胎龄别体重Z评分法评价早产儿营养状况的临床应用分析

Analysis of nutrition and clinical status in premature infants

目的：采用纠正胎龄别体重Z评分法评估早产儿出院时营养状况，探讨其与胎龄、营养支持方式、并发症之间的关系。方法选择住院时间≥2周、出生胎龄28～37周的适于胎龄儿，分别按出生胎龄分组及按营养支持方式分组，回顾分析每组入、出院时纠正胎龄别体重Z评分情况。并比较出院时Z评分＜-2组和≥-2组的并发症发生率。结果每组患儿出院时Z评分均低于入院时，差异有统计学意义（P＜0.05）；胎龄越大，出院时Z评分越低；营养支持力度越低，出院时Z评分越低，差异有统计学意义（P＜0.05）；出院时 Z 评分＜-2组严重感染、贫血、呼吸暂停及呼吸衰竭发生率较Z评分≥-2组更高（P＜0.05）。结论早产儿出院时营养状况均较出生时差，严重感染、贫血、呼吸暂停、呼吸衰竭与早产儿的营养不良具有相关性，积极的营养支持策略可改善其住院期间营养状况。

Objective To evaluate the nutrition and clinical status in premature infants at discharge with Z score of weight for correct age（CA）. Methods 1106 appropriate for gestational age（GA） premature infants with hospital stay exceeding 2 weeks but no major congenital diseases were included. Z scores of weight for age were calculated at birth and discharge. Their clinical data were retrospectively analyzed. Results At all the subgroups （categorized by GA at birth or by nutrition support method）, The Z scores at discharge were positively related with Z scores at birth（P〈0.05）; Different nutrition support method were significantly related with Z score at discharge（P〈0.05）. Incidences of respiratory failure, apnea, sepsis and anemia in the Z score 〈-2 group were higher than those in the Z score≥-2 group at discharge （P〈0.05）. Conclusions Premature infants occurred growth retardation during admission. Premature malnutrition were related with respiratory failure, apnea, sepsis and anemia at discharge. Nutritional support strategy is helpful for nutrition condition in premature infants.