Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusio...Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusion plus early enteral trophic feeding on growth in VLBW infants within the first day of life. Study Design: The effect of a high-dose 3 g amino acid (HAA)/kg/d regimen beginning on the first day of life was compared with that of low-dose amino acid (LAA) supplementation at a dose of 0.5 or 1.0 g/kg/d. The primary outcome measures were the days of regained birth weight and achieved full enteral feeding. Result: Compared with the 19 infants in the LAA group, the 17 infants in the HAA group achieved significantly earlier full enteral feeding (7.8 ± 3.6 vs. 15.2 ± 8.9, p = 0.003) and regained birth weight (13.3 ± 3.8 vs. 17.5 ± 7.9, p = 0.047). In addition, shorter parenteral nutrition time was achieved by HAA administration (p Conclusion: Aggressive early simultaneous amino acid administration plus enteral feeding during the first few days of life for preterm infants was associated with improved weight gain and earlier full enteral feeding.展开更多
目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血...目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血清TBIL水平上升率”,研究对象被分为A组(血清TBIL水平上升率≤90%)275例和B组(血清TBIL水平上升率>90%)42例。比较两组早产儿的临床特征和血清TBIL水平的变化。采用Pearson相关分析光疗相关参数与血清TBIL上升率的关系。使用Logistic回归模型分析血清TBIL快速上升的相关因素。结果VLBW早产儿出生后血清TBIL水平随着出生时间的延长而增加(P<0.05),血清TBIL水平上升率与光疗开始时的年龄呈负相关,与光疗持续时间呈正相关(r=-0.766、0.478,P<0.05)。与A组相比,B组婴儿的胎龄明显减少,出生体质量明显降低,5 min Apgar评分明显减少,开始光疗的年龄较小,光疗总持续时间较长,差异有统计学意义(P<0.05)。胎龄、出生体质量和5 min Apgar评分为VLBW早产儿血清TBIL水平快速上升的相关因素。结论血清TBIL水平上升率可作为VLBW早产儿早期光疗的指标,血清TBIL水平的快速上升与较低胎龄、较低出生体质量和5 min Apgar评分有关。展开更多
目的分析极低/超低出生体重(very/extremely low birth weight,VLBW/ELBW)早产儿代谢性骨病(metabolic bone disease of prematurity,MBDP)的发生率及危险因素。方法回顾性调查2013年9月1日至2016年8月31日全国多中心61 786例新生儿资料...目的分析极低/超低出生体重(very/extremely low birth weight,VLBW/ELBW)早产儿代谢性骨病(metabolic bone disease of prematurity,MBDP)的发生率及危险因素。方法回顾性调查2013年9月1日至2016年8月31日全国多中心61 786例新生儿资料,符合纳入标准的VLBW/ELBW早产儿504例,其中诊断MBDP 108例,纳入MBDP组,其余396例纳入非MBDP组。收集两组孕母及早产儿基本资料、住院期间主要疾病、营养支持策略和其他治疗情况并进行统计学比较分析;采用多因素logistic回归分析MBDP发生的危险因素。结果 VLBW早产儿MBDP发生率为19.5%(88/452),ELBW早产儿MBDP发生率为38.5%(20/52)。极早产儿、超早产儿MBDP发生率分别为21.7%和45.5%。单因素分析结果显示,MBDP组患儿胎龄、出生体重均小于非MBDP组,住院时间更长,出院时宫外发育迟缓发生率更高(P<0.05);MBDP组新生儿呼吸窘迫综合征、败血症、贫血、低钙血症、早产儿视网膜病变发生率较非MBDP组高(P<0.05);MBDP组较非MBDP组平均加奶速度更慢、达全肠内喂养日龄更大、肠外营养使用时间更长(P<0.05);MBDP组患儿枸橼酸咖啡因使用比例高于非MBDP组、促红细胞生成素使用比例低于非MBDP组(P<0.05)。多因素logistic回归分析结果显示,胎龄<32周、低钙血症、出院时宫外发育迟缓、败血症是MBDP发生的危险因素(P<0.05)。结论低胎龄、低钙血症、出院时宫外发育迟缓、新生儿败血症可能增加VLBW/ELBW早产儿MBDP发生的风险,应加强围生期孕期保健,避免早产,提高新生儿科医师对MBDP的防治意识,对早产儿采取积极合理的营养策略和综合管理措施,以改善VLBW/ELBW早产儿的近远期临床结局。[中国当代儿科杂志,2021,23 (6):555-562]展开更多
文摘Objective: Very-low-birth-weight (VLBW) preterm infants are at risk of growth delay if they do not receive adequate nutritional support. This study evaluated the effect of aggressive early high-dose amino acid infusion plus early enteral trophic feeding on growth in VLBW infants within the first day of life. Study Design: The effect of a high-dose 3 g amino acid (HAA)/kg/d regimen beginning on the first day of life was compared with that of low-dose amino acid (LAA) supplementation at a dose of 0.5 or 1.0 g/kg/d. The primary outcome measures were the days of regained birth weight and achieved full enteral feeding. Result: Compared with the 19 infants in the LAA group, the 17 infants in the HAA group achieved significantly earlier full enteral feeding (7.8 ± 3.6 vs. 15.2 ± 8.9, p = 0.003) and regained birth weight (13.3 ± 3.8 vs. 17.5 ± 7.9, p = 0.047). In addition, shorter parenteral nutrition time was achieved by HAA administration (p Conclusion: Aggressive early simultaneous amino acid administration plus enteral feeding during the first few days of life for preterm infants was associated with improved weight gain and earlier full enteral feeding.
文摘目的分析极低出生体质量(VLBW)早产儿出生后的血清总胆红素(TBIL)水平和上升率的变化及血清TBIL水平快速上升的危险因素。方法选取2019年1月至2021年12月出生并在该院新生儿重症监护病房接受治疗的VLBW早产儿317例作为研究对象,根据“血清TBIL水平上升率”,研究对象被分为A组(血清TBIL水平上升率≤90%)275例和B组(血清TBIL水平上升率>90%)42例。比较两组早产儿的临床特征和血清TBIL水平的变化。采用Pearson相关分析光疗相关参数与血清TBIL上升率的关系。使用Logistic回归模型分析血清TBIL快速上升的相关因素。结果VLBW早产儿出生后血清TBIL水平随着出生时间的延长而增加(P<0.05),血清TBIL水平上升率与光疗开始时的年龄呈负相关,与光疗持续时间呈正相关(r=-0.766、0.478,P<0.05)。与A组相比,B组婴儿的胎龄明显减少,出生体质量明显降低,5 min Apgar评分明显减少,开始光疗的年龄较小,光疗总持续时间较长,差异有统计学意义(P<0.05)。胎龄、出生体质量和5 min Apgar评分为VLBW早产儿血清TBIL水平快速上升的相关因素。结论血清TBIL水平上升率可作为VLBW早产儿早期光疗的指标,血清TBIL水平的快速上升与较低胎龄、较低出生体质量和5 min Apgar评分有关。
