调整性强化母乳喂养对极/超低出生体重儿早期追赶性生长影响

Effect of adjusted fortified breastfeeding on early catch-up growth in very/extremely-low birth weight infants

目的通过对比标准强化母乳喂养,探究调整性强化母乳喂养对极/超低出生体重儿早期追赶性生长的影响,并评估其安全性,为极/超低出生体重儿实现追赶性生长、提高生存质量进一步提供临床依据。方法选取2018年1月~2019年10月新生儿科住院的符合入选标准的早产儿共102例,随机分为两组,每组51例,对照组采取标准强化母乳方式喂养,观察组采用调整性强化母乳方式喂养,动态监测两组早产儿体质量、头围、身长、血生化及相关并发症发生率等指标,并随访至纠正胎龄40周,比较两组患儿各指标是否存在统计学差异。结果观察组患儿住院期间体质量、头围及身长增长速率高于对照组,平均住院时长短于对照组,差异有统计学意义(P<0.05);两组患儿恢复至出生体重时间、呼吸机使用情况、喂养不耐受、NEC发病率及住院期间各时间段血红蛋白(Hb)、碱性磷酸酶(ALP)、血清钙离子、血清磷离子相比较,差异无统计学意义(P>0.05)。纠正至胎龄40周时:观察组体质量、头围及身长均高于对照组,差异有统计学意义(P<0.05);两组患儿血红蛋白(Hb)、碱性磷酸酶(ALP)、血清钙离子、血清磷离子相比较,差异无统计学意义(P>0.05)。结论调整性强化母乳喂养更有利于极/超低出生体重儿生后早期追赶性生长,且不增加喂养不耐受及NEC发生率,不增加代谢性骨病发病风险。

Objective By comparing it to standard fortified breastfeeding,explore the effects of adjusted fortified breastfeeding on early catch-up growth in very/extremely-low birth weight infants,and assess its safety,providing a further clinical reference for achieving catch-up growth and improving the quality of life for very/extremely-low birth weight infants.Methods Prospective collection of 102 premature infants who met the criteria for admission from January 2018 to October 2019 in the neonatal department of Weifang People’s Hospital were randomly divided into two groups(n=51),and the control group adopted standard intensive breast milk to strengthen breastfeeding,and the observation group strengthened breastfeeding by adjusting fortified breast milk.Dynamic monitoring this two groups of premature infants’body weight,head circumference,body length,blood biochemistry and related complications and other indicators,and follow-up to correct the age of 40 weeks,comparing the two groups of children with statistical differences in each indicator.Results The growth rate of body mass,head circumference and length of children in the observation group was higher than that of the control group during hospitalization,and the average hospital stays was shorter than that of the control group,there was significant between two groups(P<0.05);The difference between the two groups of children including recovered to birth weight time,ventilator use,feeding intolerance,NEC incidence and hemoglobin(Hb),alkaline phosphatase(ALP),serum calcium,and serum phosphorus were no statistical significant(P>0.05).Correct gestational age to 40 weeks:the body mass,head circumference and body length of the observation group were higher than the control group,there was significant between two groups(P<0.05);Compared with hemoglobin(Hb),alkaline phosphatase(ALP),serum calcium and serum phosphorus in two groups,the differences were no statistical significant(P>0.05).Conclusions Adjusted fortified breastfeeding is more beneficial to early follow-up growth of very/extremely-low birth weight infants,it didn’t increasing feeding intolerance and NEC incidences,and didn’t increasing the risk of metabolic bone disease.