深度水解蛋白配方粉喂养早产儿相关营养状况分析  

Nutritional status of premature neonates fed with extensively hydrolyzed protein formula

作　　者：冯一[1] 洪莉[1] 潘莉雅[1] 常盼盼[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心临床营养科,200127

出　　处：《中华临床营养杂志》2015年第5期259-265,共7页Chinese Journal of Clinical Nutrition

基　　金：雅培/世界健康基金会临床营养发展中心（AFINS）（AFINS-HOPE-2013-10）

摘　　要：目的 探讨以深度水解蛋白配方粉作为开奶喂养的早产儿相关营养状况。方法 收集2013年1月至2014年12月上海儿童医学中心新生儿重症监护室首次以深度水解蛋白配方粉开奶喂养的早产儿共157例，记录相关诊断、出生情况、营养摄入、生长发育等。根据有无喂养不耐受（不耐受组和耐受组）和出生体质量（＜1 500 g、1 500~2 500 g和≥2 500 g组）进行分组，分析生长发育情况及其相关因素。结果 共60例（38.2%）早产儿发生喂养不耐受。出生体质量和胎龄越小，发生喂养不耐受越多，其中＜1 500 g组喂养不耐受为71.1%。与耐受组比较，喂养不耐受组出生体质量［（1 620±440）g比（1 980±421）g，P=0.000］、胎龄［（31.3±2.6）周比（33.0±2.1）周，P=0.000］、出生头围［（28.9±2.2）cm比（30.4±1.9）cm，P=0.000］和出生身长［（41.1±3.9）cm比（43.2±3.4）cm，P=0.000］明显减小，转奶时间［（26.4±17.6）d比（7.9±5.3）d，P=0.000］和达到足量喂养时间［（21.5±10.0）d比（13.8±6.2）d，P=0.000］明显延长。同时，开奶时间［＜1 500 g组（6.1±5.1）d，1 500~2 500 g组（3.8±2.5）d，≥2 500 g组（3.3±1.2）d，P=0.002］、转奶时间［＜1 500 g组（28.7±18.3）d，1 500~2 500 g组（9.7±8.1）d，≥2 500 g组（7.0±3.8）d，P=0.000］和达到足量喂养时间［＜1 500 g组（24.0±10.4）d，1 500~2 500 g组（14.3±6.0）d，≥2 500 g组（11.4±3.5）d，P=0.000］出生体质量越小组越晚。不耐受组和＜1 500 g组有更多患儿接受肠外营养支持（93.3%；97.8%），且肠外营养提供热量［＜1 500 g组（325.9±59.4）kJ/（kg·d），1 500~2 500 g组（281.2±64.8）kJ/（kg·d），≥2 500 g组（269.9±43.9）kJ/（kg·d），P=0.001］和持续时间［＜1 500 g组（27.1±14.5）d，1 500~2 500 g组（13.0±7.0）d，≥2 500 g组（8.7±3.4）d，P=0.000］更多。生长发育方面不耐受组头围增长较快［不耐�Objective To analyze the nutritional status of premature neonates first fed with extensively hydrolyzed protein formula. Methods From January 2013 to December 2014, 157 premature neonates hospitalized in Neonatal Intensive Care Unit of Shanghai Childrens Medical Center who were first fed with extensively hydrolyzed protein formula were enrolled. Clinical data were recorded, including related diseases, birth weight and gestational age, nutrients intake, and growth charts. Two groups were divided according to the existence or absence of feeding intolerance, and three groups were divided based on birth weight （〈1 500 g, 1 500~2 500 g, and ≥2 500 g）. Results A total of 60 （38.2%） premature infants had feeding intolerance. The lower the birth weight and gestational age, the higher the frequency of feeding intolerance, and the incidence of feeding intolerance in 〈1 500 g group was 71.1%. Compared with the feeding tolerance group, the feeding intolerance group had significantly smaller birth weight [（1 620±440）g vs. （1 980±421）g, P=0.000], gestational age [ （31.3±2.6）weeks vs. （33.0±2.1）weeks, P=0.000], birth head circumference [（28.9±2.2）cm vs. （30.4±1.9）cm, P=0.000], and birth length [（41.1±3.9）cm vs. （43.2±3.4）cm, P=0.000], but significantly longer time before transfer formula [（26.4±17.6）d vs. （7.9±5.3）d, P=0.000] and time before reaching sufficient feeding [（21.5±10.0）d vs. （13.8±6.2）d, P=0.000]. The time of first feeding [〈1 500 g group （6.1±5.1）d, 1 500~2 500 g group （3.8±2.5）d, ≥2 500 g group （3.3±1.2）d, P=0.002], time before transfer formula [〈1 500 g group （28.7±18.3）d, 1 500~2 500 g group （9.7±8.1）d, ≥2 500 g group （7.0±3.8）d, P=0.000] and time before reaching sufficient feeding [〈1 500 g group （24.0±10.4）d, 1 500~2 500 g group （14.3±6.0）d, ≥2 500 g group （11.4±3.5）d, P=0.000] increased along with the decrease of birth weight. The proportions of infants receiving parenteral nut

关 键 词：深度水解蛋白配方 早产儿 营养 

分 类 号：R722.6[医药卫生—儿科]