早期营养支持对极低出生体质量儿生长的影响  

Benefits of early and aggressive nutritional support in very low birth weight infants

作　　者：岳枫[1] 贾义军[1] 石计朋[2] 

机构地区：[1]鹤壁职业技术学院护理学院,河南鹤壁458030 [2]新乡医学院第一附属医院新生儿科,河南卫辉453100

出　　处：《肠外与肠内营养》2014年第3期155-157,160,共4页Parenteral & Enteral Nutrition

摘　　要：目的：探讨极低出生体质量儿（VLBWI）住院期间早期给予积极营养支持对体质量的影响. 方法：对178例出生体质量为1 000～1 499 g生后6h内入院、住院时间超过2周、无畸形或严重并发症,且存活出院的早产儿分为对照组（76例）和改良组（102例）.对照组病儿采用常规的营养支持方式;改良组采取尽早开奶、足量肠外营养支持方案.比较两组病儿摄入的奶量、三大营养素和热量,并比较VLBWI的生长速度和生长迟缓的发生情况. 结果：改良组病儿出生后第3和第7天,奶量摄入均高于对照组（P＜0.05）,第3天,静脉使用糖类均高于对照组（P＜0.05）.改良组病儿出生后第3天静脉使用氨基酸、脂肪乳均明显高于对照组（P＜0.05）.改良组病儿出生后第3、7和第14天总热量摄入均高于对照组（P＜0.05）.住院期间,改良组病儿体质量下降幅度小于对照组,恢复出生体质量的时间缩短,体质量平均增长速度加快（P＜0.05）.出院时,改良组病儿生长迟缓发生率（51％）明显低于对照组（67％）（P＜0.05）. 结论：早期积极营养支持治疗,增加了VLBWI奶量和三大营养素的摄入,明显改善了VLBWI生长状况,减少了宫外生长迟缓的发生率.Objective：To explore the benefits of early and aggressive nutritional support in very low birth weight （VLBW） premature infants.Methods：Conventional conservative way of nutritional support was adopted in the control group,and the early aggressive nutritional support was taken in the improved group.The comparison of volume of baby formula,three major nutrients and calories intake between were made.The nutrition support,growth rate and the incidence of VLBWI associated with extrauterine growth retardation（EUGR） were investigated.Results：Improved group had greater volume of baby formula on the 3nd and 7nd day of life（P 〈 0.05）and more carbohydrate on the 3nd day of life（P 〈 0.05） than the control group.Positive effects of early establishment of enteral nutrition and parenteral nutrition in Improved group had small decrease in birth weight,earlier return to birth weight,fastgrowing of average weight,earlier reach to hospital discharge standards （P 〈 0.05）.Conclusion：Early and more aggressive nutritional support strategy can be able to provide enough energy and nutrients for VLBWI to provide the body growth and reduce the rate of EUGR.

关 键 词：营养支持 极低出生体质量儿 体质量增长 宫外生长迟缓 

分 类 号：R459.3[医药卫生—治疗学] R722.1[医药卫生—临床医学]