出院后配方奶粉对早产儿发育迟缓的预防及治疗

Prevention and treatment of postdischarge formula on extrauterine growth restriction of premature infants

目的研究配方奶粉(PDF)对早产儿出院后实现追赶生长防止宫外发育迟缓(EUGR)的临床应用价值。方法以2014年1月至2016年1月深圳市龙华新区人民医院新生儿科200例早产儿为研究对象,按随机数字表分为研究组及对照组各100例,研究组行PDF喂养,对照组母乳喂养(BM)或母乳和足月儿奶粉(TF),比较两组早产儿生长发育指标,并于6个月后比较两组神经行为评分(NBNA)及两组早产儿1年后EUGR的发生率。结果两组研究对象于生后第1个月、第3个月以及第6个月体重(F=5 562.14,P<0.05)、身长(F=556.38,P<0.05)、头围(F=232.54,P<0.05)经方差分析均有统计学差异(P<0.05),组间两两比较经SNK法分析比较,对照组、研究组生后第1个月体重、身长、头围均无统计学差异(P>0.05);第3个月、第6个月研究组体重、身长均高于同期对照组;同期两组头围比较均无统计学差异(P>0.05);第6个月儿心量表评分中,研究组大动作(t=2.52,P<0.05)、精细动作(t=2.16,P<0.05)、适应能力(t=2.09,P<0.05)、语言(t=0.16,P<0.05)以及社交行为(t=2.58,P<0.05)均优于对照组;研究组1岁时EUGR发生率(24%)低于对照组,有统计学差异(χ~2=5.81,P<0.05)。结论早产儿配方奶粉在实现追赶生长及防止EUGR有重要的临床应用价值。

Objective To study the clinical value of postdischarge formula（ PDF） in achieving catch-up growth to prevent extrauterine growth restriction（ EUGR）. Methods Totally 200 cases of premature infants were divided into study group and control group with 100 cases in each group. The study group accepted PDF feeding,while the control group accepted breast feeding or breast milk plus term formula（ TF）. Two groups were compared in terms of premature growth indicators,neonatal behavior neurological assessment（ NBNA）after 6 months and the incidence of EUGR after one year. Results Statistical differences were found in body weight,body length and head circumference in 1,3 and 6 months after birth between two groups（ F value was 5562. 14,556. 38 and 232. 54,respectively,all P 0. 05）. SNK analysis of group comparison revealed that there was no statisical difference in body weight,body length and head circumference in the first month after birth between two groups（ all P 0. 05）. Compared to the control group,body weitht and body length in the third and sixth month after birth were higher in the study group,but head circumference was not statistically differernt（ P 0. 05）. In the sixth month gross motor,fine motor,adaptability,language and social behavior were superior in the study group than in the control group（ t value was 2. 52,2. 16,2. 09,0. 16 and 2. 58,respectively,all P 0. 05）. The incidence of EUGR（ 24%） in the study group was lower than in the control group with statsitical difference（ χ~2 = 5. 81,P 0. 05）. Conclusion The premature infant formula is of important clincial value in achieving catch-up growth and preventing EUGR.