强化母乳喂养在NICU住院早产低出生体质量儿中的应用研究

Applied research of human milk fortification feeding on premature infants in NICU

目的评价强化母乳喂养对新生儿监护病房(NICU)住院早产儿的短期生长、内环境的影响及临床安全性。方法入住NICU的早产儿根据不同奶方分为早产奶组、母乳组、强化母乳组(HMF组),比较其生长指标、血生化、不良事件发生率等。结果共147例早产儿符合要求,体质量增长速率在早产奶组、母乳组、HMF组各为(19.44±5.14)、(14.53±5.86)、(17.09±5.81)g·kg-1·d-1,差异有统计学意义(P<0.01);头围增长速率在早产奶组(0.72±0.34)cm/w和HMF组(0.71±0.29)cm/w高于母乳组(0.51±0.34)cm/w,差异有统计学意义(P<0.01);达到或超过出生体质量时间在早产奶组(8.55±3.20)d和HMF组(9.43±4.53)d患儿中较母乳组(10.93±3.02)d短,差异有统计学意义(P<0.01);出院时早产奶组和HMF组的头围宫外生长迟缓(EUGR)发生率明显低于母乳组(P<0.05);喂养不耐受率早产奶组(15.52%)高于母乳组(2.13%),差异有统计学意义(P<0.05);各组感染发生率比较,差异无统计学意义(P>0.05)。结论 HMF喂养可在有效控制感染和喂养不耐受发生率的前提下优化早产儿院内体质量和头围增长速率。

Objective To evaluate the effect of human milk fortification on short-term growth of premature infants in NICU and its clinical safety.Methods According to different formulas,the premature infants were divided into preterm formula group,human milk group and human milk fortification group（HMF group）.Its growth rate,blood biochemistry,adverse event rate and so on were compared.Results There were 147 cases meeting requirements.the weight growth velocity of preterm formula group,human milk group and HMF group were（19.44±5.14）,（14.53±5.86）,（17.09±5.81）g·kg^-1·d^-1 respectively with statistical significance（P〈0.01）;the growth velocity of head circumference of preterm formula group（0.72±0.34）cm/w and HMF group（0.71±0.29）cm/w were significantly higher than that of human milk group（0.51±0.34）cm/w（P〈0.01）;the time of regaining or overtopping birth weight of preterm formula group（8.55±3.20）d and HMF group（9.43±4.53）d was significantly shorter than that of human milk group（10.93±3.02）d（P〈0.01）;the EUGR occurrence rate of head circumference of preterm formula group and HMF group were significantly lower than that of human milk group（P〈0.01）.The feeding intolerance rate of preterm formula group（15.52%）was significantly higher than that of human milk group（2.13%）（P〈0.05）;there were no significant difference in incidence rate of infection event in each group（P〉0.05）.Conclusion Human milk fortification can control the incidence rate of infection event and feeding intolerance to increase growth velocity of weight and head circumference of premature infants during hospital stay.