喂养不耐受对早产儿近期结局的影响

Effect of feeding intolerance on the short-term outcome of premature infants

目的探讨喂养不耐受对早产儿近期结局的影响。方法以2017年1月至12月住院且符合研究标准的早产儿为研究对象。根据是否发生喂养不耐受,分为喂养不耐受组和喂养耐受组。回顾分析早产儿住院及随访至校正月龄6个月的临床资料。结果共纳入612例早产儿,其中喂养不耐受组182例和喂养耐受组430例。多因素分析结果显示,喂养不耐受是早产儿出生1周后贫血(OR=2.13,95%CI:1.29~3.51)、电解质紊乱(OR=1.75,95%CI:1.11~2.77)、胆汁淤积(OR=2.14,95%CI:1.21~3.80)的独立影响因素(P均<0.05)。喂养不耐受与早产儿住院时间延长(β=5.88,P<0.001)、达全肠内营养日龄(β=7.67,P<0.001)及经口喂养日龄(β=7.34,P<0.001)延迟以及出院体质量增加(β=100.24,P=0.001)有相关性。纳入分析的随访病例共126例,其中喂养不耐受组和喂养耐受组各63例。喂养不耐受组在校正月龄6个月时的身长、体质量、头围及Peabody运动发育评估结果与喂养耐受组差异无统计学意义(P>0.05)。结论喂养不耐受增加早产儿住院期间贫血、电解质紊乱、胆汁淤积的发生率,导致早产儿住院时间延长,达经口喂养日龄及全肠内营养日龄延迟;喂养不耐受的早产儿需要长到较大体质量才能达出院标准;喂养不耐受对早产儿校正6月龄时的体格生长及运动发育无显著影响。

Objective To investigate the effect of feeding intolerance(FI)on the short-term outcome of premature infants.Methods This is a retrospective study involving premature infants who were hospitalized from January to December,2017.According to the occurrence of FI,they were divided into the FI group and feeding tolerance group(FT group).The infants were followed up to 6 months of corrected age.Medical records and follow-up data were reviewed to investigate the effect of FI on the short-term outcome of premature infants.Results There were 612 eligible subjects with 182(29.7%)in the FI group and 430(70.3%)in the FT group.A total of 126 follow-up cases with 63 cases in each group were included for analysis.Multivariate logistic regression analysis showed that FI was an independent influencing factor for anemia(OR=2.131,95%CI:1.293-3.514,P=0.003),electrolyte disorder(OR=1.750,95%CI:1.105-2.771,P=0.017)and cholestasis(OR=2.143,95%CI:1.211-3.795,P=0.009)in premature infants one week after birth.Multiple linear regression analysis showed that FI was an independent influencing factor for the prolongation of hospitalization(β=5.884,P<0.001),the delay of reaching total enteral nutrition age(β=7.339,P<0.001),the delay of reaching oral feeding age(β=7.339,P<0.001)and the increase of body weight at discharge(β=100.237,P=0.001).There was no significant difference in length,weight,head circumference and Peabody motor development score between the two groups at 6 months of corrected age.Conclusions FI increases the incidence of anemia,electrolyte disorder and cholestasis in premature infants during hospitalization.FI leads to prolonged hospitalization time of premature infants,and it delays the infants to reach the age of total enteral nutrition and the age of oral feeding.Premature infants with FI need to grow to a larger weight to meet the discharge standard.FI had no significant effect on physical growth and motor development of premature infants at 6 months of corrected age.