新生兒喂養不耐受，為什麼

我孩子出生10天，開始有喝的羊水。抽淨後醫生開奶，胃不耐受，十二指腸不耐受，今天用啊脫品和嗎叮林不見效。奶液潴流在胃中。37周加5天出生5斤2兩。請問大家有沒有好辦法

目的總結腸道營養與腸外營養相結合的新生兒喂養效果，評價新生兒喂養不耐受對營養的影響，計算喂養不耐受的發生率，分析發生喂養不耐受的相關危險因素。方法2003年1月至2003年11月收治的381例新生兒進行臨床觀察。按黃瑛診斷標准即頻繁嘔吐≥3次/d，奶量不增或減少>3d，胃潴留（潴留量>前次喂養量的1/3）分為喂養不耐受組（feedingintolerance,fi組）和非喂養不耐受組（non-fi組）。喂養不耐受組用小劑量紅霉素治療，劑量3－5mg/kg.次，1-2次/日，連用5-7天,部分病例療程>7天。記錄每日奶量、熱卡、體重增長情況,比較喂養不耐受組與非喂養不耐受組的喂養效果，分析喂養不耐受的相關危險因素，計算喂養不耐受的發生率。結果（1）足月兒、出生體重（birthweight,bw）>2500g早產兒、2001-2500g早產兒、≤2000g早產兒喂養不耐的發生率分別為9.7%、25%、50%、73.7%,有明顯差別（χ2=92.205，p<0.01）；（2）足月兒及不同出生體重早產兒喂養不耐受組熱卡達80kcal/kg.d（334.4kj/kg.d）及恢復出生體重的日齡明顯晚於非喂養不耐受組，兩組在胎齡、出生體重、熱卡達40kcal/kg.d（167.2kj/kg.d）、經胃腸攝取熱卡達80kcal/kg.d（334.4kj/kg.d）及達全腸道喂養日齡無明顯差別；（3）低體重(p<0.01)、宮內窘迫(p<0.05)、胃出血(p<0.01)是喂養不耐受的相關危險因素；（4）喂養不耐受患兒有胃出血組達全腸道喂養的日齡比無胃出血組明顯延長（17.63±7.97與12.29±5.34天,t=-2.121,p<0.05）；兩組恢復出生體重的日齡無明顯差別（10.75±5.04與8.4±3.42天，t=-1.729,p>0.05）。結論：足月兒、出生體重>2500g早產兒、2001-2500g早產兒、≤2000g早產兒喂養不耐受組的發生率分別為9.7%、25%、50%、73.7%。用熱卡值達80kcal/kg.d（334.4kj/kg.d）及恢復出生體重的日齡來評價喂養不耐受的營養指標有臨床意義。低體重、胎兒宮內窘迫、胃出血是喂養不耐受的相關危險因素。腸外營養與正確的喂養方案相結合，可提供滿足生長所需的熱卡，最終過渡到腸道營養。
objectivetheefficacyofneonatalfeedingwithenteralnutritionandparenteralnutrition,thecompactofneonatalfeedingintoleranceonnutrition,theincidenceofneonatalfeedingintolerance,andtheriskfactorsassociatedwithneonatalfeedingintolerancewereinvestigated.methodsthesubjectswere381infantswhomwereadmittedbetweenjanuary2003tonovember2003.thecriteriaofneonatalfeedingintolerancemadebyhuangyingwasused,suchasvomiting≥3timesdaily,enteralfeedingdidn’tincreaseordecrease>3days,gastricresidualvolume>1/3ofagivenamountoffeedingwereadoped.381casesinfantsweredividedintofeedingintolerancegroup(figroup)andnon-feedingintolerancegroup(non-figroup).feedingintolerancegroupwasgivenerythromycinintravenouslyatadoseof3-5mg/kg,onetotwotimesdailyfor5-7daysand>7daysinsomecases.theclinicaldatacluesuchasdailyfeedingvolume,weightanddailycalorieintakewererecorded.comparisonwasmadebetweentwogroupsaboutfeedingefficacy,theriskfactorsassociatedwithneonatalfeedingintolerancewasanalyzed,theincidenceofneonatalfeedingintolerancewasrecorded.result(1)theincidenceofterminfantandpreterminfantbw>2500g,bw2001~2500g,bw≤2000gwas9.7%,25%,50%,73.7%,respectively,statisticaldifferenceissignificant,χ2=92.205，p<0.01.(2)comparedwiththenon-feedingintolerancegroup,terminfantsanddifferentbirthweightpreterminfantswithfeedingintolerance,thetimeofdailycalorieintakereach80kcal/kgperday（334.4kj/kgperday）andregainbirthweightwasmarkedlydelayed.butthegestationalage,birthweightandthedaycalorieintakereach40kcal/kgperday(167.2kj/kgperday)、calorieenteralintakereach80kcal/kgperday（334.4kj/kgperday）andreachfullenteralfeedingwerenotsignificantdifferentintwogroups.(3)theriskfactorsassociatedwithfeedingintolerancewerelowbirthweight(p<0.01),fetalhypoxia(p<0.05),andgastrichemorrhage(p<0.01).(4)thetimewhichreachingfullenteralfeedingwasmarkedlydelayedinthegastrichemorrhagegroupcomparedwiththenon-gastrichemorrhagegroupamongfeedingintoleranceinfants(17.63±7.97vs12.29±5.34days,t=-2.121,p<0.05).butthetimeofregainingbirthweightwasnotsignificantdifferentbetweentwogroups(10.75±5.04vs8.4±3.42days，t=-1.729,p>0.05).conclusiontheincidenceofneonatalfeedingintoleranceinterminfant,preterminfantbw>2500g、bw2001-2500g、bw≤2000gis9.7%、25%、50%、73.7%,respectively.thecriteriaofneonatalfeedingintoleranceonneonatalnutritionwereanalyzed.weconsideredthatdailycalorieintakereaching80kcal/kgperday（334.4kj/kgperday）andregainbirthweightcouldbeusedasamarkasthenutritionoffeedingintolerance.thesignificantriskfactorsassociatedwithfeedingintolerancearelowbirthweight,fetalhypoxia,gastrichemorrhage.parenteralnutritioncombinedwithcorrectfeedingschemecouldofferenoughcalorietomeetgrowthandtransittoenteralfeedingintheend.

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