极低出生体重早产儿288例体重增长速度和相关影响因素调查

Research on body weight growth rate and its correlative influencing factors of very-low-birth-weight premature infants

目的探讨极低出生体重早产儿住院期间日均体重增长速度及其相关影响因素。方法回顾性调查广东省珠江三角洲地区9个城市的9家医院新生儿科于2010年7月至2011年6月期间出院的极低出生体重早产儿的住院资料,根据住院期间日均体重增长的不同分为3组:低体重增长组[日均体重增长<10g/(kg·d)],适宜体重增长组[日均体重增长10～15g/(kg·d)],高体重增长组[日均体重增长>15g/(kg·d)],对影响其生长速度的相关因素进行分析。结果各组随着日均体重增长速度的增加,生后1周、2周、4周、达完全经口喂养前、整个住院期间的日均热卡、蛋白质摄入量均相应增加,热卡、蛋白质累计缺失量则相应减少;高体重增长组(31例)禁食总时间、开始喂养时间、完全经口喂养时间、最低体重出现时间、最低体重下降百分数、恢复出生体重时间、热卡摄入达标时间、蛋白质摄入达标时间等均小于低体重增长组(68例),适宜体重增长组(189例)上述指标介于高体重增长组与低体重增长组之间。结论营养摄入是影响极低出生体重早产儿早期体重增长的最主要因素,改善早产儿生后早期的热卡、蛋白质摄入可明显改善其生长速度。

Objective To study average daily body weight growth rate and its correlative influencing factors of very-low-birth-weight （VLBW） premature infants. Methods Clinical data of VLBW premature infants discharged from Jul. 2010 to Jun. 2011 were collected retrospectively from 9 NICUs of 9 cities in Pearl River Delta, Guangdong province. According to the average daily body weight growth rate, the infants were assigned into three groups： low growth rate group [ 〈 10 g/（kg＇d） ], suitable growth rate group [ 10 - 15 g/（kg·d） ] and high growth rate group [ 〉 15 g/（kg·d） ]. The average daily body weight growth rate and its correlative influencing factors were analyzed. Results A total of 288 cases of VLBW premature infants were enrolled in this research. As average daily body weight growth rate was increasing, the daily energy and protein intakes were increased, and the cumulative loss of energy and protein were decreased. Comparing with the low growth group, the total time of fasting, beginning to feed, reaching total enteral feeding, the time and the percentage body weight dropped most, the time to regain birth weight, reaching recommendation energy and protein intakes were smaller in the high growth rate group. These parameters were in-between in the suitable growth rate group. Conclusions Nutrition intake was the major influencing factor to average daily body weight growth rate of VLBW premature infants. Improving early postnatal energy and protein intakes could improve their body weight growth rate and reduce the incidence of extrauterine growth retardation（EUGR）.