早产儿喂养不耐受的临床特征及相关影响因素

Clinical characteristics and related factors of feeding intolerance in preterm infants

目的探讨早产儿喂养不耐受(FI)的临床特征和影响因素。方法回顾性分析肇庆市高要区人民医院NICU 2014年2月至2017年3月诊治的315例早产儿和低出生体重儿的临床资料,其中FI患儿96例,非FI患儿219例,比较两者临床资料,分析影响FI的相关因素。结果 FI发生率为30.48%,呕吐、腹胀、胃潴留是FI的主要临床表现,发生率分别为33.33%、56.25%、39.58%,胎龄小于30周早产儿腹胀、胃潴留发生率最高,胎龄33~37周、体质量≥2 500 g患儿呕吐发生率最高,与其他胎龄、体质量组比较,差异有统计学意义(P<0.05);Logistic回归分析结果显示,胎龄<34周(OR=26.433,P=0.000)、出生体质量<1 500 g(OR=21.672,P=0.001)、开奶时间>3 d(OR=17.524,P=0.001)、宫内窘迫(OR=14.211,P=0.002)、使用氨茶碱(OR=10.367,P=0.002)是FI的独立危险因素。结论呕吐、腹胀、胃潴留是FI的主要临床特征,胎龄<36周、出生体质量<1 500 g、开奶时间>3 d、宫内窘迫及使用氨茶碱是FI的独立危险因素。

Objective To investigate the clinical characteristics and influencing factors of feeding intolerance（FI） in preterm infants. Methods The clinical data of 315 cases of premature and low birth weight infants from Feb.2014 to Mar. 2017 in the People＇s Hospital of Gaoyao District of Zhaoqing were analyzed, including 96 FI children and219 non-FI children. The clinical data of them were compared and the related factors of the occurrence of FI were analyzed. Results The incidence of FI was 30.48%, and vomiting, abdominal distension and gastric retention were the main clinical manifestations of FI, with the incidence rates of 33.33%, 56.25% and 39.58%, respectively. The incidence of abdominal distension and gastric retention was the highest in preterm infants less than 30 weeks old, and the incidence of vomiting was the highest in preterm infants of 33-37 weeks in gestational age and body weight≥500 g, which showed statistically significant difference compared with other gestational age and other weight group（P〈0.05）. Logistic regression analysis showed that gestational age34 weeks（OR=26.433, P=0.000）, birth weight1 500 g（OR=21.672, P=0.001）, the time of milking3 d（OR=17.524, P=0.001）, intrauterine distress（OR=14.211, P=0.002）, aminophylline use（OR=10.367, P=0.002） were the independent risk factors of FI. Conclusion Vomiting, abdominal distension and gastric retention are the main clinical features of FI. Gestational age36 weeks, birth weight1 500 g, the time of milking3 d, intrauterine distress and aminophylline use are the independent risk factors for FI.