目的 探讨微量喂养对早产儿早期喂养不耐受喂养结局的影响。方法 选择我院2019年1月—2020年6月胎龄≤34周、出生后1周内反复出现喂养不耐受的早产儿78例,采用随机数字表法分为微量喂养组(38例)和中断喂养组(40例),比较两组患儿喂养不耐受的改善及喂养结局的差异性。结果 相对于直接中断喂养,微量喂养3～5天的患儿喂养不耐受改善率更高、体质量增长速度更快、更早达完全肠内喂养时间、静脉营养时间和住院时间也缩短了。而且胆汁淤积症发生率也低于中断喂养组,差异具有统计学意义,两组坏死性小肠结肠炎发生率比较无差异。结论 对于胎龄≤34周、生后1周内反复出现喂养不耐受的早产儿,在排除了外科或败血症早期表现的情况下,相对于中断喂养,选择微量喂养可改善患儿的喂养结局,而且不会增加坏死性小肠结肠炎的发生。

Objective To investigate the effect of minimal feeding on the outcome of early feeding intolerance in premature infants. Methods Seventy-eight premature infants with gestational age＜34 weeks and recurrent feeding intolerance within 1 week after birth in our hospital from January 2019 to June 2020 were selected. They were randomly divided into minimal feeding group (38 cases) and interrupted feeding group (40 cases) to compare the improvement of feeding intolerance and the difference of feeding outcome between the two groups. Results Compared with discontinuation of feeding, the rates of feeding intolerance improvement were higher in children who were given minimal feeding for 3-5 days,and they had faster weight gainand, the time to complete enteral feeding got earlier, intravenous nutrition time and hospitalization time were also shortened. Moreover, the incidence of cholestasis was also lower than that of the interrupted feeding group, and the difference was statistically significant. There was no difference in the incidence of necrotizing enterocolitis between the two groups. Conclusion For premature infants with gestational age＜34 weeks and feeding intolerance happened within 1 week after birth, excluding the early manifestation of surgery or sepsis, minimal feeding can improve the feeding outcome of the infants compared with discontinuation of feeding, without increasing the incidence of necrotizing enterocolitis.