早产儿出院时宫外生长迟缓危险因素分析  

Analysis of risk factors of extrauterine growth retardation in premature infants discharged from hospital

作　　者：刘彬彬 周梦竹 徐倩倩 王慧慧 沈怀云[1] LIU Binbin;ZHOU Mengzhu;XU Qianqian;WANG Huihui;SHEN Huaiyun(Department of Pediatrics,The First Affiliated Hospital of Bengbu Medical College,Anhui Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004

出　　处：《中国妇幼健康研究》2022年第10期49-53,共5页Chinese Journal of Woman and Child Health Research

基　　金：安徽省卫生计生委科研计划项目(2016QKO44)。

摘　　要：目的探讨早产儿出院时宫外生长迟缓(EUGR)发生情况及危险因素,为防治其发生提供理论依据和干预策略。方法回顾性分析2019年1月至2020年12月在蚌埠医学院第一附属医院住院的407例早产儿病历资料,根据出院体重与出院时矫正胎龄关系,分为EUGR组和非EUGR组。分析EUGR早产儿的临床资料、住院期间疾病发生、治疗及营养支持情况,并采用多因素Logistic回归分析影响因素。结果早产儿出院时EUGR人数为136例(33.42%);EUGR组出生体重低、胎龄小于非EUGR组,妊娠期高血压疾病、多胎、宫内生长迟缓(IUGR)比例大于非EUGR组,差异均有统计学意义(χ^(2)/t值介于-15.666~14.235之间,P<0.05);EUGR组新生儿呼吸窘迫综合征(NRDS)、坏死性小肠结肠炎(NEC)、新生儿窒息、新生儿贫血、有创机械通气、肺表面活性物质(PS)使用比例及生后第1周累计热卡亏空量均大于非EUGR组,且EUGR组开始肠内营养时间更晚、禁食时间更长、全胃肠道营养日龄更大、全胃肠道营养时最大热量更低,差异均有统计学意义(χ^(2)/t值介于-15.849~46.676之间,P<0.05);多因素Logistic回归分析结果显示出生体重高是EUGR的保护性因素(OR=0.044,P<0.05),多胎、全胃肠道营养日龄大、生后第1周累计热卡亏空量高是EUGR发生的危险因素(OR值分别为6.537、1.945、1.029,P<0.05)。结论出生体重、多胎、全胃肠道营养日龄、生后第1周累计热卡亏空量与早产儿EUGR的发生有关。为降低早产儿EUGR的发生率,应积极预防低体重儿出生,并采取合理的营养策略防治并发症的发生。Objective To explore the incidence and risk factors of extrauterine growth retardation(EUGR)in premature infants at discharge,so as to provide theoretical basis and intervention strategies for the prevention and treatment of EUGR.Methods The clinical data of 407premature infants hospitalized in the First Affiliated Hospital of Bengbu Medical College from January 2019to December 2020were retrospectively analyzed.According to the relationship between discharged weight and corrected gestational age at discharge,infants were divided into the EUGR group and the non-EUGR group.The clinical data,disease occurrence,treatment and nutritional support of premature infants during hospitalization were analyzed.Multivariate Logistic regression was used to analyze the risk factors of EUGR.Results The number of premature infants with EUGR at discharge was 136(33.42%).Compared with the non-EUGR group,the birth weight and gestational age of premature infants were lower and the percentages of hypertensive disorder complicating pregnancy,multiple births,intrauterine growth retardation(IUGR)were higher in the EUGR group,and the differences were statistically significant(χ^(2)/t=-15.666-14.235,respectively,P<0.05).Neonatal respiratory distress syndrome(NRDS),necrotizing enterocolitis(NEC),neonatal asphyxia,neonatal anemia,invasive mechanical ventilation,pulmonary surfactant(PS)usage percentage and cumulative calorie deficiency in the first week after birth in the EUGR group were higher than those in the non-EUGR group,and the EUGR group began enteral nutrition later,fasted longer,had longer days of total enteral nutrition and lower maximum calorie during total enteral nutrition,and the differences were statistically significant(χ^(2)/t=-15.849-46.676,respectively,P<0.05).Multivariate Logistic regression analysis showed that high birth weight was a protective factor for EUGR(OR=0.044,P<0.05),and multiple births,older age of total enteral nutrition and high cumulative calorie deficit in the first week after birth were the independent

关 键 词：早产儿 宫外生长迟缓 危险因素 营养 

分 类 号：R174[医药卫生—妇幼卫生保健]