eHPF补充喂养对早产儿喂养不耐受及肠内营养结局的影响

Effects of supplementary feeding with eHPF on feeding intolerance and enteral nutrition outcome in preterm infants

目的探究eHPF补充喂养对早产儿喂养不耐受及肠内营养结局的影响。方法回顾性分析2017年1月至2018年1月深圳市人民医院收治的80例早产儿的临床资料,根据早产儿补充喂养时选择的配方奶种类进行分组,分为eHPF组与SPF组,每组各40例。SPF组早产儿给予SPF补足喂养量,至纠正胎龄37周结束;eHPF组早产儿给予eHPF补足喂养量,14 d后转变为SPF喂养,至纠正胎龄37周结束。比较两组早产儿肠内营养结局、出生后第7天及第14天时营养相关生化指标水平、营养性相关性并发症、合并症发生情况;统计两组早产儿住院期间生长发育情况。结果与SPF组早产儿相比,eHPF组早产儿出生后第1、2周内残奶量/总喂养量、经肠道提供蛋白/总蛋白均降低,禁食时间、达到全肠道喂养时间均缩短(P<0.05);出生后第14天时,eHPF组早产儿的DB、ALP较SPF组降低而BUN和Cr较SPF升高(P<0.05);eHPF组早产儿NEC、代谢性酸中毒的发生率较SPF组均降低,代谢性骨病和宫外生长受限的发生率较SPF组均升高,但差异无统计学意义(P>0.05);两组早产儿在出生后5周内的体质量增长速率和头围增长方面比较,差异无统计学意义(P>0.05)o结论eHPF作为早期早产儿生后14d内亲母母乳缺乏或不足时的补充提高了喂养的耐受性,且不会增加其生长发育落后的风险。

Objective To explore the effect of eHPF supplementary feeding on feeding intolerance and enteral nutrition outcome in preterm infants.Methods The clinical data of 80 preterm infants admitted to Shenzhen People's Hospital from January 2017 to January 2018 were retrospectively analyzed.The infants were divided into the eHPF group and the SPF group according to the type of formula selected during supplementary feeding,40 cases in each group.Preterm infants in the SPF group were given SPF supplementary feeding until the 37th week of gestational age correction;Preterm infants in the eHPF group were given eHPF supplementary feeding,and changed to SPF underfeeding after 14 days,imtil the 37th week of gestational age correction.The outcome of enteral nutrition,nutrition-related biochemical index levels on the 7th and 14th day after birth,nutritional-related complications,occurrence of complications were compared between the two groups,and the growth and development during hospitalization of preterm infants in the two groups were counted.Results Compared with children in the SPF group,the amount of residual milk/total feeding and the protein/total protein provided through the intestine in the first and second weeks after birth of preterm infants in the eHPF group reduced,and the fasting time and the time to reach the total intestinal feeding of preterm infants in the eHPF group shortened;On the 14th day after birth,the DB and ALP of preterm infants in the eHPF group were lower than those in the SPF group,while BUN and Cr were higher than SPF(P<0.05);The incidence of NEC and metabolic acidosis in the eHPF group were lower than those in the SPF group,and the incidence of metabolic bone disease and ectopic growth restriction were higher than those in the SPF group,but the difference was not statistically significant(P>0.05);And there was no significant difierence in the growth rate of body weight and head circumference within 5 weeks after birth(P>0.05).Conclusion eHPF as a supplement for early premature infants with a lack or lack of breast milk within 14 days after birth,improves the tolerance of feeding and does not increase the risk of growth and development.