目的 了解胎龄 < 28周和胎龄≥ 28周超低出生体重儿（extremely low birth weight infant，ELBWI）的肠内喂养情况和喂养不耐受的发生情况。方法 对2018年1月至2020年1月广州医科大学附属第三医院新生儿科收治的ELBWI进行回顾性分析，将其分为胎龄 < 28周组（n=41）和胎龄≥ 28周组（n=38），比较两组早产儿住院期间的肠内喂养情况和喂养不耐受的发生情况。结果 胎龄 < 28周组41例患儿中，小于胎龄儿占5%（2例）；胎龄≥ 28周组38例患儿中，小于胎龄儿占63%（24例）。胎龄 < 28周组初始和最终达到足量肠内喂养时间均长于胎龄≥ 28周组（P < 0.05）。胎龄 < 28周组的喂养不耐受复发率高于胎龄≥ 28周组（54% vs 32%，P < 0.05）。胎龄≥ 28周组生后1~2周内喂养不耐受发生率（5%）低于胎龄 < 28周组（29%），且其喂养不耐受持续时间短于胎龄 < 28周组（P < 0.05）。与胎龄 < 28周组比较，胎龄≥ 28周组体重增长速率较高，住院时间较短，支气管肺发育不良发生率较低，但出院时宫外生长发育迟缓率较高（P < 0.05）。结论 与胎龄 < 28周ELBWI相比，胎龄≥ 28周ELBWI的喂养不耐受复发率低，达足量肠内喂养时间早，但宫外生长发育迟缓发生率高，喂养需要更加积极。
Abstract
Objective To investigate the condition of enteral feeding and the incidence of feeding intolerance (FI) in extremely low birth weight (ELBW) infants with a gestational age (GA) of < 28 weeks versus ≥ 28 weeks. Methods A retrospective analysis was performed for the ELBW infants who were admitted to the Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, from January 2018 to January 2020. According to GA, they were divided into two groups:GA < 28 weeks (n=41) and GA ≥ 28 weeks (n=38). The two groups were compared in terms of enteral feeding and incidence rate of FI during hospitalization. Results Among the 41 infants in the GA < 28 weeks group, 2 (5%) were small-for-gestational-age (SGA) infants, while among the 38 infants in the GA ≥ 28 weeks group, 24 (63%) were SGA infants. Compared with the GA ≥ 28 weeks group, the GA < 28 weeks group had significantly longer initial and final time to full enteral feeding (P < 0.05). The GA < 28 weeks group had a significantly higher recurrence rate of FI than the GA ≥ 28 weeks group (54% vs 32%, P < 0.05). Compared with the GA < 28 weeks group, the GA ≥ 28 weeks group had a significantly lower incidence rate of FI within 1-2 weeks after birth (5% vs 29%, P < 0.05) and a significantly shorter duration of FI (P < 0.05). The ELBW infants in the GA ≥ 28 weeks group had a higher velocity of weight gain, a shorter length of hospital stay, and a lower incidence rate of bronchopulmonary dysplasia, but a higher incidence rate of extrauterine growth retardation (EUGR) than the GA < 28 weeks group at discharge (P < 0.05). Conclusions Compared with the ELBW infants with a GA of < 28 weeks, the ELBW infants with a GA of ≥ 28 weeks have a lower recurrence rate of FI and can achieve full enteral feeding earlier, but with a higher incidence rate of EUGR, suggesting that enteral feeding needs to be more active for the ELBW infants with a GA of ≥ 28 weeks.
关键词
喂养不耐受 /
肠内喂养 /
宫外生长发育迟缓 /
超低出生体重儿
Key words
Feeding intolerance /
Enteral feeding /
Extrauterine growth retardation /
Extremely low birth weight infant
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