单胎与多胎极低出生体重儿生后早期生长发育状况比较  

The differences of early postnatal growth between singletons and multiplets of very low birth weight infants

作　　者：崔其亮[1] 吴繁[1,2] 张慧[1] 谭岱峰[1] 何伟彬[3] 高平明[3] 杨冰岩[4] 黄辉文[5] 张坤尧[6] 李晓东[7] 郭小芳[8] 程柳旺 

机构地区：[1]广东省广州医学院第三附属医院儿科,广州510150 [2]广东省东莞市常平医院新生儿科,广东东莞523560 [3]广东省佛山市妇幼保健院新生儿科,广东佛山528000 [4]广东省中山市博爱医院新生儿科,广东中山528400 [5]广东省珠海市妇幼保健院新生儿科,广东珠海519001 [6]广东省惠州市中心医院新生儿科,广东惠州516008 [7]广东省深圳市广东医学院附属南山人民医院新生儿科,广东深圳518052 [8]广东省江门市新会区妇幼保健院新生儿科,广东江门529100 [9]广东省肇庆市端州区妇幼保健院新生儿科,广东肇庆526040

出　　处：《中国实用儿科杂志》2013年第1期18-22,共5页Chinese Journal of Practical Pediatrics

基　　金：2011年广东省第三批科技计划项目(粤科规划字[2011]97号);广州市医药卫生科技项目(201102A213149);广州市科技计划项目应用基础研究专项重点项目(2011J4100046)

摘　　要：目的研究单胎和多胎极低出生体重儿(VLBWI)生后早期生长发育状况及其相关影响因素的异同点,为多胎VLBWI的生长发育监测提供参考依据。方法回顾性调查广东省珠江三角洲地区9个城市的9家医院新生儿科于2010-07-01—2011-06-30期间出院的早产VLBWI的住院资料,分为单胎组和多胎组,2组婴儿均统一参照"Fenton生长曲线2003—胎儿、婴儿生长曲线(供早产儿参考)(WHO生长标准版)"进行生长发育状况评估,对比性研究2组婴儿出生时宫内生长发育迟缓(IUGR)和生后2周、4周、出院时宫外生长发育迟缓(EUGR)的发生率差异,及2组婴儿的院内营养摄入情况、体重增长速度和相关疾病发生率差异等。结果单胎组和多胎组婴儿出生时IUGR和生后2周、4周、出院时EUGR的发生率差异无统计学意义(P>0.05);恢复出生体重后的日均体重增长速度和各时间段(生后2周、4周、住院期间)的营养摄入及累计缺失量差异均无统计学意义(P>0.05);多胎组婴儿的呼吸窘迫综合征及其母亲的妊娠期糖尿病发生率均高于单胎组,而羊水过少或Ⅲ度混浊的发生率小于单胎组(P<0.05)。结论多胎早产VLBWI生后呼吸窘迫综合征发生率高于单胎,但生后早期的生长发育状况与单胎者无明显差异,其生后的生长发育状态监测可参考单胎婴儿的生长曲线。Objective To study the differences of early postnatal growth between singletons and muhiplets of very low-birth-weight infants （VLBWI）, which would give the answer to the question： do singletons and multiplets need separate standards to monitor their growth？ Methods Clinical data of preterm VLBWI, discharged from July 1st, 2010 to June 30th, 2011 , were collected retrospectively from 9 NICUs of 9 cities in Pearl River Delta, Guangdong province. They were assigned into two groups： singletons group and multiplets group. Their body weight and growth rate were assessed by the same growth chart. The incidence of intrauterine growth retardation （IUGR） at birth and extrauterine growth retardaiion （EUGR）in different postnatal time pe- riods （2 weeks, 4 weeks and on discharge） were studied contrastively. The nutrition intakes, growth rate, and the relevent illnesses were also studied. Results The inci- dence of IUGR at birth and EUGR in the different postna- tal time periods （2 weeks, 4 weeks and on discharge） all showed no significant differences between singletons group and multiplets group （P 〉 0.05）. The mean growth rate daily after restoring birth weight, the nutrition in- takes and cumulative losses （energy and protein） in the different postnatal time periods （2 weeks, 4 weeks and on discharge） also showed no significant differences between sin- gletons group and muhiplets group （P 〉 0.05）. As to the incidence of neonatal respiratory distress syndrome to VLBWI and the incidence of gestational diabetes mellitus to pregnant women, muhiplets group was higher than singletons group, while the ineidenee of oligohydramnios or amniotic fluid turbidity （ Ⅲ degree） to pregnant women was lower in muhiplets group than in singletons group （P〈 0.05）.Conclusion The incidence of neonatal respiratory distress syn- drome was higher in muhiplets than in singletons .But the incidence of growth retardation of body weight shows no signifi- cant differences between muhiplets and si

关 键 词：早产儿 极低出生体重儿 多胎 生长发育监测 宫内生长发育迟缓 宫外生长发育迟缓 

分 类 号：R72[医药卫生—儿科]