小于胎龄的极低出生体重儿肠道血流特点及其对消化道并发症的影响  

Characteristics of intestinal blood flow and its effect on gastrointestinal complications of small for gestational age plus very low birth weight infants

作　　者：杨华 悦光 巨容 YANG Hua;YUE Guang;JU Rong(Department of Neonatology,The Affiliated Women and children’s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Sichuan Chengdu 610000,China)

机构地区：[1]电子科技大学医学院附属成都市妇女儿童中心医院新生儿科,四川成都610000

出　　处：《中国妇幼健康研究》2022年第3期41-46,共6页Chinese Journal of Woman and Child Health Research

基　　金：四川省卫生和计划生育委员会科研课题项目(编号:18PJ046)。

摘　　要：目的了解在极低出生体重儿中,小于胎龄儿与适于胎龄儿相比,生后早期肠系膜上动脉血流是否有显著差异,以及两者在消化道功能上是否存在显著区别。方法以2018年1月到2019年10月在成都市妇女儿童中心医院出生的极低出生体重儿为研究对象,根据体重和胎龄的关系分组,分为小于胎龄儿组和适于胎龄儿组。生后12h内完成肠系膜上动脉血流多普勒超声检查,收集患儿的一般情况、并发症等资料。结果共纳入极低出生体重儿94例,小于胎龄儿组有27例,适于胎龄儿组有67例。两组的剖宫产率(χ^(2)=20.179)、5分钟Apgar评分(Z=2.460)、呼吸窘迫综合征(χ^(2)=14.732)发生率差异均有统计学意义(P<0.05),其余一般情况两组间差异无统计学意义(P>0.05)。小于胎龄儿组的舒张期血流异常的发生率(44.4%vs.16.4%)高于适于胎龄儿组,其中舒张期血流中断的发生率(33.3%vs.13.4%)也高于适于胎龄儿组,差异均有统计学意义(χ^(2)值分别为6.351、4.923,P<0.05)。小于胎龄儿组在日龄7天内喂养不耐受的发生率明显高于适于胎龄儿组,差异有统计学意义(χ^(2)=17.809,P<0.05),新生儿NEC发病率两组差异无统计学意义(P>0.05)。结论极低出生体重儿中小于胎龄儿和适于胎龄儿的肠系膜上动脉血流有显著差异,并对胃肠道功能有影响,这对未来通过检查血流状况用于指导喂养具有一定的启发,但该领域尚需要更多的研究。Objective To explore characteristics of blood flow of superior mesenteric artery of small for gestational age(SGA)plus very low birth weight(VLBW)infants,and to find out whether there is a significant difference between SGA infants and appropriate for gestational age infants(AGA)in those VLBW infants in gastrointestinal function.Methods The VLBW infants born in our hospital over a period from January,2018 to October,2019 were selected as study subjects and they were divided into two groups according to relation between body weight and gestational age:the SGA infants as group I and the AGA infants as group II.Color Doppler ultrasonography of superior mesenteric artery was conducted within 12 hours after birth.Demographics and complications of the infants were collected.Results 94 VLBW infants were included:27 SGA plus VLBW infants in group I and 67 AGA plus VLBW infants in group II.There were significant differences in rate of cesarean section,Apgar score at 5 minutes after birth and incidence of respiratory distress syndrome between the two groups(χ^(2)=20.179,P<0.05;Z=2.460,P<0.05;χ^(2)=14.732,P<0.05),while in other conditions there were no significant differences between the two groups(all P>0.05).The incidence of diastolic blood flow abnormality in the infants in Group I was significantly higher than that in Group II(44.4%vs 16.4%),of which the incidence of diastolic blood flow interruption was significantly higher than that in Group II as well(33.3%vs 13.4%)(χ^(2)=6.351 and 4.923 respectively,both P<0.05).And the incidence of feeding intolerance within 7 days of age in group I was significantly higher than that in group II(74.1%vs 26.9%,χ^(2)=17.809,P<0.05).No significant difference in incidence of necrotizing enterocolitis(NEC)was found between two groups(19.6%vs 11.9%,P>0.05).Conclusion In VLBW infants,in blood flow of superior mesenteric artery there is a significant difference between SGA infants and AGA infants,and influence of abnormality in splanchnic circulation on gastrointestinal function and co

关 键 词：极低出生体重儿 小于胎龄儿 肠系膜上动脉 喂养不耐受 新生儿坏死性小肠结肠炎 

分 类 号：R179[医药卫生—妇幼卫生保健]