摘要
目的通过研究早产儿住院期间年龄别体重z评分,评估早产儿住院期间生长情况并探讨可能的影响因素。方法采用回顾性调查的方法,收集住院2周以上、出生胎龄在28～33周之间早产儿的临床资料,计算其住院期间年龄别体重z评分的动态变化,z评分=(实测体重-该性别该胎龄体重平均值)/该性别该胎龄体重的标准差。结果共有438例早产儿入选,男293例,女145例;出生胎龄(31.3±1.4)周,出生体重(1638±345)g,出生时z评分(-0.60±0.68),住院时间(30.3±13.9)d,出院时矫正胎龄(35.6±1.8)周,体重(2058±300)g,出院时z评分(-1.44±0.95)。不同胎龄组、适于胎龄儿及小于胎龄儿组住院期间z评分随日龄增长均呈下降趋势,出生时体重(r=0.56,P<0.01)、出生时z评分(r=0.55,P<0.01)和出院时z评分呈正相关,而开始肠内营养日龄(r=-0.33,P<0.01)、肠内营养热卡达100kcal.kg-1.d-1的时间(r=-0.32,P<0.01)、总热卡达120kcal.kg-1.d-1的时间(r=-0.30,P<0.01)与出院时z评分呈负相关,败血症与出院时z评分显著相关(χ2=7.42,P<0.01)。结论年龄别体重z评分法是早产儿生长状态评估的一个较好指标。早产儿住院期间z评分总体呈下降趋势,适宜的宫内发育及生后积极的胃肠内外营养支持均可提高早产儿z评分,并改善其生长状况。
Objective To evaluate the growth of premature infants during hospital stay with z score of weight for age and its correlated factors.Methods Data of premature infants were collected retrospectively from 10 NICUs in China.Those born between 28 to 33 weeks of gestation with hospital stay exceeding 2 weeks but with no major congenital diseases were included. Z scores of weight for age were calculated weekly till discharge. Results Of the 438 premature infants included in this study,293 were boys and 145 were girls,gestational age at birth was （31.3±1.4） wk,birth weight was （1638±345） g,z score of weight for age at birth was （-0.60±0.68）,hospital stay was （30.3±13.9） d;At discharge,corrected age was （35.6±1.8） wk,weight was （2058±300） g,and z score of weight for age was （-1.44±0.95）. The curves of all the subgroups （categorized by gestational age at birth;by AGA or SGA at birth;by z score ≥-2 or -2 at discharge respectively） tended to decline during hospital stay.Birth weight （r=0.56,P0.01） and z score of weight for age at birth （r=0.55,P0.01） were positively associated with z score of weight for age at discharge; days of initiation of enteral feeding （r=-0.33,P0.01）,days for achieving 100 kcal·kg-1·d-1 through enteral feeding （r=-0.32,P0.01） and days for achieving total energy intake of 120 kcal·kg-1·d-1 （r=-0.30,P0.01） were negatively associated with z score of weight for age at discharge. Sepsis was associated with lower z score of weight for age at discharge （χ2=7.42,P0.01）. Conclusion The z score of weight for age of premature infants declined during hospital stay. Appropriate intrauterine growth and more aggressive nutrition support after birth were associated with better z scores of weight for age at discharge.
出处
《中国新生儿科杂志》
CAS
2010年第5期263-267,共5页
Chinese Journal of Neonatology
关键词
婴儿
早产
体重
Z评分
Infant
premature
Weight
z score
