摘要
目的探讨生后早期积极的营养支持对住院期间早产儿的影响。方法研究对象选择胎龄大于28周出生体重1000g至2000g、生后12h内转入我院NICU、住院时间2周以上、无明显畸形且存活出院的早产儿，其中A组（2005年1月1日至2006年6月30日出生）81例，B组（2009年6月1日至2010年11月30日出生）79例。比较营养摄入、早产儿的生长速率及体重Z评分和血生化营养指标的差异。结果B组生后第3、7天氨基酸用量明显高于A组[2．D0（2．00，2．50）g／kg比1．50（1．50，2．00）g／kg，3．00（2．00，3．00）g／kg比2．00（1．80，2．60）g／kg，P均〈0．001]。B组第3天奶量和总热卡摄入明显高于A组[9．41（2．66，18．74）ml／kg比14．47（4．23，30．77）ml／kg，P〈0．05，（64．87±16．04）keal／kg比（55．62±17．68）keal／kg，P=0．001]。两组第1周后总热卡摄入相似。B组母乳强化剂使用率较前升高（62．8％比14．3％，P〈0．005）。无论是出生体重1000—1499g的早产儿，还是出生体重1500～2000g的早产儿，B组生长速率均更快[（20．6±3．4）g／（kg·d）比（15．4±3．2）g／（kg·d），（20．3±9．1）g/（kg·d）比（14．3±4．9）g／（kg·d），P均〈0．001]。A组生长迟缓的比例出院时较出生时增加（65．4％比40．7％，P〈0．05），B组差异无统计学意义。两组出生体重Z评分相似，而B组出院体重Z评分明显高于A组[（-1．24±0．79）比（-1．54±0．84），P〈0．05]。出生时血清白蛋白、前白蛋白、尿素水平两组差异无统计学意义，而生后2周和出院前B组明显高于A组。结论早产儿生后早期营养措施的改善有效促进了早产儿住院期间的生长和营养状况。
Objective To explore the effect of aggressive nutritional support in early life on growth of preterm infants during hospitalization. Method Two retrospective cohorts of preterm infants were compared; 81 infants of group A （born between January 1, 2005 and June 30, 2006） and 79 infants of group B （ June 1, 2009 and November 30, 2010） with gestational age above 28 weeks and birth weight between 1000 g and 2000 g, transfered to NICU of PUMCH within 12 hours after birth, hospitalized for 〉 or = 2 weeks, who were free Of major congenital anomalies and survived to discharge were recruited. The comparison of enteral and parenteral nutrition, growth rate, biochemical indices during hospitalization between these both groups were made. Result Compared to group A, group B was given greater volume of amino acid infusion on the 3rd and 7th day of life [2. 00 （2.00,2. 50） g/kg vs 1.50 （1.50,2.00） g/kg, 3.00 （2. 00,3.00） g/kg vs 2. 00 （1.80,2. 60） g/kg, all P 〈0. 001 ] , and Consumed more milk and total energy intake on the 3rd day of life [9. 41 （2. 66,18.74） ml/kg vs 14. 47（4. 23,30. 77） ml/kg, P 〈0. 05, （64. 87±16. 04） kcal/kg vs （55.62± 17.68） kcal/kg, P =0. 001 ]. Total energy intakes after a week of life were similar between the two groups. More infants received human milk fortifier in group B （62. 8% vs 14.3% ,P =0. 001 ）. After stratification according to weight, both very low birth weight infants and infants with birth weight between 1500 g and 2000 g in group B grew more rapidly （P 〈0. 001 ）. The percentage of growth retardation was increased after hospitalization in group A（65.4% vs 40. 7%, P 〈 0. 05 ）, there were no statistically significant differences in group B. The mean Z scores at birth were comparable. The mean Z scores by discharge were higher in group B （ - 1.24 vs - 1.54, P 〈 0. 05 ）. Serum albumin, prealbumin and urea values were similar in both groups at birth, but higher in group B after two weeks of life（P 〈0. 001 ）. Before dis
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2011年第10期771-775,共5页
Chinese Journal of Pediatrics
关键词
营养支持
婴儿
早产
生长和发育
肠道营养
肠外营养
Nutritional support
Infant, premature
Growth and development
Enteral nutrition
Parenteral nutrition
