Abstract: Objective To investigate the nutrition status and correlated factors of growth of very low birth weight infants (VLBWI) during the early stage. Methods Clinical data of VLBWI discharged from Jan.1^st,2009 to May.31^th,2011 were collected retrospectively according to certain criteria from department of neonatology.Nutrition support,growth pattern and factors associated with growth were studied. Results Two hundred and twenty-eight VLBWI were included.Infants as small for gestational age showed later time for initial enteral feeding,enteral feeding reached 100 kCal/(kg·d),total energy intake of 120 kCal/(kg·d) and supply of amino acids/lipid emulsions than those as appropriate for gestaional age(P<0.01).Infants as small for gestational age showed higher number ratio of feeding intolerance during hospitalization than those as appropriate for gestaional age(P<0.05).Infants as small for gestational age showed slower growth rate than those as appropriate for gestational age(P<0.05).The proportion of growth restriction was obviously increased at premature infants leaving hospital.The infants as appropriate for gestational age showed obviously lower proportion of extrauterine growth restriction than those as small for gestational age. Conclusions Most VLBWI could not achieve growth rate as desired for normal intrauterine growth rate.More aggressive enteral and parenteral nutrition strategy needs to be considered for improving the early growth of VLBWI.

Key words: very low birth weight, nutrition, growth, extrauterine growth restriction

摘要： 目的 探索出生后早期极低出生体重儿(very low birth weight infants,VLBWI)的营养摄入状况和影响其生长的相关因素。方法 采用回顾性分析研究的方法,收集2009年1月1日-2011年5月31日在本院新生儿科住院,符合病例选择标准的228例VLBWI的临床资料,对其营养摄入状况及生长情况进行分析。结果 小于胎龄儿(small for gestaional age,SGA)组较适于胎龄儿(appropriate for gestaional age,AGA)组开始喂养日龄、肠内热卡达100 kCal/(kg·d)日龄、总热卡达120 kCal/(kg·d)日龄及应用氨基酸/脂肪乳开始日龄晚(P均<0.01)。SGA组较AGA组在住院过程中发生喂养不耐受例数比大(P<0.05)。SGA组较AGA组体重增长速率慢(P<0.05)。出院时早产儿生长迟缓比例明显增加;且AGA宫外生长迟缓的比例明显低于出生时SGA者。 结论 在生后早期VLBWI大多数不能达到在宫内胎儿的正常生长速率,有必要采取更合理的肠内、肠外营养支持方案,以促进VLBWI生后的早期生长。

关键词: 极低出生体重, 营养, 生长, 宫外生长迟缓