影响极低出生体质量儿喂养方法的因素及其与体质量增长关系的探讨  

Relationship between different nutritional methods and body mass growth in very low birth mass infants

作　　者：蒋一茵[1] 钱燕[1] 王楸[1] 池美珠[1] 

机构地区：[1]温州医学院附属第一医院NICU,浙江温州325000

出　　处：《临床荟萃》2006年第10期709-711,共3页Clinical Focus

基　　金：温州市科委;S2000A16D

摘　　要：目的 探讨影响极低出生体质量儿（very low birth mass infant,VLBMI）喂养方式的因素以及不同营养方法与体质量增长关系.方法 54例VLBMI生后12小时内先给予肠道外营养（parenteral nutrition,PN）,当出现肠鸣音或排出胎便即开始鼻饲喂养,病情较重者从0.5～1 ml/h微泵持续鼻饲开始,逐渐从全部肠外营养过度到部分肠外营养,当肠道内营养供能达到418.4 kJ·kg^-1·d^-1时停PN,按照PN应用的时间分为两组;组1： PN＜10天,平均（5.79±1.99）天,共计28例;组2： PN≥10天,平均（15.92±5.36）天,共计26例.结果 54例平均应用PN时间为（10.67±6.47）天;组1的胎龄、出生体质量均高于组2,并发低T3综合征的患儿少于组2,差异有统计学意义（P＜0.05）.结论 早期微量喂养等措施有助于肠道内营养的早期建立,肠道内营养能提供更足够的能量以满足VLBMI的体质量增长,传统PN治疗方案存在能量供给不足,有待改善.Objective To discuss the relationship between the nutrition methods with risk factors and body mass growth associated in very low birth mass infants（VLBMI）. Methods Fifty-four VLBMI in NICU received parenteral nutrition（PN） in 12 hours after birth, and commenced nasogastric feeding if the infants started to have bowel tones or discharged meconium. The infants with serious condition were fed by continuous nasogastric feeding using minipump from 0.5-- 1 ml/h. When enteral nutrition was started, PN transitted from total to partial gradually. PN would be stopped when an enteral intake of 418.4 kJ · kg^-1 · d^-1 was established. All the infants were derided into two groups according to the duration of parenteral nutrition： group 1 ： using PN 〈 10 days, （5.79 ± 1.99） days on average, n = 28 group 2.. using PN ≥ 10 days （15.92± 5.36） on average, n = 26. Results The average duration of using PN in 54 infants was （10.67 ± 6.47） days. Two groups were different in gestational age, birth mass and the morbidity of hypothyroidism （ P 〈0.05）. Conclusion Early and minimal feeding can help establish enteral nutrition, which is more profitable to get adequate energy for body mass growth. Energy deficit existed in infants who received PN, so the traditional therapeutic method of PN should be improved.

关 键 词：婴儿 早产 婴儿 极低出生体重 胃肠外营养 能量代谢 

分 类 号：R591[医药卫生—内科学]