回肠造瘘术后新生儿生长速度及短期营养结局

Growth speed and short-term nutrition outcome after ileostomy in neonates

目的了解营养支持对新生儿期行回肠造瘘术后短期生长速度和营养结局的影响。方法手术患儿来源于2010年9月至2014年9月在广州市妇女儿童医疗中心新生儿外科收治后行回肠造瘘术者，出院后至门诊接受营养支持和指导，每月监测体质量、身长和头围至9月龄，与同时期门诊日常保健的无手术婴儿进行对照。计算患儿每月生长速度，与WHO标准进行比较，寻找生长加速期。结果新生儿手术后1个月时体质量增长速率低于正常参考值，男性的体质量增长速率与正常值差异有统计学意义（P=0．001），男女患儿均在3月龄时出现体质量增长速度明显提高（P=0．033，P=0．003）。5月龄后，手术患儿体格已接近对照组同龄儿。结论回肠造瘘术后患儿生长加速期可能出现在3月龄，5—9月龄体格水平接近同龄婴儿。

Objective To investigate the effects of nutrition support on short-term postoperative growth speed and nutrition outcome in neonates after ileostomy. Methods This study included the infants who re- ceived ileostomy in Department of Neonatal Surgery in Guangzhou Women and Children＇s Medical Center be- tween September 2010 and September 2014. They were given nutrition support and nutrition-related guidance after discharge, and their weights, lengths, and head circumferences were recorded every month until 9 months of age. The above measurements were compared with those of the healthy infants visiting the clinic for regular health care during the same period （controls）. Growth speeds per month of the patients were compared with WHO standards, and accelerated growth was identified. Results Body weight growth in the first postoperative month was lower in the surgical infants than the standards, especially in boys （ P = 0. 001 ）. Aeeelerated growth in body weight was observed in 3 months of age in both boys and girls （P = 0. 033, P = 0. 003 ）. After 5 months of age, the anthropometries of the surgical infants reached the level of healthy infants of the same age. Conclusion In neonates after ileostomy, body growth may accelerate at 3 months of age, and catch up with healthy infants of the same at about 5 - 9 months of age.