目的:了解新生儿重症监护室(NICU)中早产儿早期的营养状况和发生宫外生长发育迟缓(EUGR)的危险因素。方法:采用回顾性调查,收集我院2007年8月至2008年9月入住NICU的早产儿临床资料110份,分析其营养状况,对影响早产儿生长的危险因素进行分析。结果:110例早产儿中就体重、身长、头围而言EUGR的发生率分别为53.6%(59例)、31.8%(35例)、10.0%(11例)。小于胎龄儿、低出生体重、生理性体重下降的幅度大、住院期间平均体重增长速度慢、口服热卡达到推荐摄入标准时间长、母亲有并发症/合并症是导致早产儿发生EUGR的危险因素。结论:早产儿住院期间营养及生长发育状况不容乐观,EUGR发病率高。合理的营养支持、积极的防治高危因素对改善早产儿的营养状况及远期预后有重要意义。
Abstract
OBJECTIVE: To study the nutrition status of premature infants in the neonatal intensive care unit (NICU) and risk factors of extrauterine growth retardation (EUGR). METHODS: The clinical data of 110 premature infants who were admitted to the NICU from August 2007 to September 2008 were retrospectively reviewed. The possible factors influencing the nutrition status were analyzed. RESULTS: The incidence of EUGR was 53.6% (59/110), 31.8%(35/110) and 10.0%(11/110) by weight, length and head circumference respectively among the premature infants. The risk factors of EUGR included: small-for-gestational-age (SGA), low birth weight, low speed of weight gain during hospitalization, large extent of physiological weight loss, long time to reach oral calorie goal, and maternal complications. CONCLUSIONS: The nutrition status and physical development are not desirable in premature infants hospitalized in the NICU. Therefore, reasonable nutritional support and proactive control of risk factors are important strategies to improve the perinatal nutrition and long-term prognosis.
关键词
出生时低体重 /
宫外生长迟缓 /
危险因素 /
早产儿
Key words
Low birth weight /
Extrauterine growth retardation /
Risk factor /
Premature infant
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Jefferis BJ, Power C, Hertzman C. Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study[J]. BMJ, 2002, 325 (7359): 305.
[2]Hack M, Taylor HG, Klein N, Eiben R, Schatschneider C, Mercuri-Minich N. School-age outcomes in children with birth weights under 750 g[J]. N Engl Med, 1994, 331(12):753-759.
[3]Eriksson JG, Forsén T. Unravelling the fetal origins hypothesis[J].Lancet, 2002, 360(9350): 2072.
[4]Clark RH, Thomas P, Peabody J. Extrauterine growth restriction remains a serious problem in prematurely born neonates[J].Pediatrics, 2003, 111(5 Pt 1): 986-990.
[5]王丹华.早产儿的营养支持[J].中华围产医学杂志, 2006, 9 (4):280-283.
[6]早产儿营养调查协作组.新生儿重症监护病房中早产儿营养相关状况多中心调查974例报告[J].中华儿科杂志2009, 47(1):1217.
[7]中华医学会肠外肠内营养学分会儿科协作组,中华医学会儿科学分会新生儿学组. 中国新生儿营养支持临床应用指南[J].中国当代儿科杂志,2006,8(5): 352-356.
[8]Brandt I, Sticker EJ, LentzeMJ. Catch-up growth of head circumference of very low birth weight, small for gestational age preterm infants and mental development to adulthood[J]. J Pediatr, 2003,142(5): 463-468.
[9]岳晓红,赵翠霞,王红宇,芦惠,薛辛东. 非营养性吸吮对早产儿营养胰岛素及生长抑素水平的影响[J].中国当代儿科杂志,2004, 6(4): 277-280.
[10]林新祝,陈桂霞,孙晓龙. 早期足量胃肠道外营养对早产儿出院时体重的影响[J]. 中国新生儿科杂志, 2006, 21(3): 143-145.