摘要
目的探讨新生儿重症监护室(NICU)胎龄28~34周早产儿营养中断的原因,并观察肠内营养中断、肠外营养替代或弃用事件对早产儿临床结局的影响。方法采用回顾性研究,选取2019年1—6月于山西省儿童医院(山西省妇幼保健院)NICU收治的310例胎龄28~34周住院进行肠内营养和肠外营养的早产儿310例,统计分析营养中断的原因及对早产儿临床结局的影响。结果310例早产儿均在NICU期间接受过>24 h的肠内营养支持治疗,共发生280例(397次)肠内营养中断事件,共计4367 h。出现肠内营养中断的280例早产儿中123例早产儿肠内营养中断时间>12 h/d,157例肠内营养中断时间<12 h/d。不同肠内营养中断时间早产儿在恢复出生体重时间、使用呼吸机时间、平均住院时间、肠外营养替代或弃用发生率及宫外发育迟缓发生率方面比较,差异均有统计学意义(P<0.05)。结论NICU胎龄28~34周早产儿住院期间营养状况不理想。喂养不耐受、医源性操作、坏死性小肠结肠炎、监护室外检查、抢救和手术等是造成营养中断的主要原因,其中营养中断时间>12 h/d对早产儿临床结局影响较大。建议早产儿在NICU期间需要合理和规范地实施肠内营养和肠外营养,同时积极推进早产儿母乳喂养,以促进早产儿肠内营养效率,提高早产儿抗感染能力,降低宫外发育迟缓发生率,并最终达到降低早产儿患病率和病死率的目的。
Objective To explore the causes of in premature infants with gestational age of 28 to 34 weeks in Neonatal Intensive Care Unit(NICU),and to observe the influence of interruption of enteral nutrition,parenteral nutrition replacement or abandonment events on the clinical outcome of premature infants.Methods A retrospective study was used to select 310 premature infants with gestational age of 28 to 34 weeks who were admitted to NICU of Children's Hospital of Shanxi(Women Health Center of Shanxi)and hospitalized for enteral nutrition and parenteral nutrition from January to June 2019.The effect of interruption on the clinical outcomes of premature infants was statistically analyzed.Results All 310 preterm infants had received more than 24 hours of enteral nutrition support during the NICU.A total of 280 cases(397 times)of enteral nutrition interruption occurred,for a total of 4367 hours.Among 280 premature infants with interruption of enteral nutrition,the interruption time of enteral nutrition in 123 premature infants was longer than 12 h/d,and the interruption time of enteral nutrition in 157 cases was less than 12 h/d.There were significant differences in time to regain birth weight,duration of ventilator use,average length of hospital stays,incidence of parenteral nutrition replacement or abandonment,and incidence of extrauterine growth retardation among premature infants with different duration of enteral nutrition interruption(P<0.05).Conclusions The nutritional status of premature infants with gestational age of 28 to 34 weeks in NICU is not ideal during hospitalization.Feeding intolerance,iatrogenic manipulation,necrotizing enterocolitis,out-of-care examinations,rescue,and surgery are the main causes of nutritional interruption.Among them,the nutritional interruption time>12 h/d has a greater impact on the clinical outcome of preterm infants.It is recommended that preterm infants need reasonable and standardized enteral nutrition and parenteral nutrition during the NICU,and actively promote breastfeeding of
作者
李颖
郭锦丽
张静
田仲花
宋婷婷
宁晓燕
Li Ying;Guo Jinli;Zhang Jing;Tian Zhonghua;Song Tingting;Ning Xiaoyan(Nursing Department,Children's Hospital of Shanxi(Women Health Center of Shanxi),Taiyuan 030013,China;Nursing Department,Second Hospital of Shanxi Medical University,Taiyuan 030002,China;Neonatal Intensive Care Unit,Children's Hospital of Shanxi(Women Health Center of Shanxi),Taiyuan 030013,China;Pediatric Intensive Care Unit,Children's Hospital of Shanxi(Women Health Center of Shanxi),Taiyuan 030013,China)
出处
《中华现代护理杂志》
2021年第22期2997-3000,共4页
Chinese Journal of Modern Nursing
基金
山西省儿童医院山西省妇幼保健院2018年度院内科研课题(201811)。
关键词
婴儿
早产
新生儿重症监护室
营养中断
相关因素
Infant,premature
Neonatal intensive care unit
Nutritional interruption
Related factors
