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1、Domperidone on neonatal feeding intolerance Efficacy Study: China and Japan Wang Xiaoli Yang Xiaoguang Lei Xie Xiaoqiang Abstract Objective domperidone on neonatal feeding intolerance to improve the clinical results. Methods 168 cases of neonatal feeding intolerance were randomly divided into 3 grou
2、ps, control group (57 cases were given insulation, position therapy, partial parenteral nutrition and other conventional therapy. observed a group (58 patients in the control group based on the oral or nasal domperidone suspension of 0.4 ml / (kg. times, 1 / 8 h, 30 min before feeding to give a cour
3、se of 3 5 d. Observation Group 2 (53 patients in the control group on the basis of erythromycin administered intravenously, 5 mg / (kg ? times, 1 time / d, was within 1 2 h infusion with a micro infusion pump completed a course of 3 5 d. observed a group and observe the results of 2 groups of childr
4、en disappearing disease and gastric retention time was significantly shorter than the control group (P 0.05, average daily weight gain and daily increase in milk was significantly higher (P 0.05), observed a group and Observation of Group 2 course, lost time, gastric retention, average daily weight
5、gain and daily increase in milk no significant difference. Conclusions of domperidone on the improvement of neonatal feeding intolerance have better clinical results. Keywords: newborn, feeding intolerance, domperidone Abstract Objective To investigate the clinical effect of domperidone in improving
6、 neonatal feeding intolerance. Methods 168 infants with feeding intolerance were randomly divided into 3 groups, of which observation group 1 included domperidone group (58 cases), observation group 2 included erythromycin group ( 53 cases), the control group (57 cases). The infants in the control g
7、roup were treated with conventional therapy such as keeping warm, positional therapy, partial parenteral nutrition and so on. Besides the conventional therapy, the infants in the observation group 1 were given domperidone suspl 0.4ml / kg by peroral administration or nasal feeding once in every 8 ho
8、urs a day, 30 minutes before feeding. The course of treatment lasted from 3 to 5 days. The infants in the observation group 2 were given intravenous erythromycin 5mg / kg for once a day, which applied the infusion with micro infusion pump within one or two hours for the time from 3 to 5 days. Result
9、s The course of disease and the vomiting time in the observation group 1 and group 2 were shorter than those in the control group (P 0.05), whose weight gain and the amount of daily milk were higher than those in the control group (P = 3 times / d), ? milk does not increase or decrease ( 3 d), ? gas
10、tric retention ( previous feeding of 1 / 3), except for the gastrointestinal tract congenital anomalies, necrotizing enterocolitis, neonatal sepsis, neonatal asphyxia neonatal feeding intolerance .168 patients were randomly divided into 3 groups, observed a group domperidone observed group (58 cases
11、, 30 males and 28 females, gestational age (35.1 + -1.5 weeks, birth weight (1.93 +-0.51kg, day 1 5 d, 8 cases of neonatal pneumonia combined, neonatal hypocalcemia 3 cases, 3 cases of brain damage in preterm children. erythromycin observation group 2 observation group (53 patients, 23 males and 30
12、females, gestational age (34.9 + -1.3 weeks, birth weight (2.03 +-0.68kg, age 1 5 d, 4 cases of neonatal asphyxia merger, neonatal hypocalcemia in 3 cases, 2 cases of neonatal hypokalemia. the control group (57 cases, 27 males and 30 females, gestational age (34.1 + - 1.5 weeks, body weight (1.93 +-
13、0.51kg, day 1 5 d, merge 2 cases of neonatal hyperbilirubinemia, neonatal hypocalcemia .3 Before treatment, 2 cases of gender, age, weight, fetal no significant difference in age, etc., are comparable. Method of control group was given 1.2 insulation, position therapy, partial parenteral nutrition a
14、nd other conventional therapies. Observed a group on the basis of the control group 30 min before feeding oral or nasal domperidone suspension 0.4 ml / (kg. times, 1 / 8 h , 3 5 d. observe the course of 2 groups on the basis of the control group, intravenous erythromycin, 5 mg / (kg. times, 1 time /
15、 d, in 1 2 h in complete with micro infusion pump infusion , treatment 3 5 d. 1.3 Efficacy of clinical observation: via this form by hand detailed records of changes in condition, daily milk, gastric retention, body weight, frequency of vomiting. Observed side effects: crying children were observed
16、during treatment and neurological symptoms. 1.4 Statistical analysis of data recorded by +-s that the statistical treatment using t test. 2 Results 3 groups improved feeding compared to the situation in Table 1. Observe the course of 1,2-group patients, gastric retention time and disappeared back to
17、 the number of days required for birth weight were significantly shorter than the control group (P 0.05), average daily weight gain and daily increase in milk was significantly higher (P 0.10. Table 13 Comparison of group feeding to improve the situation 3 Discussion Newborn children with feeding in
