早产儿院内和出院后营养管理分析  

Analysis of Nutrition Management of Preterm Infant During Hospitalization and Post-discharge

作　　者：余慕雪[1] 庄思齐[1] 郭楚怡[1] 谢巧庆[1] 司徒妙琼[1] 陈静蓉[1] 何美群[1] 

机构地区：[1]中山大学附属第一医院儿科,广东广州510080

出　　处：《继续医学教育》2016年第11期122-123,共2页Continuing Medical Education

基　　金：广东省自然科学基金资助项目(2015A030313148)

摘　　要：目的探讨早产儿的院内和出院后营养管理。方法对1例胎龄25^(+2)周、出生体重550 g的极早早产超低出生体重儿的院内和出院后营养管理和生长发育情况进行分析。结果出生24小时予以该早产儿建立中心静脉置管,出生36小时即启动肠内营养予以母乳微量管饲喂养。在肠内营养母乳量和强化密度增加的过程中,个体化调整肠外营养液和能量密度,使肠外营养量渐减,校正胎龄37^(+5)周时患儿母乳全量强化并达全肠内营养。至校正胎龄41^(+6)周出院时患儿体重、头围生长曲线评估百分位数逐渐上升。出院后个体化指导患儿进行营养强化和优质辅食添加,较好地满足其体格追赶生长需要和神经精神发育。结论积极和个体化的院内肠外肠内营养供给和出院后的营养管理,为早产儿理想的体格追赶生长和神经精神发育提供了重要保障。Objective To investigate the nutrition management of preterm infant during hospitalization and post-discharge. Methods In this study, the nutrition management and growth evaluation of an extremely low birth weight preterm infant （gestational age of 25^＋2 weeks, birth weight 550 g during hospitalization and post-discharge were analyzed. Results The preterm infant was performed central venous access within 24 hours and received the minimal enteral nutrition with breast milk by Tube feeding within 36 hours after birth. During the process of increasing the breast milk feeding volume and the proportion of fortifier, the parenteral nutrition was decreased by adjusting the parenteral nutrition composition and energy density individually. The infant achieved full enteral feeding of full-fortified breast milk at corrected gestational age of 37^＋5 weeks. The centiles for weight and head circumference in the growth chart of the preterm infant were increased gradually and he was discharged at corrected gestational age of 41^＋6 weeks. The preterm infant received nutrition management such as nutrition fortification and complementary feeding individually after discharge in order to adequate healthy catchup growth and neurodevelopment. Conclusion The aggressive nutrition including parenteral and enteral during hospitalization and individualized nutrition management post-discharge is effective in improving growth and neurodevelopment ofpreterm infants.

关 键 词：早产儿 院内 出院后 营养 

分 类 号：R722[医药卫生—儿科]