改良营养方案对极低出生体重儿短期预后的影响  

The clinical effects of modified nutrition regimens on short-term outcomes in very low birth weight infants

作　　者：苏锦珍 阮敏仪[1] 谢伊玲[1] 杨勇[1] 张兰[1] 李敏许[1] Su Jinzhen;Ruan Minyi;Xie Yiling;Yang Yong;Zhang Lan;Li Minxu(Department of Neonatology,Dongguan Maternal and Child Health Hospital,Dongguan 523000,China)

机构地区：[1]东莞市妇幼保健院新生儿科,东莞523000

出　　处：《中华新生儿科杂志(中英文)》2025年第2期71-75,共5页Chinese Journal of Neonatology

基　　金：东莞市社会发展科技项目(20221800905762,20231800905282)。

摘　　要：目的探讨改良喂养方案对极低出生体重儿短期预后的影响。方法选择2015年1月至2021年12月东莞市妇幼保健院新生儿科收治的极低出生体重儿进行回顾性研究。以2019年1月开始实施改良肠内营养和肠外营养方案为截点,分为改良组和对照组,改良后的方案更早开奶、更快加奶并积极使用母乳强化剂,分析两组基础资料、喂养情况及住院期间相关并发症发生情况。应用SPSS 21.0统计软件对数据进行分析。结果共纳入857例极低出生体重儿,改良组339例,对照组518例。两组胎龄及出生体重差异无统计学意义(P>0.05);改良组母亲合并绒毛膜羊膜炎、产前使用完整疗程激素促胎肺成熟比例高于对照组,差异有统计学意义(P<0.05)。改良组初次喂养时间和恢复出生体重时间早于对照组[17(6,25)h比18(13,24)h,7(5,9)d比10(7,13)d],肠外营养时间和达全肠内营养时间短于对照组[11(9,16)d比23(16,32)d,16(12,22)d比29(21,40)d],新生儿坏死性小肠结肠炎发生率低于对照组(13.3%比19.9%),差异均有统计学意义(P<0.05);两组胆汁淤积综合征、高甘油三酯血症和败血症发生率差异无统计学意义(P>0.05)。结论改良后的喂养方案能促进极低出生体重儿尽早实现全肠内营养,并未增加相关并发症。ObjectiveTo study the clinical effects of modified nutrition regimens on short-term outcomes in very low birth weight(VLBW)infants.MethodsFrom January 2015 to December 2021,VLBW infants admitted to the neonatal department of our hospital were retrospectively studied.Modified nutrition regimens including earlier enteral feeding,faster increment of feeding volumes and proactive use of breast milk fortifiers were started from January 2019.The infants before January 2019 were assigned into the control group and after January 2019 the modified nutrition group.The general data,feeding patterns and complications of the two groups were analyzed.ResultsA total of 857 infants were enrolled,including 518 in the control group and 339 in the modified nutrition group.No significant differences existed in gestational age and birth weight between the two groups(P>0.05).Comparing with the control group,the modified nutrition group had significantly higher incidences of mothers with chorioamnionitis and completed a full course of antenatal corticosteroids(P<0.05).The time to initial enteral feeding[17(6,25)h vs.18(13,24)h]and regain birth weight[7(5,9)d vs.10(7,13)d]in the modified nutrition group were earlier than the control group(P<0.05).The duration of parenteral nutrition[11(9,16)d vs.23(16,32)d]and the time to total enteral nutrition[16(12,22)d vs.29(21,40)d]were shorter in the modified nutrition group(P<0.05).The incidence of neonatal necrotizing enterocolitis in the modified nutrition group was lower than the control group(13.3%vs.19.9%,P<0.05).No significant differences existed in the incidences of neonatal cholestasis,hypertriglyceridemia and sepsis between the two groups(P>0.05).ConclusionsThe modified nutrition regimens can help VLBW infants achieve earlier total enteral nutrition without increasing complications.

关 键 词：喂养方案 极低出生体重儿 坏死性小肠结肠炎 并发症 

分 类 号：R722.6[医药卫生—儿科]