个体化母乳强化对<32周早产儿体格生长及并发症影响分析

Effects of individualized breast milk fortification on physical growth and complications in preterm infants aged less than 32 weeks

目的 通过前瞻性对照研究,分析个体化母乳强化对<32周早产儿体格生长以及主要并发症的影响。方法 选取本院2020年6月~2022年3月NICU<32周住院早产儿95例,随机分为实验组(47例)和对照组(48例)。实验组早产儿采用基于血清尿素氮水平的个体化母乳强化方案,对照组早产儿采用标准母乳强化方案喂养,观察两组早产儿的体重、身长、头围、氧暴露时间、平均住院时长及喂养不耐受(FI)、坏死性小肠结肠炎(NEC)、支气管肺发育不良(BPD)等主要并发症的发生率,并进行统计学分析。结果 FI患儿62例,FI的发生率为65.26%;NEC患儿7例,NEC发生率为7.37%;BPD患儿13例,BPD发生率为13.68%.两组早产儿出生时在胎龄、性别、分娩方式、母亲产前是否使用激素、出生体重、出生身长、出生头围等方面比较,差异均无统计学意义(P>0.05)。早产儿住院期间,两组在FI、NEC发生率比较,差异有统计学意义(P<0.05),BPD发生率两组间比较,差异无统计学意义(P>0.05)。两组早产儿在出院时,体质量增长速率、身长增长速率以及头围增长速率比较,差异均有统计学意义(P<0.05)。结论 个体化母乳强化喂养方案可促进早产儿体格发育,有助于降低FI、NEC的发生率,并不能显著降低早产儿BPD的发生率。

Objective To analyze the effects of individualized breast milk fortification on physical growth and major complications of preterm infants less than 32 weeks through prospective controlled studies.Methods From June 2020 to March 2022,the hospitalized premature infants who met the criteria in neonatal intensive care unit(NICU) within 32 weeks were selected, and the preterm infants who met the criteria were randomly divided into experimental group and control group.The experimental group of premature infants adopted an individualized breast milk fortification protocol based on serum urea nitrogen levels, and the control group of premature infants was fed with a standard breast milk fortification protocol.The weight, length, head circumference, oxygen exposure time, average length of hospital stay, and the incidence of major complications such as feeding intolerance(FI),necrotizing enterocolitis(NEC) and bronchopulmonary dysplasia(BPD) were observed in the two groups.The incidence of major complications such as FI,NEC and BPD was observed and statistically analyzed.Results Among them, there were 62 cases of FI children, and the incidence of FI was 65.26%;There were 7 children with NEC,and the incidence of NEC was 7.37%;There were 13 children with BPD,and the incidence of BPD was 13.68%.There were no significant differences between the two groups of preterm infants in terms of gestational age, sex, mode of delivery, whether the mother used hormones before birth, birth weight, birth length, and birth head circumference(P>0.05).During hospitalization of preterm infants, the incidence of FI and NEC was statistically significant(P<0.05) between the two groups, and the incidence of BPD was not statistically significant(P>0.05).When the two groups of preterm infants were discharged from the hospital, the rate of body mass growth, the growth rate of body length and the growth rate of head circumference were statistically significant(P<0.05).Conclusion The individualized breast milk intensive feeding program can promote the physical development of preterm infants, and the growth and development indicators of preterm infants in the individualized breast milk intensive group are better than those in the standard intensive group.Individualized breast milk fortification regimens help reduce the incidence of FI and NEC,but do not significantly reduce the incidence of BPD in preterm infants.