de Ville K, Knapp E, Al-Tawil Y, Berseth C L
Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Am J Clin Nutr. 1998 Jul;68(1):103-8. doi: 10.1093/ajcn/68.1.103.
It is unknown whether it is better to feed preterm infants intragastrically by bolus or continuous infusion. This study compared the effect of 2 feeding rates on antral and duodenal motor responses and gastric emptying. Continuous perfusion manometry with a low-compliance machine was performed in 22 infants given feedings at 2 infusion rates. Gastric emptying was also assessed by using a dye-dilution technique to determine whether changes in motor response were reflected by changes in function. The number of antral contractions with both feeding rates decreased from that seen during fasting. Duodenal motor responses increased when infants were fed by slow infusion and decreased when they were fed by rapid infusion. Infants emptied 12 mL/kg of a 20-mL/kg feeding by 20 min after completion of the feeding given by slow infusion concomitantly with the increase in duodenal motor activity but only 8 mL/kg by 20 min after completion of the bolus feeding, when duodenal motor activity decreased (P < 0.01). Two hours after completion of the feeding, volumes remaining in the stomach after slow infusion were one-ninth those remaining after bolus feeding. When preterm infants are fed by slow infusion over 120 min, their duodenal motor responses are more like those observed in adults and their gastric contents are emptied faster and more completely than when they are fed with a rapid bolus.
对于早产儿是采用推注还是持续输注的方式进行胃内喂养更好尚不清楚。本研究比较了两种喂养速度对胃窦和十二指肠运动反应以及胃排空的影响。对22名以两种输注速度进行喂养的婴儿使用低顺应性机器进行连续灌注测压。还通过染料稀释技术评估胃排空情况，以确定运动反应的变化是否反映在功能变化上。两种喂养速度下的胃窦收缩次数均较空腹时减少。缓慢输注喂养时婴儿的十二指肠运动反应增强，快速输注喂养时则减弱。缓慢输注喂养结束后20分钟，婴儿排出了20毫升/千克喂养量中的12毫升/千克，此时十二指肠运动活动增强；而推注喂养结束后20分钟，仅排出了8毫升/千克，此时十二指肠运动活动减弱（P<0.01）。喂养结束两小时后，缓慢输注喂养后胃内残留量是推注喂养后残留量的九分之一。当早产儿在120分钟内缓慢输注喂养时，其十二指肠运动反应更类似于成年人，并且与快速推注喂养相比，其胃内容物排空得更快、更彻底。
