CAJ | 학술논문

目的回顾超低出生体重儿(ELBWI)胃肠道内喂养的临床资料,分析影响ELBWI胃肠道内喂养的各种因素.方法对2000年1月至2010年1月间的24例ELBWI的临床资料进行回顾性分析,根据达到足量胃肠道内喂养的时间分为A组和B组,比较两组之间各项指标的差异.结果 24例ELBWI胎龄为(29.0±1.8)周(26.14～34.43周),出生体重为[(882±67)(730～970)]g,A组11例,达到足量喂养时间为(27±6)d;B组13例,达到足量喂养时间为(46±10)d.生后窒息(18.2%∶61.5%,P=0.047)、脐静脉插管时间长于10 d(18.2%∶61.5%,P=0.047)、机械通气时间长于14 d(27.3%∶76.9%,P=0.038)的比例,以及第21、28天的奶量[(88.9±35.4)ml:(37.4±34.9)ml,P=0.002;(121.1±37.4)ml:(53.2±33.1)ml,P=0.000]在两组间差异有统计学意义.胎龄、出生体重、动脉导管未闭、红细胞增多症、血糖异常、败血症、开奶日龄、开奶量、第1周加奶量、第2周加奶量、第3、7、14天奶量均无统计学差异.结论窒息、脐静脉插管时间、机械通气时间可能影响ELBWI的胃肠道内喂养,喂养较顺利的ELBWI在生后第3周时即可表现出较好的耐受性.但因ELBWI的胃肠道内喂养可能受到多种因素的影响,在进行喂养时应针对不同情况制定个体化方案.
목적 회고초저출생체중인(ELBWI)위장도내위양적림상자료,분석영향ELBWI위장도내위양적각충인소.방법 대2000년1월지2010년1월간적24례ELBWI적림상자료진행회고성분석,근거체도족량위장도내위양적시간분위A조화B조,비교량조지간각항지표적차이.결과 24례ELBWI태령위(29.0±1.8)주(26.14～34.43주),출생체중위[(882±67)(730～970)]g,A조11례,체도족량위양시간위(27±6)d;B조13례,체도족량위양시간위(46±10)d.생후질식(18.2%∶61.5%,P=0.047)、제정맥삽관시간장우10 d(18.2%∶61.5%,P=0.047)、궤계통기시간장우14 d(27.3%∶76.9%,P=0.038)적비례,이급제21、28천적내량[(88.9±35.4)ml:(37.4±34.9)ml,P=0.002;(121.1±37.4)ml:(53.2±33.1)ml,P=0.000]재량조간차이유통계학의의.태령、출생체중、동맥도관미폐、홍세포증다증、혈당이상、패혈증、개내일령、개내량、제1주가내량、제2주가내량、제3、7、14천내량균무통계학차이.결론 질식、제정맥삽관시간、궤계통기시간가능영향ELBWI적위장도내위양,위양교순리적ELBWI재생후제3주시즉가표현출교호적내수성.단인ELBWI적위장도내위양가능수도다충인소적영향,재진행위양시응침대불동정황제정개체화방안.
Objective To review the clinical data of enteral feeding of extremely low birth weight infants (ELBWI), and analyze the influencing factors. Method From Jan. 2000 to Jan. 2010, data of 31 ELBWI from Peking Union Medical College Hospital were retrospectively collected. ELBWI were assigned to different groups according to the time achieving full enteral feeding, comparison was done between two groups for enteral feeding. Result Twenty-four infants were analyzed, their mean gestational age was ( 29. 0 ±1.8) weeks (26. 14-34. 43 weeks), birth weight (882 ±67)g(730-970 g), there were 11 infants in group A, whose time for achieving full enteral feeding was (27 ±6)days, there were 13 infants in group B, whose time achieving full enteral feeding was ( 46 ± 10 ) days. The ratio of asphyxia ( 18.2% vs. 61.5%, P =0. 047 ), duration of umbilical vein catheterization longer than 10 days ( 18. 2% vs. 61.5%, P = 0. 047 ),and duration of mechanical ventilation longer than 14 days(27.3% vs. 76.9% ,P = 0. 038 )in group A was higher than in group B. The milk volume on the 21st and 28th day in group A was much more than that in groupB[(88.9±35.4)mlvs. (37.4±34.9) ml, P=0. 002;(121.1±37.4) ml vs. (53.2±33.1) ml,P =0. 000]. There were no significant differences between the two groups in gestational age, birth weight,patent ductus arterious, erythrocytosis, dysglycemia, sepsis, the time to begin enteral feeding, the beginning milk volume, the adding milk volume in the 1st, 2nd week, and the milk volume on the 3rd, 7th, 14th day.Conclusion Asphyxia, duration of umbilical vein catheterization, and duration of mechanical ventilation are likely to influence the enteral feeding of ELBWI, ELBWI with successful enteral feeding could show good tolerance in the 3rd week. But individual program should be made for enteral feeding of ELBWI, because enteral feeding could be influenced by multiple factors.