摘要
目的观察极低出生体重早产儿住院期间的生长速度及营养支持情况,研究影响其生长的因素。方法采用回顾性调查的方法,收集2005年1月1日至2006年6月30日我国不同地区10所三甲医院极低出生体重早产儿的临床资料,对影响早产儿生长的因素进行分析。结果共有238例符合条件的极低出生体重早产儿,出生胎龄为(30.9±1.9)周,出生体重(1313±129)g。生后第1周～第6周平均体重生长速率分别为-7.2、14.2、13.6、13.7、14.2、14.8g/(kg·d)。肠内、外营养开始平均时间分别为(3.4±2.3)d和(3.1±1.7)d,总热卡达120kcal/(kg·d)平均时间为(21.3±11.6)d,喂养奶量达150ml/(kg·d)平均时间为(23.4±10.8)d。恢复出生体重后平均生长速率为(13.8±3.5)g/(kg·d),平均住院时间(39.8±13.9)d。出生时小于胎龄者较适于胎龄者恢复出生体重后的平均生长速率快[14.4vs13.2g/(kg·d),t=2.703,P<0.05]。结论平均生长速率较快组[≥15g/(kg·d)]与较慢组[<15g/(kg·d)]相比,出生胎龄差异无显著性,但出生体重低、接受肠内肠外营养早。大多数极低出生体重早产儿在住院期间不能达到正常胎儿在宫内的生长速率。更积极的肠内肠外营养,可能有利于极低出生体重儿生后的早期生长。
Objective To investigate the nutrition support and growth rate of very low birth weight （VLBW） premature infants during hospital stay. Methods Clinical data of VLBW premature infants discharged from Jan.1st, 2005 to Jun. 30th, 2006 were collected retrospectively according to certain criteria from 10 tertiary NICUs in China. Nutrition support, growth pattern and factors associated with growth rates were studied. Results Two hundred and thirty-eight VLBW premature infants were included. Mean gestational age at birth was （30.9 -＋ 1.9） week, mean birth weight was （1313 ± 129） g. The growth rate from the 1st week to the 6th week during hospital stay was -7.2 g/（kg·d）, 14.2 g/（kg·d）, 13.6 g/（kg·d）, 13.7 g/（kg·d）, 14.2 g/（kg·d） and 14.8 g/（kg·d） respectively. Enteral feeding was started at （3.4 ± 2.3） days of life, parenteral nutrition was given at （3.1 ± 1.7） days of life, total energy intake of 120 kcal/（kg·d） was achieved at （21.3 ± 11.6） d, enteral feeding reached 150 ml/（kg·d） at （23.4 ± 10.8） d. The average hospital stay was （39.8 ±13.9） days. The average growth rate after regaining birth weight was （13.8 ± 3.5） g/（kg·d）. Infants in higher growth rate group [ ≥ 15 g/（kg·d）] had lower birth weight, earlier start of enteral feeding and parenteral nutrition. Infants born as small for gestational age showed higher growth rate than those born as appropriate for gestational age [24.00 vs 21.50 g/（kg·d）, Z = 2.325, P 〈 0.05]. Conclusions Most VLBW premature infants failed to achieve growth rate of ≥ 15 g/（kg·d） as desired for normal intrauterine growth rate. Earlier enteral and parenteral nutrition might be good for the growth of VLBW premature infants.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2009年第3期248-251,共4页
Journal of Clinical Pediatrics
关键词
早产儿
极低出生体重
营养
生长速率
premature infants
very low birth weight
nutrition
growth rate
