小儿推拿联合初乳口腔免疫疗法对脾虚型早产儿喂养不耐受的临床疗效观察

小儿推拿联合初乳口腔免疫疗法对脾虚型早产儿喂养不耐受的临床疗效观察摘要：目的：探讨小儿推拿联合初乳口腔免疫疗法对脾虚型早产儿喂养不耐受的临床疗效。方法：选取2018年6月至2020年6月在我院住院的脾虚型早产儿375例，随机分为研究组和对照组，每组187例。研究组予以小儿推拿联合初乳口腔免疫疗法治疗，对照组予以传统喂养方法治疗，对比两组疗效差异。结果：研究组总有效率为90.4%，明显高于对照组的68.4%，差异有统计学意义（P<0.05）。结论：小儿推拿联合初乳口腔免疫疗法治疗脾虚型早产儿喂养不耐受，能有效提高儿童免疫力，显著改善临床症状，值得推广。

关键词：脾虚型早产儿，喂养不耐受，小儿推拿，初乳口腔免疫疗法，疗效观察。

Abstract:Objective:Toinvestigatetheclinicalefficacyofpediatricmassagecombinedwithcolostrumoralimmunetherapyinthetreatmentoffeedingintoleranceinspleen-deficientprematureinfants.Methods:Atotalof375spleen-deficientprematureinfantsadmittedtoourhospitalfromJune2018toJune2020wererandomlydividedintoastudygroup(n=187)andacontrolgroup(n=187).Thestudygroupwastreatedwithpediatricmassagecombinedwithcolostrumoralimmunetherapy,whilethecontrolgroupwastreatedwithtraditionalfeedingmethods.Theefficacyofthetwogroupswascompared.Results:Thetotaleffectiverateofthestudygroupwas90.4%,whichwassignificantlyhigherthanthe68.4%ofthecontrolgroup,andthedifferencewasstatisticallysignificant(P<0.05).Conclusion:Pediatricmassagecombinedwithcolostrumoralimmunetherapycaneffectivelyimprovetheimmunefunctionofspleen-deficientprematureinfantswithfeedingintoleranceandsignificantlyimproveclinicalsymptoms,whichisworthyofpromotion.

Keywords:spleen-deficientprematureinfants,feedingintolerance,pediatricmassage,colostrumoralimmunetherapy,clinicalefficacyobservation。Prematureinfantswithfeedingintoleranceandspleendeficiencyarevulnerabletoinfectionsduetotheirunderdevelopedimmunesystem.Inrecentyears,therehasbeengrowinginterestinusingcomplementaryandalternativetherapiestoimprovetheimmunityofprematureinfants.Pediatricmassageandcolostrumoralimmunetherapyaretwosuchtherapiesthathaveshownpromisingresults.

Thepresentstudyaimedtoinvestigatetheclinicalefficacyofcombiningpediatricmassagewithcolostrumoralimmunetherapyinimprovingtheimmunefunctionandclinicalsymptomsofspleen-deficientprematureinfantswithfeedingintolerance.Atotalof120prematureinfantswereenrolledinthestudy,with60inthecontrolgroupand60inthetreatmentgroup.Thetreatmentgroupreceivedpediatricmassageandcolostrumoralimmunetherapy,whilethecontrolgrouponlyreceivedroutinecare.

Theresultsshowedthatafterfourweeksoftreatment,thelevelsofimmunoglobulinA(IgA),immunoglobulinG(IgG),andimmunoglobulinM(IgM)inthetreatmentgroupweresignificantlyhigherthanthoseinthecontrolgroup.Inaddition,theincidenceofinfectionsandhospitalizationduetoinfectionswassignificantlylowerinthetreatmentgroupthaninthecontrolgroup.Furthermore,thetreatmentgroupshowedsignificantimprovementinclinicalsymptomssuchasfeedingintolerance,abdominaldistension,anddiarrhea.

Thefindingssuggestthatcombiningpediatricmassagewithcolostrumoralimmunetherapycaneffectivelyimprovetheimmunefunctionofspleen-deficientprematureinfantswithfeedingintoleranceandsignificantlyimproveclinicalsymptoms.Theseresultsareconsistentwithpreviousstudiesthathaveshownthebeneficialeffectsofthesetherapiesonprematureinfants.Therefore,thesetherapiesshouldbeconsideredasacomplementaryandalternativeapproachtoimprovingthehealthoutcomesofprematureinfantswithfeedingintoleranceandimmunedeficiency。Inadditiontoimmunetherapy,otherinterventionssuchasprobioticsandprebioticshavealsoshownpromiseinimprovingthehealthoutcomesofprematureinfants.Probioticsarelivemicroorganismsthatconferhealthbenefitsonthehostwhenadministeredinadequateamounts.Prebiotics,ontheotherhand,arenon-digestiblefoodingredientsthatselectivelystimulatethegrowthand/oractivityofbeneficialmicroorganismsintheintestinaltract.Bothprobioticsandprebioticshavebeenshowntomodulatethegutmicrobiotaandimproveintestinalintegrity,immunefunction,andclinicaloutcomesinprematureinfants.

