摘要
目的分析极低出生体重(VLBW)婴儿宫外生长发育迟缓(EUGR)发生率及其影响因素。方法选择我院2013年1月至2015年6月住院治疗的VLBW婴儿,对其临床资料进行回顾性分析,包括胎龄、出生体重等基本资料,对并发症情况及入院前2周营养情况进行记录,并根据出生体重分组,计算EUGR发生率,并比较有、无宫内生长发育迟缓(IUGR)患儿中EUGR及严重EUGR的发生率。结果共纳入345例VLBW婴儿,其中IUGR80例。发生EUGR共285例,发生率为82.6%。IUGR患儿出院时均为EUGR,非IUGR患儿EUGR发生率为77.4%。非IUGR患儿出生体重越低,EUGR及严重EUGR发生率越高。EUGR组出生体重、平均每日体重增长及全经口喂养最大热量小于非EUGR组,胎龄大于非EUGR组。EUGR组前2周末氨基酸、脂肪乳及能量摄入量均低于非EUGR组,两组间并发症比较差异无统计学意义;严重EUGR组呼吸窘迫综合征(RDS)、支气管肺发育不良(BPD)、败血症明显高于非EUGR组,差异有统计学意义。Logistic回归分析结果显示,胎龄、出生体重为EUGR的独立影响因素。结论出生时存在IUGR的患儿EUGR发生率较高。影响EUGR发生的主要因素包括胎龄、出生体重以及生后前2周的氨基酸、脂肪乳及能量的摄入等。存在RDS、BPD、败血症的VLBW婴儿更易发生严重EUGR。
Objective To study the incidence and the risk factors of extrauterine growth restriction （EUGR）in very low birth weight （VLBW） infants. Methods From January 2013 to June 2015, the clinical data of 345 VLBW infants admitted to our hospital were retrospectively analyzed, including the basic information of the infants, complications, and the nutritional status during the first two weeks after birth. The incidence of EUGR and severe EUGR were studied. Results A total of 345 VLBW infants were included in the study. The incidence of intrauterine growth restriction （IUGR） at birth was 23.2% （80 cases） while the incidence of EUGR at discharge was 82. 6% （285 cases）. All the 80 cases of IGUR developed EUGR. Among the remaining 265 cases of non-IGUR, 205 cases developed EUGR, and the incidence was 77.4%. The lower the birth weight （ BW ）, the higher the incidence of EUGR and severe EUGR. The BW, average daily weight gain and the maximum energy intake in EUGR group were lower than non-EUGR group while their gestational age （GA） higher than non-EUGR group. During the first 2 weeks after birth, average daily protein, lipid and energy intake in EUGR group were lower than non-EUGR group. Respiratory distress syndrome （RDS）, asphyxia,septicemia, suppurative meningitis, necrotizing enterocolitis （ NEC ）, intracerebral hemorrhage （ ICH ）, bronchopulmonary dysplasia （BPD） had no significant differences between EUGR group and non-EUGR group （P 〉 0. 05 ） . But severe EUGR group had significantly higher incidences of RDS, BPD, septicemia than non-EUGR group （P 〈 0. 05 ）. The logistic regression analysis showed that GA and BW were independent risk factors of EUGR. Conclusions The risk of developing EUGR in IUGR infants was higher than non-IUGR. The risk factors included BW, GA, the protein, lipide and energy intake during first 2 weeks after birth. The incidences of complications including RDS, BPD, and septicemia increased in servere EUGR group.
出处
《中国新生儿科杂志》
CAS
2016年第4期289-293,共5页
Chinese Journal of Neonatology
关键词
婴儿
极低出生体重
宫外生长迟缓
宫内生长迟缓
营养状况
Infant, very low birth weight
Extrauterine growth restriction
Intrauterine growth retardation
Nutritional status
