摘要
目的:探讨深度水解蛋白配方奶(eHF)在极低出生体质量儿喂养中的临床效果。方法:采用前瞻性临床对照研究。选取2018年1月至12月珠海市妇幼保健院新生儿科收治的入院日龄<12 h、出生体质量999~1500 g、胎龄28~33周的极低出生体质量儿。将符合入选标准的患儿,根据母亲疾病状况和家长母乳喂养意愿分为母乳喂养组(HM组)和非母乳喂养组,非母乳喂养组患儿根据家长喂养意愿分为eHF组和早产儿配方奶喂养组(PF组)。排除未达足量喂养前出院或死亡者、出生28 d内出院者、患先天性畸形(复杂先天性心脏病、消化道畸形等)、严重感染者。采用χ2检验和单因素方差分析进行统计分析,比较3组患儿喂养不耐受发生率、胎便排空日龄、恢复出生体质量日龄、达胃肠道全量喂养时间、住院时间、新生儿坏死性小肠结肠炎(NEC)发生率、胆汁淤积发生率、宫外发育迟缓发生率,出生4周内头围、身长、体质量增长速度,出生2周及4周血清生化指标。结果:最终纳入分析102例,eHF组35例,PF组37例,HM组30例。eHF组[22.0%(8/35例)]和HM组[16.7%(5/30例)]喂养不耐受发生率均低于PF组[54.0%(20/37例)],差异均有统计学意义(χ^2=7.366、9.901,均P<0.05)。eHF组和HM组胎粪排尽时间[(7.2±1.8)d、(6.6±1.8)d比(8.7±2.1)d]、恢复出生体质量时间[(8.9±1.8)d、(9.1±1.4)d比(10.8±2.9)d]、达全胃肠道喂养[(42.8±2.8)d、(42.3±3.3)d比(45.5±3.4)d]及住院时间[(52.9±1.1)d、(52.3±1.2)d比(54.1±1.2)d]均短于PF组,差异均有统计学意义(均P<0.05),但eHF组与HM组比较差异无统计学意义(均P>0.05)。3组间NEC发生率、胆汁淤积发生率、宫外发育迟缓发生率,出生4周内头围增长速度、身长增长速度、体质量增长速度,出生2周和4周血清清蛋白、肌酐、尿素氮比较,差异均无统计学意义(均P>0.05)。eHF组和HM组出生2周血清总胆红素水平[(109.4±4.6)μmol/L、(110.2±1.0)μmol/L�
Objective To evaluate the clinical efficacy of extensively hydrolyzed protein formula(eHF)in very low birth weight(VLBW)infants.Methods A prospective controlled signal-center trial was conducted in this study,the preterm infants with gestational age of 28-33 weeks and birth weight of 999-1500 g who were hospitalized at Department of Neonatology,Zhuhai Maternal Hospital within the first 12 hours between January and December 2018,were selected.They were assigned into breast feeding group(HM)and formula feeding group according to the mothers′disease and parents′breastfeeding willingness.The formula feeding group was assigned into eHF group and preterm formula(PF)group according to the parents′breastfeeding willingness.The infants discharging or dead before achieving full feeding,discharging within 28 days after birth,with congenital malformation(complex congenital heart disease,digestive system malformation,etc)and severe sepsis were rolled out.Chi-square test and One-Way ANOVA were used for statistical analysis.Prospective study was conducted among the 3 groups comparing the incidence of feeding intolerance,duration of meconium discharge,the time to regain birth weight and reach full enteral feeding,average hospital stay,incidence of necrotizing enterocolitis of newborn(NEC),cholestasis and extrauterine growth retardation(EUGR),the growth rate of head circumference,length and weight in the first 4 weeks of life,and blood biochemical indices at the first 2 weeks and 4 weeks of life.Results A total of 102 infants were enrolled,35 cases in the eHF group,37 cases in the PF group and 30 cases in the HM group.Compared with the PF group[54.0%(20/37 cases)],the eHF group[22.0%(8/35 cases)]and the HM group[16.7%(5/30 cases)]had lower incidence of feeding intolerance,and the differences were statistically significant(χ2=7.366,9.901,all P<0.05).The time to regain birth weight[(8.9±1.8)d,(9.1±1.4)d vs.(10.8±2.9)d],time for achieving full enteral feeding[(42.8±2.8)d,(42.3±3.3)vs.(45.5±3.4)d],the duration of meconiu
作者
马海燕
林广
黄辉文
邓宜雅
Ma Haiyan;Lin Guang;Huang Huiwen;Deng Yiya(Department of Neonatology,Zhuhai Maternal Hospital,Zhuhai 519000,Guangdong Province,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2020年第11期829-833,共5页
Chinese Journal of Applied Clinical Pediatrics