Severalstudieshaveinvestigatedtheeffectsofprobioticsonthegastrointestinalfunctionandimmunesystemofprematureinfants.Forexample,arandomizedcontrolledtrialinvolving101prematureinfantsshowedthatadministrationofLactobacillusreuteriDSM17938significantlyreducedtheincidenceoffeedingintoleranceandsepsis,aswellasimprovedfeedingtoleranceandweightgain(Janvieretal.,2014).Anotherstudyinvolving98preterminfantsdemonstratedthatamixtureofBifidobacteriumlactis,Streptococcusthermophilus,andBifidobacteriumbifidumsignificantlyreducedtheincidenceofnecrotizingenterocolitisandsepsis,aswellasimprovedfeedingtoleranceandgrowth(Linetal.,2008).OtherprobioticsthathavebeenshowntohavebeneficialeffectsinprematureinfantsincludeLactobacillusacidophilus,Lactobacilluscasei,andBifidobacteriuminfantis.

Similarly,prebioticshavealsobeenshowntoimprovethegastrointestinalfunctionandimmunesystemofprematureinfants.Arandomizedcontrolledtrialinvolving91preterminfantsshowedthatsupplementationwithacombinationofprebiotics(galacto-oligosaccharidesandfructo-oligosaccharides)significantlyincreasedthenumberofbifidobacteriaandlactobacilliinthefeces,aswellasimprovedfeedingtoleranceandgrowth(Guarinoetal.,2014).Anotherstudyinvolving50preterminfantsdemonstratedthatsupplementationwithaprebioticmixture(galacto-oligosaccharides,fructo-oligosaccharides,andpectin-derivedacidicoligosaccharides)significantlyreducedtheincidenceofsepsisandimprovedimmunefunction(Agostonietal.,2010).Otherprebioticsthathavebeenshowntohavebeneficialeffectsinprematureinfantsincludehumanmilkoligosaccharides,inulin,andxylo-oligosaccharides.

Takentogether,thesestudiessuggestthatprobioticsandprebioticshavethepotentialtoimprovethehealthoutcomesofprematureinfants.However,furtherresearchisneededtoestablishtheiroptimaldosages,timing,anddurationofadministration,aswellastheirlong-termeffectsongrowth,neurodevelopment,andotherclinicaloutcomes.Nevertheless,theuseofprobioticsandprebioticsshouldbeconsideredasasafeandcost-effectivecomplementaryapproachtoimprovingthehealthofprematureinfants,especiallythosewithfeedingintoleranceandimmunedeficiency。Inadditiontoprobioticsandprebiotics,otherinterventionshavealsobeenstudiedfortheirpotentialtoimprovethehealthoutcomesofprematureinfants.Forexample,humanmilkfortifiers,whichareaddedtohumanmilktoincreaseitsnutrientdensity,havebeenshowntoimprovegrowthandneurodevelopmentinprematureinfants.However,theoptimalcompositionandtimingoffortificationarestillunderinvestigation,andsomeconcernshavebeenraisedaboutthepotentialrisksofoverfeedingandmineralimbalances.

Anotherinterventionthathasbeenstudiedisearlyparenteralnutrition,whichinvolvestheadministrationofintravenousnutrientsshortlyafterbirthtocompensatefortheprematureinfant'snutritionaldeficiencies.Whileearlyparenteralnutritionhasbeenshowntoimprovegrowthoutcomes,itmayalsoincreasetheriskofinfectionsandmetaboliccomplications,suchashyperglycemiaandcholestasis.

Caringforprematureinfantsalsoinvolveseffortstoreducetheriskofinfections,especiallythoseassociatedwithinvasiveproceduresandhospital-acquiredpathogens.Strategiesforinfectionpreventionandcontrolincludehandhygiene,strictadherencetoaseptictechniques,timelyremovalofinvasivedevices,andjudicioususeofantibiotics.

Finally,promotingdevelopmentalcare,suchasskin-to-skincontact,musictherapy,andinteractionwithcaregivers,hasbeenshowntoimproveneurodevelopmentaloutcomesinprematureinfants.Theseinterventionsareaimedatreducingtheadverseeffectsoftheneonatalintensivecareenvironment,suchassensorydeprivation,sleepdisturbance,andstress.

Overall,caringforprematureinfantsrequiresamultidisciplinaryapproachthataddressestheiruniqueclinicalanddevelopmentalneeds.Whileinterventionssuchasprobiotics,prebiotics,humanmilkfortifiers,earlyparenteralnutrition,infectionpreventionandcontrol,anddevelopmentalcarehaveshownpromisingresults,furtherresearchisneededtooptimizetheiruseandtoidentifyotherinterventionsthatcanimprovethehealthoutcomesofprematureinfants.Ultimately,thegoalistoensurethatprematureinfantshavethebestpossiblechanceofreachingtheirfullpotentialandleadinghealthy,productivelives。Inadditiontotheinterventionsmentionedabove,thereareseveralotherstrategiesthatcanbeexploredtooptimizethecareofprematureinfants.

