不同强化喂养方式对早产极低出生体重儿营养代谢及生长速率的影响

doi:10.11852/zgetbjzz2023-0038

中国儿童保健杂志 ›› 2024, Vol. 32 ›› Issue (1): 84-88.DOI: 10.11852/zgetbjzz2023-0038

不同强化喂养方式对早产极低出生体重儿营养代谢及生长速率的影响

宁月¹, 罗丽艳², 段江¹, 谢云波¹, 齐志业¹, 张彩营¹, 杨丽¹, 钟庆华¹

1.昆明医科大学第一附属医院新生儿科,云南昆明 650032;
2.大理州妇幼保健院新生儿科

收稿日期:2023-01-09 修回日期:2023-07-04 发布日期:2024-01-04 出版日期:2024-01-10
通讯作者: 钟庆华,E-mail:zqh114@126.com
作者简介:宁月(1990-),女,云南人,主治医师,硕士学位,主要研究方向为新生儿疾病及保健。
基金资助:
云南省医疗卫生内设研究机构项目(2018NS0144);云南省科技厅—昆明医科大学应用基础研究联合专项资金面上项目[2019FE001(-050)];云南省高层次卫生技术人才培养(学科带头人)基金资助项目(RLMY20200007)

Effects of different fortified feeding methods on the nutrient metabolism and growth rate of very low birth weight preterm infants

NING Yue¹, LUO Liyan², DUAN Jiang¹, XIE Yunbo¹, QI Zhiye¹, ZHANG Caiying¹, YANG Li¹, ZHONG Qinghua

1. Department of Neonatology, The First Affiliated Hospital of Kunming Medical University, Kunming,Yunnan 650032,China;
2. Department of Neonatology, Dali Maternal and Child Health Hospital

Received:2023-01-09 Revised:2023-07-04 Online:2024-01-10 Published:2024-01-04
Contact: ZHONG Qinghua, E-mail: zqh114@126.com

摘要/Abstract

摘要： 目的探讨不同强化喂养方式对早产极低出生体重儿(VLBWI)营养代谢及生长速率的影响,为改善早产儿的预后提供新思路。方法纳入2019年1月—2020年12月昆明医科大学第一附属医院新生儿科收治的早产 VLBWI 115 例,根据喂养方式分为强化母乳喂养组(HFM 组)、混合喂养组、早产儿配方奶喂养组(PF 组),分析不同的喂养方式对早产 VLBWI 的营养代谢、生长速率等的影响。结果 1)HFM 组住院时间短于PF组、混合喂养组(t=7.185、6.924,P＜0.05);2)住院期间 HFM 组并发坏死性小肠结肠炎(NEC)的比例低于PF组(P＜0.05),住院期间 HFM 组并发晚发型败血症(LOS)、宫外生长发育迟缓(EUGR)的比例低于PF 组(χ²=5.030、4.147,P＜0.05);并发LOS的比例低于混合喂养组(χ²=6.589,P＜0.05);3)住院期间 HFM 组并发腹胀、便血、嗜酸性粒细胞增高比例低于PF 组(P＜0.05),混合喂养组并发腹胀比例低于PF组(P＜0.05);4)出院时 HFM 组体重、身长增长速率均高于混合喂养组(t=3.722、0.425,P＜0.001)及PF 组(t=6.015、0.496,P＜0.001)。结论强化母乳喂养能更有效提高早产 VLBWI 的生长速率,改善营养代谢,减少早产儿相关并发症及喂养不良反应,更安全有效。

关键词: 早产儿, 极低出生体重, 喂养, 营养代谢, 生长速率

Abstract: Objective To analyze the effects of different fortified feeding Methods on nutritional metabolism and growth rate of preterm very low birth weight infants (VLBWI), in order to provide new clues for improving the prognosis of the preterm infants. Methods A total of 115 cases of premature VLBWI admitted to Department of Neonatology, The First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 were included in this study, and were divided into fortified breastfeeding group (HFM group), mixed feeding group, and premature formula feeding group (PF group) based on their feeding methods. The effects of different feeding Methods on the nutritional metabolism and growth rate of premature VLBWI were analyzed. Results 1) The hospitalization time of infants in the HFM group was shorter than that in PF group and mixed feeding group (t=7.185, 6.924, P<0.05). 2) The proportion of necrotizing enterocolitis (NEC) in the HFM group during hospitalization was lower than that in the PF group (P＜0.05); the proportions of late onset septicemia(LOS) and extra uterine growth restriction(EUGR) in the HFM group during hospitalization were lower than those in the PF group (χ²=5.030, 4.147, P＜0.05); the proportion of LOS was lower than that of the mixed feeding group(χ²=6.589, P＜0.05). 3) During hospitalization, the proportions of abdominal distension, bloody stools and increased eosinophils in the HFM group were lower than those in the PF group (P＜0.05), which in mixed feeding group was lower than those in PF group (Fisher exact test, P＜0.05). 4) At discharge, the weight and length growth rate of the HFM group were higher than those of the mixed feeding group (t=3.722, 0.425, P<0.001) and the PF group (t =6.015, 0.496, P< 0.001). Conclusion Fortified breastfeeding can more effectively increase the growth rate of VLBWI in premature infants, improve nutritional metabolism, reduce complications and adverse feeding reactions related to premature infants, and is safer and more effective.

Key words: preterm, very low birth weight, feeding, nutrient metabolism, growth rate

中图分类号:

R722.6

宁月, 罗丽艳, 段江, 谢云波, 齐志业, 张彩营, 杨丽, 钟庆华. 不同强化喂养方式对早产极低出生体重儿营养代谢及生长速率的影响[J]. 中国儿童保健杂志, 2024, 32(1): 84-88.

NING Yue, LUO Liyan, DUAN Jiang, XIE Yunbo, QI Zhiye, ZHANG Caiying, YANG Li, ZHONG Qinghua. Effects of different fortified feeding methods on the nutrient metabolism and growth rate of very low birth weight preterm infants[J]. Chinese Journal of Child Health Care, 2024, 32(1): 84-88.

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不同强化喂养方式对早产极低出生体重儿营养代谢及生长速率的影响

Effects of different fortified feeding methods on the nutrient metabolism and growth rate of very low birth weight preterm infants

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