目的 通过三种不同的营养评价方法对极低与超低出生体重儿进行营养评估,探讨早产儿理想的营养评价方法。方法 84例极低出生体重儿(包括超低出生体重儿)按照肠外营养(parentaral nutrition,PN)应用的时间分为两组,记录两组出生体重及住院期间的体重变化,将患儿体重生长指标进行统计,应用三种方法,即Mounla 营养评价法、以宫内生长速度为标准的判断方法、日均体重增长曲线与Christensen 体重生长曲线对比的方法,来评估不同营养方式患儿的营养状况。结果 根据Mounla 营养评价方法,两组营养状况组成差异无统计学意义;根据宫内生长速度为标准进行评估,两组住院期间平均体重增长均>15 g/(kg·d),两组比较差异有统计学意义(t=3.731,P<0.05);将两组日均体重增长曲线与Christensen 体重生长曲线对比,发现四项体重生长指标落后于Christensen 曲线数值,PN时间较长的组2指标明显落后。 结论 应用三种营养评价方法评估不同营养方式的患儿的营养状况,得出不同的结论。推测评估极低、超低出生体重儿的营养状况,以宫内生长速度为标准的判断方法过于简单,Mounla营养评价方法可能不够全面,而Christensen体重生长曲线是否适合中国儿童尚不确定,更合理的营养评估方法有待进一步扩大样本量进行深入研究。

Objective To explore very low and extremely low birth weight children by three different methods of nutritional evaluation of nutritional assessment,explore the ideal nutrition for premature children evaluation methods. Methods A total of 84 VLBWIs and ELBWIs were collected.They were divided into two groups according to the length of their days receiving PN.General clinical data of birth weight,head circumference,height,and weight variance (measured once per day) were recorded.Comparisons were made among the three parenteral and enteral nutrition methods (Mounla's method,the Chinese criteria of VLBWI's growth assessment,and Christensen's weight growth chart),while using them to analyze the nutrition conditions of each group. Results Applying the Mounla's method of nutrition assessment,there were no significant difference (P>0.05) in elements and intake amounts of nutrition between the two groups.while according to the domestic preterm low birth weight child growth assessment methods,average weight growth were both more than 15 g/(kg·d).And there were significant differences(P<0.05) between the two groups.Compared weight growth chart of two groups with Christensen's,five weight growth indicators were found all behind the growth of Christensen's value,the Group 2 was more apparentent. Conclusions The conclusion of applying Mounla nutrition evaluation method and standard of the intrauterine growth rate to assess the nutrition composition of VLBWIs and ELBWIs is not comprehensive with the results found in this study,and growth curve of Christensen are uncertain for use in chinese baby.a more reasonable method of nutritional assessment and the establish of VLBWI and ELBWI growth curve needs expanding samples for further study.