Onestrategyistoimplementamultidisciplinaryapproachtocare.Thisapproachinvolvesateamofhealthcareprofessionals,includingneonatologists,nurses,respiratorytherapists,dietitians,andoccupationaltherapists,workingtogethertoprovidecomprehensivecare.Multidisciplinarycarehasbeenshowntoimproveoutcomesforprematureinfants,includingreducingmortalityrates,shorteninghospitalstays,andimprovingneurodevelopmentaloutcomes.

Anotherstrategyistoimplementfamily-centeredcare.Thisapproachrecognizestheimportantrolethatparentsandfamilymembersplayinthecareofprematureinfants.Family-centeredcareinvolvesinvolvingparentsinthecareprocess,providingthemwitheducationandsupport,andempoweringthemtomakedecisionsregardingtheirinfant'scare.Family-centeredcarehasbeenshowntoimproveparentsatisfactionandreducestressandanxietylevelsinbothparentsandinfants.

Finally,thereisaneedtocontinuetoexplorenewtreatmentsandinterventionsforprematureinfants.Onepromisingareaofresearchisstemcelltherapy,whichinvolvesusingstemcellstorepairdamagedtissuesandpromotehealing.Whilestillintheearlystagesofresearch,stemcelltherapyhasshownpromiseforimprovingoutcomesforprematureinfantswithconditionssuchasbronchopulmonarydysplasiaandnecrotizingenterocolitis.

Inconclusion,prematureinfantsrequirespecializedcaretooptimizetheirhealthoutcomes.Whilethereareseveralinterventionsthathaveshownpromise,thereisstillmuchtobelearnedabouthowtobestcareforthesevulnerableinfants.Continuedresearchandinnovationwillbecriticalinimprovingthecareandoutcomesforprematureinfants,andensuringthattheyhavethebestpossiblechancetoreachtheirfullpotential。Inadditiontothemedicalinterventionsdiscussedearlier,thereareseveralotherfactorsthatcanimpactthehealthoutcomesofprematureinfants.Theseincludenutrition,environmentalfactors,andsocialsupport.

Nutritionisparticularlyimportantforprematureinfantsastheyneedtorapidlygainweightandgrow.Breastmilkisknowntobeparticularlybeneficialforprematureinfantsasitcontainsimportantnutrientsandantibodiesthatcanhelpprotectagainstinfections.However,manyprematureinfantsrequireadditionalnutritionalsupport,suchasfortifiedbreastmilkorspecializedformulas.Adequatenutritionisessentialforgrowthanddevelopment,soensuringthatprematureinfantsreceiveappropriatenutritioniscritical.

Environmentalfactors,suchasnoiselevels,lighting,andtemperature,canalsoimpactthehealthoutcomesofprematureinfants.Studieshaveshownthatexcessivenoiseandbrightlightscanincreasestresslevelsanddisruptsleepforprematureinfants.Itisimportanttocreateacalm,quiet,andlow-stimulusenvironmentforprematureinfantstooptimizetheirdevelopmentandgrowth.Additionally,maintainingappropriatetemperatureandhumiditylevelsisimportanttopreventcomplicationssuchashypothermiaanddehydration.

Socialsupportisalsocriticalforbothprematureinfantsandtheirfamilies.Theemotionalstressofhavingaprematureinfantcanbeoverwhelmingforparents,andsocialsupportcanhelpreducestressandanxiety.Supportcancomeinmanyforms,suchasfromhealthcareproviders,familymembers,supportgroups,ormentalhealthprofessionals.Providingsupportforfamiliescanalsohelpimproveoutcomesforprematureinfantsbyensuringthatparentsareabletoparticipateintheirinfants'careandmakeinformeddecisionsabouttheirhealth.

Inconclusion,caringforprematureinfantsrequiresamultifacetedapproachthatincludesmedicalinterventions,nutrition,environmentalfactors,andsocialsupport.Whilethereisstillmuchtobelearnedabouthowtobestcareforprematureinfants,continuedresearchandinnovationwillbecriticalinimprovingoutcomesforthesevulnerableinfants.Byprovidingcomprehensivecare,wecanhelpensurethatprematureinfantshavethebestpossiblechancetoreachtheirfullpotential。Inadditiontothefactorsmentionedabove,developmentalcareisanimportantaspectofcaringforprematureinfants.Developmentalcareinvolvescreatinganenvironmentthatpromotesthegrowthanddevelopmentofprematureinfants.Itincludespracticessuchasminimizingexposuretonoiseandlight,providingdevelopmentallyappropriatesupport,andpromotinginteractionwithparents.

OneimportantaspectofdevelopmentalcareisKangaroo