影响极低出生体重儿早期生长赶超的原因  

Influence on early catch-up growth of very low birth weight infants

作　　者：蒋一茵[1] 钱燕[1] 池美珠[1] 王楸[1] 

机构地区：[1]温州医学院附属第一医院NICU,325000

出　　处：《中华围产医学杂志》2007年第5期301-304,共4页Chinese Journal of Perinatal Medicine

摘　　要：目的 分析极低出生体重儿（very low birth weight infant，VLBWI）在纠正胎龄40周时的生长赶超情况及影响因素。方法 以50例VLBWI作为研究对象。以40周胎龄健康足月儿和15个城市不同胎龄婴儿出生体重为正常值，比较50例VLBWI在出生、出院时及纠正胎龄40周时的小于胎龄儿（small for gestational age，SGA）发生率；分析喂养方式、并发症、辅助治疗等对VLBWI生长赶超的影响。结果 50例VLBWI在纠正胎龄40周时的体重为（3290±640）g，与同胎龄足月儿比较差异无统计学意义（P〉0．05）。50例VLBWI出院时SGA所占比例为64．0％（32／50），明显高于出生时的24．0％（12／50）和纠正胎龄40周时的32．0％（15／50），P均〈0．05。出生时SGA（OR=0．035，95％CI0．003-0．487）、低T3综合征（OR=0．101，95％CI0．013～0．774）及长期使用静脉营养（OR=0．307，95％CI0．097-0．972）是导致VLBWI生长赶超失败的危险因素，而早期开展肠道喂养（OR=8．241，95％CI1．373～49．470）则有利于VLBWI的生长赶超。并发低T3综合征的VLBWI住院4周期间及出院后平均体重增长速度均低于未并发低T3综合征的VLBWI（P均〈0．05）。结论 合理的营养方案、降低并发症的发生率是VLBWI实现早期生长赶超的关键。Objective To analyze the influence on early catch-up growth of very low birth weight infants （VLBWI）. Methods Fifty VLBWI were enrolled in this study. Body weight after birth from 50 full-term neonates and 15 cities healthy neonates was compared. The incidence of small for gestational age （SGA） at birth,discharge and postconceptional age 40 weeks and the influence factors on catch-up growth of VLBWI were analyzed. Results The weight of 50 VLBWI at postconceptional age 40 weeks was （3290± 640） g. There was no significant difference with normal value （P〉 0.05）. The incidence of SGA at discharge （64.0%, 32/50）was higher than at birth （24. 0%） and postconceptional age 40 weeks（32.0%）, respectively. SGA （OR = 0. 035,95 % CI 0. 003 - 0. 487）, low-T3 syndrome （OR= 0. 101,95% CI 0. 013-0. 774）and long term parenteral nutrition treatment （OR=0. 307,95% CI 0. 097-0. 972） could interfere the catch-up growth of VLBWI. However, enteral feeding earlier （OR= 8. 241,95 % CI 1. 373-49. 470） was helpful. The weight increase speed of VLBWI with low-T3 syndrome during hospitalization and postdischarge was lower than those without low-T3 syndrome （P〈0.05）. Conclusions Appropriate nutrition and decrease the incidence of complication were important for VLBWI to gain early catch-up growth.

关 键 词：婴儿 极低出生体重 胎儿生长迟缓 婴儿营养 体重增长 

分 类 号：R722[医药卫生—儿科]