早期不同肠内喂养方式对VLBWI住院期间的发育、营养指标的影响  

Effects of early enteral feeding on the development and nutritional indexes of VLBWI during hospitalization

作　　者：曹沐琳[1] 杜志云[1] 邱锐琴[1] 乔木[1] 韩雁雁 CAO Mu-lin;DU Zhi-yun;QIU Rui-qin(Department of Neonatology,The First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院新生儿科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2023年第11期1197-1200,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫计委科研课题(编号:20180852);秦皇岛市科学技术研究与发展计划项目(编号:202004A026)。

摘　　要：目的探讨不同的早期肠内喂养方式对极低出生体重早产儿(VLBWI)发育及营养指标的影响。方法前瞻性选取2017年1月至2022年1月秦皇岛市第一医院新生儿科收治的125例VLBWI,采用简单随机法将其分为A组(n=63)和B组(n=62)。A组采用医院专用液态配方奶粉进行肠内喂养,B组采用母乳+母乳喂养强化剂进行肠内喂养。比较两组VLBWI出生后1、14、28 d时间点的体重、身长、头围、日均体重增长速度、营养学指标(白蛋白、球蛋白、前白蛋白)、肝功能指标[丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆红素(TBIL)、直接胆红素(DBIL)]以及并发症发生情况。结果出生后1 d,A组和B组的体重、身长、头围测定值比较,差异均无统计学意义(P>0.05);出生后14、28 d,A组的体重、身长、日均体重增长速度测定值高于B组,差异均有统计学意义(P<0.05)。出生后1 d,A组和B组的血清白蛋白、球蛋白、前白蛋白测定值比较,差异均无统计学意义(P>0.05);出生后14、28 d,A组的血清白蛋白、球蛋白、前白蛋白测定值高于B组,差异均有统计学意义(P<0.05)。出生后1、28 d,A组和B组的血清ALT、γ-GT、TBIL、DBIL测定值比较,差异均无统计学意义(P>0.05)。住院治疗过程中,A组的并发症发生率为20.63%(13/63),B组的并发症发生率为22.58%(14/62),两组并发症发生率比较,差异无统计学意义(P=0.792)。结论医院专用液态配方奶粉进行肠内喂养较母乳+母乳喂养强化剂进行肠内喂养能更有效地促进VLBWI体格发育,同时提高营养水平,有效预防早产儿并发症。Objective To investigate the effects of different early enteral feeding methods on the development and nutritional indexes of very low birth weight premature infants(VLBWI).Methods A total of 125 VLBWI admitted to the Department of Neonatology,The First Hospital of Qinhuangdao from January 2017 to January 2022 were prospectively selected and randomly divided into group A(n=63)and group B(n=62)by simple grouping test.Group A adopted hospital specific liquid formula for enteral feeding,and group B adopted breast milk+breast feeding fortifier for enteral feeding.The weight,length,head circumference,daily average weight growth rate,nutritional indicators(albumin,globulin,prealbumin),liver function indicators[alanine aminotransferase(ALT),γ-glutamyl transpeptidase(γ-GT),total bilirubin(TBIL),direct bilirubin(DBIL)]at 1,14,28 days after birth,occurrence of complications.Results At 1 day after birth,there were no significant differences in the measured values of weight,length and head circumference between group A and group B(P>0.05);at 14 and 28 days after birth,the body weight,body length and daily average weight growth rate of group A were higher than those of group B,the differences were statistically significant(P<0.05).At 1 day after birth,there were no significant differences in serum albumin,globulin and prealbumin between group A and group B(P>0.05);at 14 and 28 days after birth,the serum albumin,globulin and prealbumin in group A were higher than those in group B,the differences were statistically significant(P<0.05).There were no significant differences in the measured values of serum ALT,γ-GT,TBIL and DBIL at 1 and 28 days after birth(P>0.05).The overall complication rate was 20.63%(13/63)in group A and 22.58%(14/62)in group B during the hospitalization procedure,there was no statistically significant difference in the incidence of complications between the two groups(P=0.792).Conclusion Enteral feeding of hospital specific liquid formula milk powder is more effective than enteral feeding of breast milk+b

关 键 词：肠内喂养 极低出生体重早产儿 发育 营养 

分 类 号：R722.6[医药卫生—儿科]