早期足量胃肠道外营养对早产儿出院时体重的影响

The effect of early full parenteral nutrition on the weight gaining of premature infants at discharge

目的探讨早期足量胃肠道外营养对早产儿出院时体重的影响。方法将我院收治的适于胎龄的存活低出生体重早产儿256例随机分为两组,各128例,治疗组应用早期足量胃肠道外营养,对照组应用传统新生儿胃肠道外营养。计算两组患儿各营养指标及出院时宫外生长发育迟缓(EUGR)的发生率,进行统计学分析。结果治疗组除生后第7天热卡与对照组相比 (P>0．05)无显著性差异外,其他各营养指标,如生后体重下降幅度、恢复至出生体重时间、每天体重增长克数、经胃肠达到摄入标准时间、应用胃肠道外营养天数、生后第3天热卡、平均住院天数等均优于对照组(P<0．01),具有非常显著性差异;治疗组出院时发生EUGR 60例,发生率为 46．9％,对照组出院时发生EUGR 87例,发生率为68．0％(x2=11．65,P<0．01),具有非常显著性差异。结论早期足量胃肠道外营养,可减少早产低出生体重儿或极低出生体重儿EUGR的发生率,为今后实现追赶性生长打下良好基础,且未见有严重副作用,值得临床推广应用。

Objective To explore the effect of early full parenteral nutrition （PN） on the weight gaining of premature infants at discharge. Methods Two hundred and fifty-six appropriate for gestational age（AGA） low birth weight or extremely low birth weight premature infants were divided into two groups randomly, there was 128 babies in each group. Early full PN was given to therapy group, and traditional PN was used in control group. The nutrition indexes and the incidence of extrauterine growth retardation （EUGR） in two groups at discharge were analyzed. Results Except for calorie intake at the 7th day, therapy group infants had better nutrition indexes than control group, they included less weight drop after birth, quick recovering to birth weight, more weight gaining per day, short PN duration, more calorie intake at 3 days of age, and less hospital stay（P all 〈0.01 ）. There were 60 and 87 babies diagnosed as EUGR at discharge in therapy and control group respectively. The incidence of EUGR at discharge had significantly difference between two groups, 46. 9% vs 68.0% （X^2 = 11.65, P 〈 0. 01 ）. Conclusions Early full PN is able to reduce the incidence of EUGR of premature infants, and this will provide good basis for catching up growth. There is no side effect noted.