不同强化喂养方式对早产极低出生体重儿营养代谢及生长速率的影响  

Effects of different fortified feeding methods on the nutrient metabolism and growth rate of very low birth weight preterm infants

作　　者：宁月 罗丽艳 段江[1] 谢云波[1] 齐志业[1] 张彩营[1] 杨丽[1] 钟庆华[1] NING Yue;LUO Liyan;DUAN Jiang;XIE Yunbo;QI Zhiye;ZHANG Caiying;YANG Li;ZHONG Qinghua(Department of Neonatology,The First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650032,China;Department of Neonatology,Dali Maternal and Child Health Hospital)

机构地区：[1]昆明医科大学第一附属医院新生儿科,云南昆明650032 [2]大理州妇幼保健院新生儿科

出　　处：《中国儿童保健杂志》2024年第1期84-88,共5页Chinese Journal of Child Health Care

基　　金：云南省医疗卫生内设研究机构项目(2018NS0144);云南省科技厅—昆明医科大学应用基础研究联合专项资金面上项目[2019FE001(-050)];云南省高层次卫生技术人才培养(学科带头人)基金资助项目(RLMY20200007)。

摘　　要：目的探讨不同强化喂养方式对早产极低出生体重儿(VLBWI)营养代谢及生长速率的影响,为改善早产儿的预后提供新思路。方法纳入2019年1月—2020年12月昆明医科大学第一附属医院新生儿科收治的早产VLBWI 115例,根据喂养方式分为强化母乳喂养组(HFM组)、混合喂养组、早产儿配方奶喂养组(PF组),分析不同的喂养方式对早产VLBWI的营养代谢、生长速率等的影响。结果1)HFM组住院时间短于PF组、混合喂养组(t=7.185、6.924,P<0.05);2)住院期间HFM组并发坏死性小肠结肠炎(NEC)的比例低于PF组(P<0.05),住院期间HFM组并发晚发型败血症(LOS)、宫外生长发育迟缓(EUGR)的比例低于PF组(χ^(2)=5.030、4.147,P<0.05);并发LOS的比例低于混合喂养组(χ^(2)=6.589,P<0.05);3)住院期间HFM组并发腹胀、便血、嗜酸性粒细胞增高比例低于PF组(P<0.05),混合喂养组并发腹胀比例低于PF组(P<0.05);4)出院时HFM组体重、身长增长速率均高于混合喂养组(t=3.722、0.425,P<0.001)及PF组(t=6.015、0.496,P<0.001)。结论强化母乳喂养能更有效提高早产VLBWI的生长速率,改善营养代谢,减少早产儿相关并发症及喂养不良反应,更安全有效。Objective To analyze the effects of different fortified feeding Methods on nutritional metabolism and growth rate of preterm very low birth weight infants(VLBWI),in order to provide new clues for improving the prognosis of the preterm infants.Methods A total of 115 cases of premature VLBWI admitted to Department of Neonatology,The First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 were included in this study,and were divided into fortified breastfeeding group(HFM group),mixed feeding group,and premature formula feeding group(PF group)based on their feeding methods.The effects of different feeding Methods on the nutritional metabolism and growth rate of premature VLBWI were analyzed.Results 1)The hospitalization time of infants in the HFM group was shorter than that in PF group and mixed feeding group(t=7.185,6.924,P<0.05).2)The proportion of necrotizing enterocolitis(NEC)in the HFM group during hospitalization was lower than that in the PF group(P<0.05);the proportions of late onset septicemia(LOS)and extra uterine growth restriction(EUGR)in the HFM group during hospitalization were lower than those in the PF group(χ^(2)=5.030,4.147,P<0.05);the proportion of LOS was lower than that of the mixed feeding group(χ^(2)=6.589,P<0.05).3)During hospitalization,the proportions of abdominal distension,bloody stools and increased eosinophils in the HFM group were lower than those in the PF group(P<0.05),which in mixed feeding group was lower than those in PF group(Fisher exact test,P<0.05).4)At discharge,the weight and length growth rate of the HFM group were higher than those of the mixed feeding group(t=3.722,0.425,P<0.001)and the PF group(t=6.015,0.496,P<0.001).Conclusion Fortified breastfeeding can more effectively increase the growth rate of VLBWI in premature infants,improve nutritional metabolism,reduce complications and adverse feeding reactions related to premature infants,and is safer and more effective.

关 键 词：早产儿 极低出生体重 喂养 营养代谢 生长速率 

分 类 号：R722.6[医药卫生—儿科]