调整性母乳强化对支气管肺发育不良早产儿生长发育的近期影响

Short-term effect of adjustable milk fortification on the growth and evelopment of premature infants with bronchopulmonary dysplasia

目的 探讨调整性母乳强化对支气管肺发育不良(BPD)患儿生长发育的近期影响,为早产儿提供喂养依据。方法 选取2018年1月~2020年12月潍坊医学院附属医院新生儿重症监护室(NICU)胎龄<32周的BPD患儿进行回顾性研究,按喂养方式的不同分为SF组及AF组,SF组采用母乳标准强化喂养,AF组采用基于BUN水平的调整性母乳强化喂养,分析BPD患儿肠内外营养情况、生长发育情况以及住院期间并发症发生率。结果 研究期间纳入分析的BPD患儿41例,AF组20例,SF组21例。AF组蛋白质摄入量[(4.90±0.37)g/(kg·d)]高于SF组[(3.62±0.31)g/(kg·d)],差异有统计学意义(P<0.05);AF组的蛋白能量比(PER)[(3.84±0.35)/100kcal]高于SF组[(2.93±0.28)/100kcal],差异有统计学意义(P<0.05)。AF组的体重增长速度[(17.22±3.70)g/(kg·d)]高于SF组[(14.63±2.71)g/(kg·d)],差异有统计学意义(P<0.05);AF组的头围增长速度[(0.75±0.10)cm/w]高于SF组[(0.68±0.14)cm/w],差异有统计学意义(P<0.05)。AF组和SF组的并发症的发生率差异无统计学意义(P>0.05)。结论 调整性母乳强化可改善BPD患儿的近期体格生长,并未增加并发症的发生率。

Objective To explore the short-term effect of adjustable milk fortification on the growth and development of children with bronchopulmonary dysplasia(BPD),so as to provide feeding basis for preterm infants.Methods BPD children with gestational age less than 32 weeks in the neonatal intensive care unit(NICU) of the Affiliated Hospital of Weifang Medical University from January 2018 to December 2020 were selected for retrospective study.BPD children were divided into SF group and AF group according to different feeding methods.SF group was fed with breast milk standard intensive feeding.AF group was fed with adjusted breast milk intensive feeding based on bun level.To analyze the enteral and parenteral nutrition of BPD children Growth and development and the incidence of complications during hospitalization.Results During the study period, 41 children with BPD,20 in AF group and 21 in SF group were included in the analysis.The average protein intake in AF group[(4.90±0.37)g/(kg·d)] were higher than those in SF Group[(3.62±0.31)g/(kg·d)],the difference was statistically significant(P<0.05);The average protein energy ratio(PER) in AF group[(3.84±0.35)/100 kcal] were higher than those in SF Group[(2.93±0.28)/100 kcal],the difference was statistically significant(P<0.05).The growth rate of body weight in AF group[(17.22±3.70)g/(kg·d)] were higher than that in SF group[(14.63±2.71)g/(kg·d)],the difference was statistically significant(P<0.05);The growth rate of head circumference in AF group[(0.75±0.10)cm/w] were higher than that in SF group[(14.63±2.71)g/(kg·d)],the difference was statistically significant(P<0.05);There was no significant difference in the incidence of complications between AF group and SF group(P>0.05).Conclusion Adjusted breast milk fortification can improve the recent physical growth of children with BPD without increasing the incidence of complications.