with infant formula (n = 19) during the first 14 days of life. We attempted to advance all infants to full enteral nutrition by 21 days of age. There was no statistically significant difference in timing of the first stool among the three groups. The overall median age at first stool was 43 hours, and the 75th percentile was 10 days. The range was 1/2 hour to 27 days. There was no concordance between time of first stool and birth weight within the range studied. There was no concordance between time of first stool and necrotizing enterocolitis, although there was little statistical power to detect this. There was also very little concordance with feeding tolerance. Other than necrotizing enterocolitis, no significant GI disease developed in any of the infants studied.(ABSTRACT TRUNCATED AT 250 WORDS)
首次排出胎粪的时间一直被视为足月儿胃肠道功能正常的一个标志。关于孕龄小于32周的极低出生体重儿的胎粪排出模式,相关信息有限。尚不清楚喂养方式是否会影响这些婴儿首次排便的时间。我们回顾性研究了47名出生体重在1250克及以下的极低出生体重儿,他们之前参加了一项胃肠道启动研究。母亲希望母乳喂养的婴儿(n = 7)用其母亲自己的母乳进行胃肠道启动。其余婴儿在出生后的前14天被随机分配,分别单独接受全胃肠外营养(n = 21)或用婴儿配方奶进行胃肠道启动(n = 19)。我们试图让所有婴儿在21日龄时过渡到完全肠内营养。三组婴儿首次排便的时间没有统计学上的显著差异。首次排便的总体中位年龄为43小时,第75百分位数为10天。范围是半小时至27天。在所研究的范围内,首次排便时间与出生体重之间没有一致性。首次排便时间与坏死性小肠结肠炎之间也没有一致性,尽管检测这一点的统计学效力很小。与喂养耐受性之间也几乎没有一致性。在所研究的任何婴儿中,除了坏死性小肠结肠炎外,没有发生其他严重的胃肠道疾病。(摘要截短于250字)