早产儿喂养不耐受临床特征分析

Clinical features of feeding intolerance in preterm infants

摘要:

目的：探讨早产儿喂养不耐受的临床特征，为早产儿喂养不耐受的防治提供临床依据。方法：2007年1月至2009年12月入住新疆医科大学第一附属医院的早产儿716例为研究对象，对其临床特征进行回顾性分析。结果：①716例早产儿中197例(27.5%)发生喂养不耐受，其中极低出生体重儿喂养不耐受发生比率高达77.6%。临床表现中以单纯胃潴留所占比例最高(47.2%)。②喂养不耐受出现时间集中在开始喂养后3 d内。③喂养不耐受组早产儿胎龄和出生体重低于耐受组、开奶时间晚于耐受组、早产儿合并窒息及呼吸性疾病比例高于耐受组（P＜0.05）；而民族、性别、孕母年龄、分娩方式、有无宫内窘迫两组差别无统计学意义（P＞0.05）。随着胎龄增大、出生体重增加、尽早开始喂养，早产儿喂养不耐受发生风险降低。结论：早产儿喂养不耐受的发生与患儿胎龄、出生体重、开奶时间及合并症有关。

Abstract:

OBJECTIVE: To study the clinical features of feeding intolerance in preterm infants in order to provide clinical evidence for preventing feeding intolerance. METHODS: A total of 716 preterm infants hospitalized in the First Affiliated Hospital of Xinjiang Medical University between January 2007 and December 2009 were enrolled. The clinical data of the infants were retrospectively studied. RESULTS: Feeding intolerance occurred in 197 (27.5%) out of 716 infants, with an incidence of 76.4% in the very low birth weight infants. Simple gastric retention (47.2%) was found as the most common clinical manifestation. Feeding intolerance usually occurred within 3 days after feeding. Compared with the preterm infants with feeding success, the preterm infants with feeding intolerance showed lower gestational age and birth weight, more delayed feeding and higher rate of asphyxia and respiratory diseases (P<0.05). There were no significant differences in the gender, maternal age, ethnic group, delivery way and the incidence of fetal distress between the two groups. With increasing gestational age, increasing birth weight, early feeding, the incidence of feeding intolerance in preterm infants was reduced. CONCLUSIONS: The low gestational age, low birth weight, delayed feeding and complications may be associated with the development of feeding intolerance in preterm infants.