早期营养干预对低/极低体重儿营养状况及败血症发生率的影响

Effect of Early Nutritional Intervention on Nutritional Status and Incidence of Sepsis in Low/Very Low Birth Weight Infants

目的:探讨早期营养干预对低/极低体重儿营养状况、体格发育及败血症发生率的影响。方法:选取2020年8月—2022年8月我院收治的200例低/极低体重儿为研究对象,按照随机数字法分为观察组和对照组各100例,2组患儿间胎龄、性别、出生体重、体长及头围间差异均无统计学意义(P>0.05),具有可比性。对照组低/极低体重儿采用常规营养干预方式,观察组患儿采用早期肠内和肠外联合方式进行营养干预,比较2组低/极低体重儿干预前后血清营养指标、感染指标变化,以及体格发育情况和晚发型败血症发生情况。结果:相比于常规营养干预,早期营养干预可显著提高低/极低体重儿血清ALB、BUN水平(均有P<0.05),但对体重和身长生长无特殊优势(P>0.05)。另外,对照组患儿晚发型败血症发生率为12%,观察组为3%,观察组晚发型败血症发生率显著低于对照组(χ^(2)=5.838,P<0.05),且营养干预后,观察组患儿血清WBC、CRP及PCT水平显著低于干预前和对照组(P<0.05)。结论:早期营养干预可改善患儿营养状况,保证体格发育,降低晚发型败血症的发生率,临床上对可耐受早期营养干预的低/极低体重儿应进行积极的早期营养干预。

【Objective】To investigate the effects of early nutritional intervention on the nutritional status,physical development and incidence of sepsis in low/very low weight infants.【Method】Totally 200 cases of low/very low weight infants admitted to our hospital from August 2020 to August 2022 were selected for the study,and were divided into 100 cases in the observation group and 100 cases in the control group according to the random number method.The differences in gestational age,sex,birth weight,body length and head circumference between the two groups were not statistically significant(P>0.05).In the control group,conventional nutritional interven⁃tion was used for low/very low weight children,and in the observation group,a combination of early enteral and parenteral nutritional intervention was used.The changes in serum nutritional indicators and infection indicators,as well as physical development and the occur⁃rence of late-onset sepsis in the two groups of low/very low weight infants before and after intervention were compared.【Result】Compared with conventional nutritional intervention,early nutritional intervention significantly increased serum ALB,and BUN levels in low/very low weight children(all P<0.05),but had no specific advantage on weight and length growth(P>0.05).In addition,the incidence of lateonset sepsis was 12%in the control group and 3%in the observation group,and the incidence of late-onset sepsis in the observation group was significantly lower than that in the control group(χ^(2)=5.838,P<0.05),and the serum WBC,CRP and PCT levels in the observation group were significantly lower than those in the pre-intervention and control groups after the nutritional intervention(P<0.05).【Conclu⁃sion】Early nutritional intervention can improve the nutritional status of children,ensure physical development,and reduce the incidence of late-stage sepsis.Clinically,active early nutritional intervention should be performed for low/very low weight children who can tolerate early nutritional intervention.