18、tolerance, and digestive system anatomy and physiology function of immature gastrointestinal neuroendocrine regulation 2, as lower esophageal sphincter, transient lower esophageal sphincter relaxation, lower esophageal sphincter length shorter intra-abdominal, His angle larger, delayed gastric empty
19、ing 3, intragastric pressure, esophageal body pressure increased, the low level of plasma motilin, manifested as decreased esophageal motility, esophageal swallowing incoordination, decreased esophageal peristalsis, or push disappear. antrum, pylorus and duodenum motility disorders, the enteral feed
20、ing prone to vomiting, abdominal distension, gastric retention phenomena such as feeding difficulties, often take longer to parenteral nutrition, is not conducive to recovery of gastrointestinal function newborn, and prone to cholestasis, bleeding, jaundice and other complications 4. Links to Resear
21、ch Papers Download http:/ Feeding newborn gastrointestinal tract can not only direct access to nutrients, while promoting the release of gastrointestinal hormones, and promote gastrointestinal motility of maturity. Domperidone as a peripheral dopamine receptor antagonist, directly on the gastrointes
22、tinal wall, increase the lower esophageal sphincter to prevent reflux, increased gastrointestinal motility, and promote gastric emptying, gastric and duodenal coordination of movement, suppression of nausea, vomiting, and effectively prevent bile reflux, does not affect the secretion of gastric juic
23、e 5,6 . This study shows that domperidone suspension after treatment, children with disease, gastric retention time and disappeared back to the birth weight was significantly shorter than the required number of days in the control group, the average daily weight gain and increase the milk was signif
24、icantly higher at . domperidone can increase the tolerance of neonatal feeding. erythromycin is a macrolide antibiotic, in recent years it has found a variety of non-antibacterial function 7: that it can effectively stimulate the gastric antrum, duodenum and colonic activity, the mechanism is by sti
25、mulating the release of acetylcholine plexus, and promote synthesis of nerve plexus of substance P, motilin in the gastrointestinal tract to stimulate the release of cells, the plasma motilin levels. motilin is to start the digestion of integrated EMG and integrated EMG caused by digestion of the ho
26、rmone phase III, which led to faster movement of the gastrointestinal 8. erythromycin are not only for the whole gastrointestinal tract prokinetic effect of different levels, and the digestive tract and force an obvious dose-effect relationship. anti-infective therapeutic dose, the normal mobility m
27、otor complex (MMCIII phase is disrupted, stomach, small intestine, where a strong irregular contractions, nausea, vomiting 9. Small dose induced gastrointestinal smooth muscle contraction, induced by MMC III phase appears. Our data show that low-dose erythromycin treatment, children with disease, ga
28、stric retention time and disappeared back to the birth weight was significantly shorter than the required number of days in the control group , the average daily weight gain and increase the milk was significantly higher at. This study shows that small doses of domperidone and erythromycin, the diff
29、erence was not significant. Erythromycin by the liver and can cause liver damage, long-term use can lead to drug resistant strains can cause intestinal flora. Domperidone side effects small, and easy through the blood-brain barrier, no inhibitory effect of dopamine in the brain, there is no extrapyr
30、amidal symptoms. At the same time the drug low cost, is the intervention of feeding intolerance in infants ideal drug. References 1, Ying Huang, Shao Xiaomei, ZENG Ji Ye, and so on. Neonatal feeding difficulties and gastrointestinal motility of erythromycin. Pediatrics, 2000,38 (11:696 698. 2 Riezzo
31、 G, Indrio F, Montagna O, et al. Gastric electrical activity and gastric emptying in term and preterm newborns. Neurogastroenterol Motil, 2000,12 (3:223 229. 3 Zhou Xuelian, Europe and Bute You. 61 cases of infants with gastroesophageal reflux disease. Of Clinical Pediatrics, 1999,14 (4:207. 4 Zhao
32、Yunxia. Low-dose erythromycin treatment of feeding difficulties in preterm children patients. Chinese Medicine, 2008,10 (5:112. 5 Jinhan Zhen, Huang Min, the official Xiji. Practical neonatology. Beijing: Peoples Medical Publishing House, 2004.95 96. 6 Yang Wenying, Qi Lingzhi. Domperidone treatment
33、 of functional dyspepsia clinical observation of 69 cases. Chinese Journal of Internal Medicine, 2006,26 (5): 393. 7 Vang Pao force. Macrolide antibiotics, non-antibacterial effect. International Journal of Pediatrics Volume, 2001,28 (4:208 210. 8 Dong Yanping. Erythromycin on the impact of gastric electrical activity in children analysis of 46 cases. Pediatrics, 1999,37 (3): 151. 9 Chen Jianping, Liu. Erythromycin and neonatal feeding intolerance. Neonatal Medicine, 2005,20 (5): 230 233. Links to Research Papers Download http:/
