早期积极经口喂养对早产儿宫外发育迟缓的影响  

Effect of very early feeding on extrauterine growth restriction in preterm infants

作　　者：张惠芳[1,2] 章玉丹 张红爱[2] 赵玉娟[2] 李晖[1] 

机构地区：[1]西安交通大学医学院第一附属医院新生儿科,陕西西安710016 [2]西安市儿童医院新生儿科,陕西西安710003

出　　处：《中国妇幼健康研究》2015年第2期175-177,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨生后实施早期积极经口喂养对早产儿达到稳定全肠内营养及宫外发育迟缓(EUGR)的影响。方法比较生后24小时内给予经口喂养(A组,n=35)与24小时后给予经口喂养(B组,n=32)的早产儿住院期间达到稳定全肠内营养所用时间、生长速率及出院时EUGR发生率的差异。排除不能早期经口喂养的早产儿。结果 A组早产儿达全肠内营养时间(z=-6.34,P<0.001)、恢复出生体重所需时间(t=-2.30,P<0.5)及住院时间(z=-3.29,P<0.5)均较B组短;生理性体重下降幅度(t=-6.28,P<0.001)较B组低。A组早产儿体重、头围、身长增长速率较B组快(z值分别为-2.53、-3.76、-4.65,均P<0.05),EUGR的发生率较B组低(体重、头围及身长HUGR发生率x^2值分别为4.07、4.28、7.84,均P<0.05)。两组均无坏死性小肠结肠炎病例。结论早产儿生后早期积极经口喂养,达全肠内营养时间及住院时间明显缩短,有效改善了早产儿住院期间的营养状况,降低EUGR的发生率,且未增加住院期间的相关并发症。Objective To examine the effect of initiating very early feeding on time-to-reach full feeding and extrauterine growth restriction （EUGR） in preterm infants.Methods There were two groups of preterm infants randomly allocated to very early feeding group （within 24 hours of birth, group A, n=35） and delayed feeding group （after 24 hours of birth, group B, n=32）.Time-to-reach full feeding, growth rate and EUGR incidence were compared between two groups.Infants unable to start early feeding were excluded.Results Group A needed shorter time to reach full feeding （z=-6.34,P〈0.001）, to regain birth weight （t=-2.30,P〈0.5） and to hospitalize （z=-3.29,P〈0.5） than group B, and the decline degree of physiological weight in group A was less than in group B （t=-6.28,P〈0.001）.Group A had faster increasing in body weight, head circumference and body length （ z value was -2.53, -3.76 and -4.65, respectively, all P〈0.05）, and the incidence of EUGR was lower in group A than in group B （χ^2 value was 4.07, 4.28 and 7.84, respectively, all P〈0.05）.No necrotizing enterocolitis （NEC） was documented in both groups.Conclusion Preterm infants with very early feeding regimen achieve full enteral feeding and are discharged home significantly earlier than those with delayed regimen, and nutritional status of them during hospitalization is improved effectively.The incidence of EUGR is reduced without increasing of complications in hospital.

关 键 词：早期积极经口喂养 全肠内营养 宫外发育迟缓 早产儿 

分 类 号：R722.6[医药卫生—儿科]