新生儿食管闭锁修复手术早期肠内喂养

Q3 Medicine

Evidence Based Care Journal Pub Date : 2020-10-01 DOI:10.22038/EBCJ.2021.52120.2384

G. Khademi, Marzieh Ghorbani, S. Jafari, R. Shojaeian, Majid Sezavar Dokht Farogh, H. Boskabadi, A. Rezaeian

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引用次数: 1

摘要

背景:新生儿的能量储备有限。在食管闭锁(EA)修复手术中，由于手术的位置，有关于喂养开始的担忧。目的:探讨早期肠内喂养对食道闭锁新生儿喂养耐受性及住院时间的影响。方法:本随机临床试验选取2015年7月至2017年11月在Dr. Sheikh(伊朗东部亚专科中心)行c型食管闭锁手术的48例新生儿，随机分为干预组和对照组。干预组术后48小时经胸片确认吻合口无瘘后开始喂养。对照组从术后第5天开始进行常规喂养。比较两组患者的喂养耐受性和住院时间(LOS)。数据在SPSS-16中使用Fisher精确T检验和独立样本T检验进行分析。结果:干预前对照组平均体重为2550.1±523.4 g，干预组平均体重为2540.6±856.0 g。结果显示，干预组与对照组的喂食量耐受频率差异无统计学意义(P=0.48)。干预组NGT喂养的平均持续时间、达到口腔完全喂养的时间和LOS均显著低于对照组(P<0.05)。实践意义:在EA修复手术中，早期肠内喂养改善了喂养耐受性，降低了LOS。因此，建议重新审视EA修复术后的喂养方式，考虑到患者的情况，甚至可以从术后48小时开始。

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Early Enteral Feeding in Neonates Undergoing Esophageal Atresia Repair Surgery

Background: Neonates have limited reserves of energy. In esophageal atresia (EA) repair surgery, there were concerns about feeding initiation due to the location of the surgery. Aim: To determine the effect of early enteral feeding on feeding tolerance and the duration of hospital stayin neonates with esophageal atresia. Method: In this randomized clinical trial, 48 neonates who underwent type-C esophageal atresia surgery at Dr. Sheikh (a subspecialty centers in eastern Iran), July 2015 - November 2017 were randomly divided into the intervention and control groups. In the intervention group, 48 hours after surgery, feeding was initiated once the absence of anastomotic leakage was confirmed by a chest X-ray. The control group received routine feeding from the fifth day after surgery. Feeding tolerance and length of hospital stay (LOS) were compared. Data were analyzed in SPSS-16 using Fisher's exact and Independent sample T tests. Results: The mean weight before intervention was 2550.1±523.4 grams in control and 2540.6±856.0 grams in intervention groups. Results revealed no significant differences between the intervention and control groups in the frequency of feeding volume tolerance (P=0.48). The mean duration of NGT feeding , time to achieve complete oral feeding and LOS were significantly lower in the intervention group (P<0.05). Implications for Practice: In EA repair surgery early enteral feeding improved feeding tolerance and decreased LOS. So the approach to feeding after EA repair surgery is recommended to be reviewed, and considering patient’s condition, can be started earlier even from 48th hours after surgery.

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来源期刊

Evidence Based Care Journal Medicine-Health Policy

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： The Evidence Based Care Journal (EBCJ) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of patient care. The primary aim is to promote a high standard of clinically related scholarship which advances and supports patient care in practice. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, EBCJ seeks to enrich insight into clinical needs and the implications for patient care intervention and models of service delivery. Emphasis is placed on clinical practicality of research findings and strength of study design. EBCJ is essential reading for anyone involved in healthcare professions, whether clinicians, researchers, educators, managers, policy makers, or students. Contributions are welcomed from other health professionals on issues that have a direct impact on patient care.