新生儿营养风险筛查及相关因素分析

Nutrition risk screening on newborns and its relevant factors analysis

目的 运用改良的儿科营养不良筛查工具（STAMP）对新生儿进行营养风险筛查,分析新生儿营养风险与疾病的相关性.方法 选择2015年2—12月山西省儿童医院新生儿中心（NICU、新生儿科、新生儿外科）收治的新生儿2300例运用改良的STAMP量表进行新生儿营养风险筛查,对资料进行汇总、分析.结果 新生儿疾病与营养风险高风险居前5位的依次为新生儿肺透明膜病、肠扭转、便血原因待查、早产儿、腹胀原因待查.不同科室新生儿营养不良、营养摄入情况比较差异均有统计学意义（χ2值分别为31.74、177.00;P〈0.005）;NICU和新生儿外科以无营养摄入居多,内科以营养摄入减少一半以上居多.不同科室早产儿和足月儿高营养不良风险、营养摄入不足情况比较差异均有统计学意义（χ2值分别为72.70、53.95;P〈0.001）;不同科室新生儿体重增长情况比较差异有统计学意义（χ2=13.57,P=0.002）.结论 运用改良的STAMP可以识别导致新生儿营养中高风险的因素有疾病、胎龄、营养摄入、生长发育.可根据筛查结果实施个体化营养支持方案,有助于改善宫外发育迟缓的现状.

Objective To conduct nutrition risk screening on newborns with modified screening tool for the assessment of malnutrition in pediatrics （STAMP）, and to analyze the correlation between nutritional risk of newborns and diseases. Methods A total of 2 300 newborns treated in Neonatal Center （NICU, Department of Neonatology and Department of Neonatal Surgery） in Children＇s Hospital of Shanxi from February to December 2015 were screened by modified scale STAMP about their nutritional risks, with the data collected and analyzed. Results Top five high risks concerning disease and nutrition among newborns were： hyaline membrane, volvulus, hematochezia of unknown origin, premature infants, and abdominal distension of unknown origin. Differences of malnutrition conditions and nutrition intake among newborns from different departments were statistically significant （χ2=31.74, 177.00; P〈0.005）. Majority of newborns in NICU and Department of Neonatal Surgery were without any nutrition intake at all, while majority of newborns in Department of Internal Medicine were with only half or less nutrition intake. Differences of high malnutrition risks and insufficient nutrition intake among premature and term infants from different departments were statistically significant （χ2=72.70, 53.95; P〈0.001）. Differences of weight growth conditions among newborns from different departments were statistically significant （χ2=13.57, P=0.002）. Conclusions By using modified STAMP, it can be identified that factors causing high risks of neonatal nutrition include diseases, gestational age, nutritional intake, growth and development. Individualized nutritional support program should be implemented according to results of the screening, so that status quo of extrauterine growth restriction can be improved.