早期微量胃肠营养对早产儿生长速率的影响

Early micro-enteral nutrition support on the growth rate of premature infants

目的通过观察早产低出生体重儿住院期间早期微量胃肠营养支持,了解其对生长速率的影响。方法回顾性分析2008年1月1日—2013年6月30日收住符合条件的早产儿,分为治疗组（早期微量胃肠营养）54例和对照组（非早期微量胃肠营养）49例,治疗组患儿出生后4-6 h,如生命体征稳定且无胃肠喂养禁忌证,开始0.1-4ml·kg-1·d-1缓慢加奶,对吸吮能力欠佳者,经口胃管喂养。对照组生后仅给予静脉营养,待患儿出现吸吮反射后则给予早产儿配方奶粉,每次5-10 ml,每天每次增加奶量2.5-5 ml/kg。观察两组间生长速率及喂养不耐受情况。计量资料采用t检验,计数资料采用χ2检验,P〈0.05为差异有统计学意义。结果治疗组生后1-4周每周的平均体重生长速率分别为：（-2.12±5.23）、（11.84±3.76）、（15.93±4.15）、（21.34±4.21）g·kg-1·d-1。对照组生后1-4周每周的平均体重生长速率分别为（-3.6±5.23）、（9.43±4.27）、（14.23±3.64）、（18.14±4.49）g·kg-1·d-1,比较差异均有统计学意义（均P〈0.05）。结论早期微量胃肠营养对早产儿生长速率影响显著,且减少出现喂养不耐受,应积极开展早产儿微量喂养技术。

Abstract： Objective To observe early micro - enteral nutrition support for premature infants of low birth weight during hospital stay, so as to understand its influence on growth rate. Methods A retrospective study was carried out on ehnical data of premature infants treated from Jan 1 st ,2008 to Jun. 30th,2013, who were divided into treatment group（ n = 54） and control group （ n = 49 ） . In treatment group, for infants 4 - 6 h after birth if the vital signs were stable and there was no en teral feeding contraindication, milk was added slowly at 0.1 -4 ml ·kg-1 · d-1 ; for those with poor sucking ability, oral gastric tube feeding was adopted. In control group, intravenous nutrition support was given after birth until sucking reflex appeared when formula milk was given, 5 to 10 ml once, with daily increments of 2.5 to 5 ml/kg. Both groups were com pared for growth rate and feeding intolerance. Measurement data were processed by t - test, count data byx2 test, the result of P 〈 0.05 was considered statistically significant. Results The average weekly weight growth rate was （-2.12±5.23）、（11.84±3.76）、（15.93±4.15）、（21.34±4.21）g·kg-1·d-1 respectively 1 -4 weeks after birth in treatment group. The average weekly weight growth rate was （-3.6±5.23）、（9.43±4.27）、（14.23±3.64）、（18.14±4.49）g·kg-1·d-1respectively in control group. There was significant difference between the two groups. Conclusions Ear ly micro - feeding has an obviously impact on growth rate and can reduce the occurrence of feeding intolerance in preterm infants, therefore micro - feeding technology should be ctively conducted.