广东省新生儿重症监护室早产儿微量元素及维生素使用情况调查  

Investigation on the use of trace elements and vitamins in premature infants in neonatal intensive care unit of Guangdong Province

作　　者：王艳丽[1] 颜慧恒[1] 王俊平[1] 张春一[1] 叶秀桢[1] 陈运彬[1] WANG Yan-li;YAN Hui-heng;WANG Jun-ping;ZHANG Chun-yi;YE Xiu-zhen;CHEN Yun-bin(Department of Neonatology,Guangdong Women and Children Hospital,Guangdong Provincial Neonatal ICU Medical Quality Control Center,Guangzhou 510010,Guangdong,China)

机构地区：[1]广东省妇幼保健院新生儿科、广东省新生儿ICU医疗质量控制中心,广东广州510010

出　　处：《广东医学》2022年第5期584-587,共4页Guangdong Medical Journal

基　　金：广东省科技计划项目(2017ZC0322)。

摘　　要：目的调查广东省新生儿重症监护室内早产儿微量元素、维生素使用情况及早产儿代谢性骨病发生情况。方法自制调查问卷包括微量元素及维生素的补充情况、早产儿代谢性骨病发生情况。以广东省新生儿质量控制中心名义对广东省内新生儿重症监护室进行分层抽样然后以问卷星形式进行匿名调查。此次调查共有39所医疗机构,其中省级医院3家、地市级19家、区县级17家。结果几乎所有医疗机构(97.4%)在早产儿生后1~2周每天补充400~800 IU维生素D;超过一半医疗机构(64.1%)在生后1周内常规补充脂溶性或水溶性维生素。大约一半医疗机构(48.7%)在早产儿生后2~3周常规补充铁剂;而不足1/3的医疗机构(28.2%)在早产儿生后1~2周补充钙剂;只有6家医疗机构(15.4%)在早产儿住院期间常规补磷,多数在生后1周进行补充。关于早产儿代谢性骨病调查发现只有9所(23.1%)医疗机构在早产儿住院期间约生后4~6周进行骨代谢碱性磷酸酶及D3含量检测,在所有调查医疗机构中有8家医疗机构(20.5%)发生过院内骨折事件,发生频率大概是每年1例。不同级别医疗机构比较发现三级医院在铁剂、脂溶性维生素补充方面高于二级医院,而二级医院水溶性维生素补充率高于三级医院,其他结果差异无统计学意义(P>0.05)。结论广东省内新生儿重症监护室早产儿微量元素及维生素补充缺乏规范,主要原因可能是由于目前国内尚无早产儿微量元素及维生素补充专家共识导致,而且大部分医院未常规对早产儿代谢性骨病筛查,建议尽快制定早产儿住院期间微量元素及维生素补充规范及早产儿代谢性骨病的早期筛查规范。Objective To investigate the use of trace elements and vitamins in preterm infants and metabolic os-teopathy in neonatal intensive care unit(NICU)in Guangdong Province.Methods The self-made questionnaire in-cluded the supplement of trace elements and vitamins,and the incidence of metabolic bone disease in premature infants were applied for study.Stratified sampling was conducted in neonatal intensive care units(NICUs)of Guangdong Province in the name of Guangdong Provincial neonatal ICU medical quality control center,and anonymous survey was conducted.A total of 39 medical institutions were investigated,including 3 provincial hospitals,19 prefecture level hospitals and 17 district and county-level hospitals.Results Almost all medical institutions(97.4%)provided 400-800 IU vitamin D supplement every day within 1-2 weeks after birth;more than half of the medical institutions(64.1%)routinely provid-ed fat or water-soluble vitamins within 1 week after birth.About half of the medical institutions(48.7%)routinely pro-vided supplement iron 2-3 weeks after birth;less than one-third of the medical institutions(28.2%)provided supple-ment calcium 1-2 weeks after birth;only 6 medical institutions(15.4%)routinely provided supplement phosphorus dur-ing hospitalization of preterm infants,and most of them provided supplement phosphorus one week after birth;only 9(23.1%)medical institutions have metabolic bone disease survey on bone metabolism alkaline phosphatase(ALP)and D3 content for premature infants 4-6 weeks after birth.Among all the investigated medical institutions,8 medical institu-tions(20.5%)had hospital fracture events,and the incidence was about 1 case per year.The iron,fat soluble vitamin supplements in tertiary hospitals were higher than those in secondary hospitals,while the water-soluble vitamin supple-ment rate in secondary hospitals was higher than that in tertiary hospitals.There was no significant difference in other inde-xes.Conclusion The lack of standards for trace elements and vitamin supplementation of p

关 键 词：早产儿 微量元素 维生素 代谢性骨病 调查 

分 类 号：R722.1[医药卫生—儿科] R722.6[医药卫生—临床医学]