早期母乳喂养对NICU住院早产极低体重儿宫外生长发育的影响

Effect of early breast feeding on the extrauterine growth of very low weight premature infants in NICU

目的探讨早期母乳喂养对NICU住院早产极低体重儿生长发育及喂养相关不良事件的影响。方法按喂养方式分为母乳组和早产奶组,前者开奶后即予母乳喂养,母乳量达100 ml·kg^(-1)·d^(-1)时加早产奶喂养,后者开奶后至出院前均予早产奶喂养,监测两组住院期间体重、身长、头围等指标的变化,比较两组早产儿生长速率、恢复出生体重时间、静脉营养应用时间、奶量达100 ml·kg^(-1)·d^(-1)的时间、住院天数、出院时宫外生长发育迟缓发生率及住院期间喂养相关不良事件发生率。结果两组体重、身长、头围生长速率、恢复出生体重时间、静脉营养应用时间、奶量达100 ml·kg^(-1)·d^(-1)的时间、出院时宫外生长发育迟缓发生率比较差异无统计学意义(P>0.05)。母乳组喂养相关不良事件即喂养不耐受、新生儿坏死性小肠结肠炎(NEC)及感染发生率较早产奶组低,住院时间短,差异有统计学意义(P<0.05)。结论早期母乳喂养组与早产奶喂养组生长发育相似,母乳喂养组更安全。

Objective To explore the effect of early breast feeding on the growth and feeding related adverse events of very low birth weight premature infants.Methods According to the ways of feeding,the very low birth weight premature in-fants were divided into early breast feeding group and premature milk feeding group.The former group were fed with maternal breast milk from the opening of milk to the volume of maternal breast milk increasing to 100 ml·kg-1 ·d-1 ,and then were fed with premature milk until they left hospital. The latter group were fed with premature milk until they left hospital.The change of weight,length,head circumference,etc of two groups during their hospitalization were monitored.In addition,the rate of growth,the time of recovering to the weight of born,application time of intravenous nutrition and time of the volume increas-ing to 100 ml·kg-1 ·d-1 ,the days of hospitalization,the incidence rate of extrauterine growth retardation upon leaving hospi-tal and the adverse events related to feeding during hospital stay between two groups were compared.Results No statistically significant difference was found in the growth rate of weight,length,head circumference,the time of recovering to the weight of born,application time of intravenous nutrition and time of the volume increasing to 100 ml·kg-1 ·d-1 ,and the incidence rate of extrauterine growth retardation upon leaving hospital between the two groups（P〉0.05）.The incidence rate of adverse events such as feeding intolerance,neonatal necrotizing ulcerative colitis（ NEC）and the incidence of infection of breast feeding group was lower than that of the premature milk feeding group,and the hospital stay was shorter as well,so difference between the two groups was statistically significant（P〈0.05）.Conclusion Growth and development of the breast feeding group is similar to that of the premature milk feeding group,and the former group is safer.