目的 分析复方嗜酸乳杆菌、抚触结合母乳喂养用于剖宫产低体重早产儿喂养不耐受的临床效果及价值。方法 选择2017年07月至2019年07月本院收治的122例剖宫产低体重早产儿喂养不耐受患儿,根据随机双盲法分为两组。对照组61例,实施常规对症治疗及母乳喂养；联合组61例,接受复方嗜酸乳杆菌、抚触结合母乳喂养。对比两组临床疗效、喂养耐受指标、早产儿生长发育指标及并发症,并观察治疗前后血清胆红素及蛋白水平变化。结果 联合组治疗总有效率较对照组高(88.52% VS 72.13%),腹胀、呕吐、便秘、新生儿坏死性小肠结肠炎(necrotizingenterocolitis,NEC)、病理性黄疸发生率均较对照组低(P均＜0.05)；联合组每日进奶量较对照组高,达到经口全胃肠喂养时间、胎粪排空日龄较对照组低(P均＜0.05)；联合组恢复至出生体重时间较对照组短,第14d头围增长、体重增长均较对照组高(P均＜0.05)；治疗后联合组总胆红素、直接胆红素水平比对照组低,前白蛋白、血红蛋白水平比对照组高(P均＜0.05)。结论 复方嗜酸乳杆菌、抚触结合母乳喂养用于剖宫产低体重早产儿喂养不耐受中效果显著,可促进患儿胃肠功能发育、成熟,改善胃肠动力,提高喂养耐受性,降低血清胆红素水平,减少并发症发生。

Objective To analyze the clinical effects and value of compound Lactobacillus acidophilus, touching and breastfeeding in low birth weight premature infant with feeding intolerance in cesarean section. Methods 122 low birth weight premature infant with feeding intolerance in cesarean section admitted in the hospital from January 2017 to September 2019 were selected, and they were divided into two groups by randomized double blind method, with 61 cases in each group. Control group was given routine symptomatic treatment and breastfeeding, while combined group was given compound Lactobacillus acidophilus, touching and breastfeeding. The clinical efficacy, feeding tolerance indexes, growth and development indexes, complications were compared between the two groups. The changes of serum bilirubin and protein before and after treatment were observed. Results The total effective rate of combined group was higher than that of control group (88.52% VS 72.13%), while the incidence of abdominal distension, vomiting, constipation, neonatal necrotizing enterocolitis (NEC), pathological jaundice in combined group was lower than that in control group (Pall<0.05); The daily milk intake of combined group was higher than that of control group, while the time of reaching the oral whole gastrointestinal feeding and meconium emptying in combined group was lower than that in control group(Pall<0.05); The time of recovering birth weight in combined group was shorter than that in control group, while the 14d head circumference growth and weight growth in combined group were higher than those in control group (Pall<0.05); After treatment, the levels of total bilirubin and direct bilirubin in combined group were lower than those in control group, while the levels of prealbumin and hemoglobin in combined group were higher than those in control group(Pall<0.05). Conclusion Compound Lactobacillus acidophilus, touching and breastfeeding in low birth weight premature infant with feeding intolerance in cesarean section is effective, it can promote development and maturation of gastrointestinal function, improve gastrointestinal motility, increase feeding tolerance, decrease the level of serum bilirubin, and reduce complications.