Objective To investigate the effect of low dose heparin on blood coagulation and therapeutic outcomes in premature infants with sepsis.Methods Clinical data of 69 septic preterm newborns weighting less than 1 500 g treated in Beijing Obstetrics and Gynecology Hospital were retrospectively analyzed.Among them,29 infants received heparin therapy (6 U/kg,q 8 h,for 3 d,then q12 h,heparin group)and 40 infants did not receive heparin therapy (control group),the coagulation index and therapeutic outcomes were compared between two groups.Results The coagulation indexes PT,TT,APTT and D dimer in heparin group were all significantly lower than those in control group [(15.5±3.5) s vs.(19.0±3.9) s,(15.4±3.5) s vs.(18.8±3.5) s,(47.5±8.6) s vs.(58.4±18.1) s,(1.7±0.8) mg/L vs.(2.6±1.9) mg/L;t=-3.815,4.275,-3.004,-2.459,P＜0.05].The overall clinical effective rate in heparin group was significantly higher than that in control group (86.2％ vs.60.0％,x2 =4.408,P＜0.05).Conclusion Low dose heparin can significantly improve the blood coagulation function and improve the therapeutic effect of premature infants with sepsis.

Objective To discuss the effect of milking in different times on very low birth weight premature infants .Methods Totals of 78 very low birth weight premature infants were chosen and divided into the no asphyxia group A(Apgar score 7-10), mild asphyxia group B(Apgar score 4-6.9), sever asphyxiation group C(Apgar score 0-3.9) according to the Apgar score.Then every group was randomly divided into the subgroups:13 neonates for group A1, group A2, group B1, group B2, group C1 and group C2.Group A1, group B1 and group C1 added early trace formula into enteral feeding in 24 hours until converted to full-intestinal absorption, while group A2 , group B2 and group C2 were given the same nutrition after 24 hours.Changes of indicators of infants were observed in all groups .Results The weight gain , excrement , time to regain body bass, PPN time, FEN time and hospitalization day was respectively (17.5 ±6.6) g/d,(3.2 ±1.2) times/d, (4.7 ±2.6)d, (9.2 ±4.1)d, (20.4 ±7.1)d ,(25.6 ±4.8)d in group A1, and(11.4 ±5.3)g/d, (1.9 ± 1.7)times/d, (6.2 ±3.1) d,(13.1 ±3.7) d,(25.1 ±7.9) d and(29.7 ±5.3) d in group A2, and the differences were statistically significant ( t =7.045,5.379,6.001,5.891,5.913,7.704, respectively;P <0.05).The weight gain, excrement, time to regain body bass, PPN time, FEN time and hospitalization day was respectively (10.0 ±3.5) g/d,(1.4 ±0.8) times/d,(7.9 ±3.7) d, (15.6 ±5.2) d, (27.7 ±6.8) d, (32.8 ±8.2)d in group B1, and(10.6 ±2.8)g/d,(1.3 ±1.1)times/d,(8.1 ±3.1)d,(14.8 ±6.1)d, (28.1 ±5.4)d,(36.4 ±8.7)d in group B2, and the differences were not statistically significant (t=1.964, 1.157,2.131,1.467,2.003,1.980, respectively;P>0.05).The weight gain, excrement, time to regain body bass, PPN time, FEN time and hospitalization day was respectively (4.4 ±1.8) g/d,(0.0 ±0.3) times /d, (13.4 ±4.8)d, (19.2 ±7.7)d, (36.1 ±9.5)d,(43.5 ±10.2)d in group C1, and (7.4 ±3.4)g/d,(1.1 ± 0.9)times/d,(10.6 ±3.1) d,(17.0 ±6.9) d,(30.2 ±7.5) d and(39.9 ±9.1) d in group C2, and the differences were statistically significant ( t =5.549,6.000,5.836,5.907,8.114,7.908, respectively;P <0.05).There was statistically significant difference of gastrointestinal functional damage between group A 1 and A2(χ2 =8.496,P<0.05).There was no statistically significant difference of gastrointestinal functional damage between group B1 and B2 (χ2 =2.001,P>0.05).There was statistically significant difference of gastrointestinal functional damage between group C1 and C2 (χ2 =13.457,P <0.01).Conclusions Presence of asphyxia hazard is one of the most important standards of starting breastfeeding in 24 hours for very low birth weight premature infants , and Apgar score can be used as one of the references for start milking for premature infants .

Objective To explore the effect of three-in-one nursing including the music therapy , massage and non-nutritional sucking on the prevention of feeding intolerance in very low birth weight infant . Methods One hundred and twenty very low birth weight infants from January 2010 to January 2013 were chosen and randomly divided into the control group and the intervention group , each with 60 cases.All patients received the homogeneous parenteral nutrition and a little formula through enteral feeding , and at the same time the control group received the massage and non-nutritional sucking , and the intervention group received the three-in-one nursing .The feeding effect was compared between two groups .Results The time of recovery of birth weight , the weight gain every day , and the time of parenteral nutrition and reaching enough enteral feeding, the length of time were respectively (2.9 ±2.1)d, (17.8 ±7.9)g and (7.7 ±3.1) d,(17.4 ±6.3)d, (19.6 ±5.9)d in the intervention group, and were better than those of the control group , and the differences were statistically significant (t=7.685, 9.001, 7.061,11.047,17.438,14.225, respectively;P<0.05).The incidence rate of feeding intolerance was 6.67% in the intervention group , and was 20.00% in the control group, and the difference was statistically significant (χ2 =12.005,P<0.01).Conclusions Three-in-one nursing can improve the early enteral feeding in very low birth weight infant , and improve the function of the routine massage and non-nutritional sucking , and reduce the incidence rate of feeding intolerance .