极低出生体重儿喂养不耐受相关因素的探讨

Study on factors associated with feeding intolerance in very low birth weight infants

【目的】了解极低出生体重儿（very low birth weight infants，VLBWI）喂养不耐受的影响因素，探讨有利于VLBWI喂养成功的要点。【方法】对2004年1月～2009年1月入住本科158例极低出生体重儿进行了回顾性分析，采用Logistic回归等筛选出与喂养不耐受相关的因素。【结果】①68例出现喂养不耐受，占43．0％；②喂养不耐受发生的相关因素有胎龄、体重、开始喂养日龄；③胎龄越小、出生体重越低，喂养不耐受发生率越高，差异均有显著性（P〈0．01或〈0．05）；开始喂养日龄〉3d组喂养不耐受发生率高于开始喂养日龄≤3d组（P〈0．01）；性别、氨茶碱的使用、母亲有无妊娠合并症、有无宫内窘迫或出生窒息等与喂养不耐受无明显关系。【结论】VLBwI喂养不耐受与患儿的胎龄、出生体重、开奶日龄等因素密切相关；早期微量喂养，可促进胃肠功能成熟，提高喂养耐受性。

[Objective] To investigate the factors associated with feeding intolerance in very low birth weight infants （VLBWI） and to find the beneficial factors for preventing feeding intolerance. [ Methods] Retrospectively analysis was carried out on 158 VLBWI cases in our hospital from January 2004 to January 2009. The risk factors of feeding intolerance were found by logistic regression analysis. [Results] （1）The total rate of feeding intolerance in VLBWI was 43.0%. （2） There were 3 risk factors （gestational age, birth weight and the timing of feeding initiation） involved for feeding intolerance in very low birth weight infants（VLBWI）. （3）The smaller the gestation age and birth weight was,the higher rate of feeding intolerance was, there was a significant difference each in the clinical factors （gestational age, birth weight）（P〈0.01 or 0.05） ;As for the timing of feeding initiation, a significant difference was found between times of 〉3 days and ≤3 days（P〈0. 01）; Sex, theophylline therapy, asphyxia, complications of mother were not associated with feeding intolerance. [Conclusion] The feeding intolerance rate is close related with the clinical factors（gestational age,birth weight,the age of the first feeding）in VLBWI. The early minimal feeding is suggested to improve gastrointestinal maturation and the feeding tolerance.