不同开奶配方应用于极低出生体重儿的临床研究

Effect of different feeding initiation formulas on very low birth weight infants

摘要:

目的 研究不同奶方用于极低出生体重早产儿开奶对生长发育和喂养耐受性的影响。方法 根据开奶奶方，86例胎龄 < 34周、出生体重 < 1 500 g的早产儿分为标准早产儿配方奶喂养组（SPF组，n=31）、深度水解蛋白奶喂养组（eHF组，n=27）和母乳喂养组（对照组，n=28），比较各组早产儿生长指标、喂养情况、血生化、住院时间及喂养不耐受、败血症、坏死性小肠结肠炎、宫外生长迟缓（EUGR）的发生率。结果 SPF组、eHF组和对照组三组间院内体重、头围及身长增长速率、住院时间和出院时EUGR发生率的比较差异无统计学意义（P > 0.05）；SPF组和eHF组胎便转黄时间明显短于对照组（P < 0.01）；SPF组的足量喂养时间明显短于eHF组和对照组（P < 0.01），而后二者无显著差别；SPF组血清前白蛋白水平显著低于eHF组和对照组（P < 0.01）；SPF组和eHF组的出院Hb水平显著高于对照组（P < 0.01）；eHF组出院时血嗜酸性粒细胞百分比水平明显低于SPF组（P < 0.01）；各组喂养不耐受、败血症、坏死性小肠结肠炎的发生率差异无统计学意义（P > 0.05）。结论 eHF和SPF均可用于 < 34周的极低出生体重早产儿开奶，且不增加EUGR发生率。

Abstract:

Objective To explore the effect of feeding initiation with different formulas on the growth, development, and feeding tolerance in very low birth weight infants. Methods A total of 86 preterm infants with a gestational age of < 34 weeks and a birth weight of < 1 500 g were divided into three groups according to their feeding initiation formulas:standard preterm formula feeding group (SPF group; n=31), extensively hydrolyzed protein formula feeding group (eHF group; n=27), and breastfeeding group (control group; n=28). Comparisons were made between the groups in terms of growth indices, feeding condition, blood biochemistry, length of hospital stay, and incidence rates of feeding intolerance, sepsis, necrotizing enterocolitis (NEC), and extrauterine growth retardation (EUGR). Results There were no significant differences among the above three groups in body weight, head circumference, and rate of increase in body length measured during hospitalization, as well as length of hospital stay and EUGR incidence rate at discharge (P > 0.05). The SPF and eHF groups had a significantly shorter transition time from meconium to yellow stool than the control group (P < 0.01). The SPF group had a significantly shorter time to standard enteral feeding than the eHF and control groups (P < 0.01), with no significant difference observed between the latter two groups. The SPF group had a significantly lower serum prealbumin level than the eHF and control groups (P < 0.01). The SPF and eHF groups had a significantly higher hemoglobin level at discharge than the control group (P < 0.01). The percentage of eosinophils at discharge was significantly lower in the eHF group than in the SPF group (P < 0.01). No significant differences were found among the three groups regarding the incidence rates of feeding intolerance, sepsis, and NEC (P > 0.05). Conclusions Both eHF and SPF can be used for feeding initiation for very low birth weight preterm infants with a gestational age of < 34 weeks without increasing the incidence rate of EUGR.