积极营养支持策略对早产儿宫外发育迟缓的影响
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王莉,主任医师。

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Effect of positive nutritional support strategy on extrauterine growth restriction in preterm infants
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    摘要:

    目的 探讨生后实施早期积极营养支持策略对早产儿住院期间营养状况及宫外发育迟缓(EUGR)的影响。方法 比较既往营养方案组(A组,n=99)与积极营养方案组(B组,n=101)早产儿住院期间营养摄入、生长速率及出院时EUGR发生率的差异。结果 B组生后1周内肠内营养热卡摄入量及总热卡摄入量均明显高于A组。B组早产儿开奶日龄、恢复出生体重所需时间、静脉营养持续时间、达足量喂养时间及住院时间均较A组短,生理性体重下降幅度较A组低。< 32周的B组早产儿体重、头围、身长增长速率较A组快,EUGR的发生率较A组低;≥32周的B组早产儿体重增长速率快及以体重、头围评价的EUGR的发生率较低。住院期间B组喂养不耐受、坏死性小肠结肠炎、败血症的发生率明显低于A组。结论 早产儿生后早期积极营养支持措施的实施,有效改善了早产儿住院期间的营养状况,降低EUGR的发生率,且未增加住院期间的相关并发症。

    Abstract:

    Objective To investigate the effects of positive nutritional support in the early stage after birth on the nutritional status during hospitalization and extrauterine growth restriction (EUGR) in preterm infants. Methods There were two groups of preterm infants. Group A (n=99) was given the previous nutritional program, while group B (n=101) was given positive nutritional support. The nutritional intake, growth rate and EUGR incidence were compared between the two groups. Results Compared with group A, group B had significantly higher enteral calorie intake and total calorie intake within one week after birth. Additionally, the age of first feeding, time of regaining birth weight, duration of intravenous nutrition, time to full enteral feeding, and length of hospital stay in group B were all shorter than in group A. Group B also had less physiological weight loss than group A. Among the preterm infants with a gestational age less than 32 weeks, group B had faster increases in body weight, head circumference, and body length and a lower incidence of EUGR compared with group A. Among the preterm infants with a gestational age not less than 32 weeks, group B had faster increases in body weight and a lower incidence of EUGR (evaluated based on body weight and head circumference) compared with group A. During hospitalization, group B had significantly lower incidence of feeding intolerance, necrotizing enterocolitis, and sepsis than group A. Conclusions Positive nutritional support strategy, applied in preterm infants early after birth, can effectively improve their nutritional status during hospitalization and reduce the incidence of EUGR without increasing the incidence of related complications during hospitalization.

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王学敏, 朱艳萍, 王莉.积极营养支持策略对早产儿宫外发育迟缓的影响[J].中国当代儿科杂志,2013,15(12):1054-1058

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  • 收稿日期:2013-05-15
  • 最后修改日期:2013-06-27
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  • 在线发布日期: 2013-12-15
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