极低出生体重儿出院后不同营养强化策略效果的临床研究  

Clinical study of the effects of different nutrition strengthening strategies on very low birth weight infants after discharge

作　　者：尹欢[1] 王义乾 许云波[1] 蔡成[2] 程红斌[1] YIN Huan;WANG Yiqian;XU Yunbo;CAI Cheng;CHENG Hongbin(Department of Neonatology,Hubei Huangshi Maternal and Child Health-Care Hospital,Hubei Huangshi 435000,China;Department of Neonatology,Shanghai Children's Hospital,Shanghai 200062,China)

机构地区：[1]湖北省黄石市妇幼保健院新生儿科,湖北黄石435000 [2]上海市儿童医院新生儿科,上海200062

出　　处：《中国妇幼健康研究》2022年第12期80-85,共6页Chinese Journal of Woman and Child Health Research

基　　金：黄石市医疗卫生科技计划项目(2019A19)。

摘　　要：目的探讨极低出生体重儿(VLBWI)出院后不同营养强化策略对其体格生长、营养状态及神经发育的影响。方法选取2019年5月至2020年7月本院早产儿出院后定期随访的符合纳入标准的102例VLBWI为研究对象,根据营养强化策略将其分为早产儿配方组(n=59)和母乳强化组(n=43)。比较两组VLBWI的基本资料、体格生长指标、营养指标和1岁时神经发育情况。结果两组VLBWI在性别、出生胎龄、出生体重、身长、头围、出生时年龄别体重Z评分(WAZ)和血红蛋白(Hb)方面的差异无统计学意义(P>0.05),具有可比性。两组VLBWI 1岁内各并发症及神经干预的发生率差异无统计学意义(P>0.05)。早产儿配方组VLBWI在纠正胎龄40周、纠正月龄1月时体重、身长、前白蛋白、尿素氮水平高于母乳强化组(纠正胎龄40周:t值分别为4.420、2.604、4.897、2.170,P<0.05;纠正月龄1月:t值分别为3.602、3.069、4.605、2.000,P<0.05);两组VLBWI头围、WAZ和其他营养指标(Hb、钙、磷)无统计学差异(P>0.05)。1岁时母乳强化组VLBWI的神经功能区精细动作和语言发育商高于早产儿配方组(t值分别为2.236、2.393,P<0.05),其余功能区无统计学差异(P>0.05)。结论VLBWI出院后早产儿配方和母乳强化喂养均可以满足营养和早期体格发育需求,但母乳强化喂养不仅能满足追赶生长,而且有利于神经发育。Objective To investigate the effects of different nutritional strengthening strategies on physical growth,nutritional status and neurodevelopment of very low birth weight infants(VLBWI)after discharge.Methods A total of 102 cases of VLBWI among preterm infants,who were followed up regularly after discharge in our hospital and met the inclusion criteria from May 2019 to July 2020 were selected as the study subjects.According to the nutrition enhancement strategy,they were divided into the preterm infant formula group(n=59)and the breast milk fortification group(n=43).The basic data,physical growth indexes,nutritional indexes and neurodevelopment at the age of 1 year were compared between the two groups of VLBWI.Results There were no significant differences between the two groups in sex,gestational age,birth weight,body length,head circumference,weight-for-age Z score(WAZ)and hemoglobin(Hb)(P>0.05),and they were comparable.There were no significant differences in the incidences of complications and neurointerventions within 1 year in very low birth weight infants between the two groups(P>0.05).The weight,length,prealbumin and urea nitrogen levels in the preterm infant formula group at 40 weeks and 1 month of corrected gestational age were significantly higher than those in the breast milk fortification group(corrective gestational age of 40 weeks:t=4.420,2.604,4.897 and 2.170,respectively,P<0.05;corrective month age of 1 month:t=3.602,3.069,4.605 and 2.000,respectively,P<0.05).There were no significant differences in the head circumference,WAZ and other nutritional indicators(Hb,calcium and phosphorus)between the two groups(P>0.05).At 1 year old,the fine motion and language development quotient in neural function area in the breast milk fortification group were higher than those in the premature infant formula group(χ~2=2.236 and 2.393,respectively,P<0.05),but there were no significant differences in other functional areas(P>0.05).Conclusion Both the premature infant formula and intensive breast-feeding for VLBWI

关 键 词：极低出生体重 营养策略 发育商 出院后强化喂养 

分 类 号：R174.4[医药卫生—妇幼卫生保健]