目的 分析早产儿(胎龄＜34周)喂养不耐受的临床表现及相关影响因素,以期为临床早产儿的喂养不耐受防治提供参考。方法 选取2018年2月—2020年8月桐庐县妇幼保健院胎龄＜34周的早产儿107例,采用自制问卷调查表、查询病历资料等方式调查产妇及早产儿的基本资料、临床表现及喂养耐受情况,采用单因素和多因素Logistic回归分析胎龄＜34周的早产儿喂养不耐受的临床表现及相关影响因素。结果 本研究中,36.45%的早产儿存在喂养不耐受,经单因素分析显示,出生体重轻、存在脐带异常、多胎、开始喂养时间晚、肠内喂养达110kCal/kg时间晚、肠内喂养达150kCal/kg时间晚、胎便排尽时间晚均是早产儿喂养不耐受的相关危险因素(P＜0.05)。经多因素Logistic回归分析显示,出生体重重是早产儿喂养不耐受的独立保护因素(OR=0.003,95%CI:0.000～0.789,P＜0.05),开始喂养时间晚、肠内喂养达110kCal/kg时间晚、肠内喂养达150kCal/kg时间晚、胎便排尽时间晚均是早产儿喂养不耐受的独立危险因素(OR=1.213、1.525、1.230、1.505,95%CI:1.011～1.456、1.186～1.960、1.097～1.378、1.027～2.207,P＜0.05)。结论 临床需密切关注出生体重轻、开始喂养时间晚、肠内喂养达110kCal/kg时间晚、肠内喂养达150kCal/kg时间晚、胎便排尽时间晚的早产儿,并针对上述因素对早产儿采取及时有效的干预治疗。
Abstract
Objective To analyze the clinical manifestations and related factors of feeding intolerance in premature infants (<34 weeks gestation), in order to provide reference for the prevention and treatment feeding intolerance. Methods A total of 107 premature infants <34 weeks gestation in Tonglu Maternity and Child Health Care Hospital from February 2018 to August 2020 were selected in this study. The basic data, clinical manifestations and feeding tolerance of maternal and premature infants were investigated by self-made questionnaire and medical records. The related influencing factors of feeding intolerance of premature infants <34 weeks gestation were analyzed by univariate and multivariate Logistic regression analysis. Results In this study, 36.45% of very preterm infants had feeding intolerance. Univariate analysis showed that lower birth weight, abnormal umbilical cord, multiple births, late start of feeding, late enteral feeding up to 110kCal/kg, late enteral feeding up to 150kCal/kg and late evacuation of faeces were the risk factors of feeding intolerance in premature infants (P<0.05). Multivariate Logistic regression analysis showed that higher birth weight was an independent protective factor for feeding intolerance in premature infants (OR=0.003, 95%CI:0.000 - 0.789, P<0.05), while late start of feeding(OR=1.213, 95%CI:1.011 - 1.456), late enteral feeding up to 110kCal/kg(OR=1.525, 95%CI:1.186 - 1.960), late enteral feeding up to 150kCal/kg(OR=1.230, 95%CI:1.097 - 1.378) and late evacuation of faeces (OR=1.505, 95%CI:1.027 - 2.207) were independent risk factors for feeding intolerance in premature infants (P<0.05). Conclusion It is necessary to pay close attention to the premature infants with lower birth weight, late start of feeding, late enteral feeding up to 110kCal/kg, late enteral feeding up to 150kCal/kg and late defecation, and take timely and effective interventions for the above factors.
关键词
早产儿 /
喂养不耐受 /
肠内喂养
Key words
premature infants /
feeding intolerance /
late enteral feeding
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