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宝宝呕吐的原因有哪些？吉林新华明

发布日期：2022-06-05 08:00:37编辑：佚名

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症状，也有可能是疾病引起的。呕吐发生的原因，百分之八十来自于胃肠问题，但宝宝若发生持续性的呕吐，除了适时补充电解质、水分，及注意宝宝有无出现脱水症状外，应尽快送医诊治，找出原因。呕吐是指胃内容物被强而有力的从口腔中排出。反覆而剧烈的呕吐，可引起脱水、体内电解质失调、代谢性中毒及营养障碍...。呕吐是人体的一种反射动作，当延脑的呕吐中枢接受到来自肠胃道、耳前庭、视觉、大脑皮质，或血液、脑脊髓液中一些物质刺激时，即可引起呕吐。所以，呕吐虽然是一种胃肠道症状，但不见得是来自于胃肠道疾病，而是很多疾病的常见症状或先兆。不同年龄层呕吐原因不同引起呕吐的原因很多，虽然大部分属于胃肠疾病，但喉咙发炎、咳嗽后呕吐、中耳炎、神经系统疾病、代谢性疾病、泌尿道感染等也有可能会引起呕吐。有些时候，呕吐物会含有一些绿绿的胆汁，表示胃肠道有一段发生了阻塞，且发生的部位可能在十二指肠第二部分以后的位置。当然，含有胆汁的呕吐物，也有可能只是单纯的发生在剧烈呕吐，而无肠胃道阻塞的情形。要判别造成宝宝呕吐的原因，在不同年龄层需要考虑有不同的疾病。新生儿期在讨论此时期宝宝呕吐的原因前，我们必须先分辨与呕吐症状十分相似的“溢奶”。

“呕吐”是指胃内容物被强而有力的喷出，而“溢奶”则是指食道或胃中的东西不自主的流出嘴巴外，尤其容易发生在打嗝、排气，或是宝宝正在手舞足蹈的时候。大部分未满周岁的正常婴儿，都会有轻微的溢奶现象，这是因为生理性的食道下括约肌控制不好的原因，使得食物容易从胃逆流而上(胃食道逆流)。而这种现象大多数在宝宝开始添加副食品后(约五、六个月大时)，症状就会逐渐减轻，而在一岁或一岁半时完全消失。不过有些时候，因为喂奶方式的不适当，使得宝宝吞入大量的空气，或宝宝肚子受到压迫(例如换尿布、喂奶后抱的姿势不正确)，也是常造成婴幼儿溢奶的原因之一。这种“胃食道逆流”情形，多数是以“溢奶”来表现，较严重者仍会出现吐奶的状况，其症状在出生几天后开始出现，每次发生的时间较不固定，可能在喂奶中、喂奶后、睡醒一活动或在换尿布时，临床上可能以溢奶、呕吐、贫血、营养不良、体重增加不理想等表现，有时甚至会有吸入性肺炎、食道炎等并发症。对于“胃食道逆流”症状较轻微的婴儿，父母在喂奶后不要让宝宝太快躺下，先维持直立或半直立的姿势二十至三十分钟再轻轻放下。趴睡或右侧躺效果也不错，但趴睡要小心“婴儿猝死症”的问题，故不建议。至于少量多餐，牛奶中添加壳类制品或使用低溢奶配方奶粉也有帮忙。

当呕吐症状改善之后，有些宝宝会开始腹泻一段时间。在这段期间内，前六个月大宝宝饮食可以将牛奶浓度泡稀，而六个月后的宝宝可先尝试米汤加盐、稀饭、干饭、白土司、馒头。六个月大之后，因为母亲给予宝宝的抗体逐渐消失，及宝宝向外界接触的机会增加，宝宝感冒的机会就增多了。宝宝常会因为中耳炎、喉咙发炎，而合并呕吐的症状，即所谓的“肠胃型感冒”。除了一般呕吐的处理原则之外，此时更重要的是治疗引起的原因。若呕吐伴随着其他症状，家长也必须注意。如合并着间歇性腹痛(类似生产时的阵痛)，果酱颜色大便，就要小心是否有肠套叠的可能了。超音波为诊断肠套叠最有用的检查，若证实是肠套叠，可采取“钡剂”灌除套叠的部分，若无法完全解套，则开刀将套叠的肠子拉开。幼儿期这个时期因先天性异常疾病而造成呕吐的机会已变少(因多已被诊断出来)，但是门诊偶尔还是会发现，因胆道囊肿或肠道旋转不良，而造成呕吐的宝宝。呕吐的原因反而较多来自于一些感染性的疾病，如咽喉炎、中耳炎、鼻宝炎、肺炎、急性胃肠炎、泌尿系统感染9月大婴儿呕吐没有发热，及神经系统的疾病等。有些呕吐是急性的，有些则是慢性，而且是周期性的。周期性呕吐的病人通常每隔一段时间就会出现剧烈的呕吐而无法进食，常需住院打点滴处理；每次约持续三至五天，然后自行好转，而这种病人通常做了很多的检查，但都显示正常。

另一种慢性呕吐也常见于神经性呕吐，神经性呕吐症常见于二到六岁，比较神经质或脾气大的宝宝，往往会因一点点小事就会想吐，属于心理性的呕吐。例如妈妈老是逼迫宝宝进食，造成宝宝看到食物就会想到呕吐，呕吐的本身并没什么好担心9月大婴儿呕吐没有发热，反而父母应该改善育儿的方法。居家饮食照顾对策当宝宝有呕吐时，居家、饮食方面应如何照护？1、维持呼吸道的畅通呕吐厉害时，呕吐物可能从鼻腔喷出，父母需立即清除鼻腔异物，以保持呼吸道的畅通。若呕吐发生在宝宝直立或卧床时，可以先让宝宝身体向前倾或维持侧卧的姿势，让呕吐物易于流出，不至于让宝宝吸入呕吐物，以免造成窒息或吸入性肺炎。2、保持口腔的清洁呕吐之后，会有一些胃酸、消化，及未消化的食物残渣残留在口腔中，难闻的味道，会使宝宝更加的不舒服。所以较小的宝宝，父母可以以湿纱布沾开水清洁口腔；而较大的宝宝，可以以温开水漱口，以保持口腔清洁。3、短暂禁食，然后清淡饮食往往父母因看到小孩呕吐，慌了手脚，觉得小孩可怜，所以当呕吐完毕后，又急着喂他吃东西，结果又引起第二波的呕吐(可能吐的比吃进去的还多！)。其实，对于呕吐最好的处理是暂时先禁食四至六小时，包括开水、牛奶都不准喝，等待呕吐反应过去。在这段期间内，若宝宝吵着要喝水，可以以棉花棒沾水润湿口腔，大宝宝则可以给予棒棒糖。当症状改善，宝宝较舒服时，再给予多次少量电解质液(可以运动饮料代替，但若同时合并腹泻时，应将运动饮料稀释再喝)，若无明显恶心、呕吐、腹胀情形，可再给予清淡食物(如稀饭、干饭、
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