CAJ | 학술논문

目的探讨生后早期积极的营养支持对住院期间早产儿的影响.方法研究对象选择胎龄大于28周出生体重1000 g至2000 g、生后12 h内转入我院NICU、住院时间2周以上、无明显畸形且存活出院的早产儿,其中A组(2005年1月1日至2006年6月30日出生)81例,B组(2009年6月1日至2010年11月30日出生)79例.比较营养摄入、早产儿的生长速率及体重Z评分和血生化营养指标的差异.结果 B组生后第3、7天氨基酸用量明显高于A组[2.00(2.00,2.50) g/kg比1.50(1.50,2.00) g/kg,3.00(2.00,3.00) g/kg比2.00(1.80,2.60) g/kg,P均＜0.001].B组第3天奶量和总热卡摄入明显高于A组[9.41(2.66,18.74) ml/kg比14.47(4.23,30.77) ml/kg,P＜0.05,(64.87±16.04) kcal/kg比(55.62±17.68) kcal/kg,P=0.001].两组第1周后总热卡摄入相似.B组母乳强化剂使用率较前升高(62.8％比14.3％,P＜0.005).无论是出生体重1000～1499 g的早产儿,还是出生体重1500～2000 g的早产儿,B组生长速率均更快[(20.6±3.4)g/( kg·d)比(15.4±3.2)g/( kg·d),(20.3±9.1)g/(kg·d)比(14.3±4.9) g/(kg·d),P均＜0.001].A组生长迟缓的比例出院时较出生时增加(65.4％比40.7％,P＜0.05),B组差异无统计学意义.两组出生体重Z评分相似,而B组出院体重Z评分明显高于A组[(-1.24±0.79)比(-1.54±0.84),P＜0.05].出生时血清白蛋白、前白蛋白、尿素水平两组差异无统计学意义,而生后2周和出院前B组明显高于A组.结论早产儿生后早期营养措施的改善有效促进了早产儿住院期间的生长和营养状况.
목적 탐토생후조기적겁적영양지지대주원기간조산인적영향.방법 연구대상선택태령대우28주출생체중1000 g지2000 g、생후12 h내전입아원NICU、주원시간2주이상、무명현기형차존활출원적조산인,기중A조(2005년1월1일지2006년6월30일출생)81례,B조(2009년6월1일지2010년11월30일출생)79례.비교영양섭입、조산인적생장속솔급체중Z평분화혈생화영양지표적차이.결과 B조생후제3、7천안기산용량명현고우A조[2.00(2.00,2.50) g/kg비1.50(1.50,2.00) g/kg,3.00(2.00,3.00) g/kg비2.00(1.80,2.60) g/kg,P균＜0.001].B조제3천내량화총열잡섭입명현고우A조[9.41(2.66,18.74) ml/kg비14.47(4.23,30.77) ml/kg,P＜0.05,(64.87±16.04) kcal/kg비(55.62±17.68) kcal/kg,P=0.001].량조제1주후총열잡섭입상사.B조모유강화제사용솔교전승고(62.8％비14.3％,P＜0.005).무론시출생체중1000～1499 g적조산인,환시출생체중1500～2000 g적조산인,B조생장속솔균경쾌[(20.6±3.4)g/( kg·d)비(15.4±3.2)g/( kg·d),(20.3±9.1)g/(kg·d)비(14.3±4.9) g/(kg·d),P균＜0.001].A조생장지완적비례출원시교출생시증가(65.4％비40.7％,P＜0.05),B조차이무통계학의의.량조출생체중Z평분상사,이B조출원체중Z평분명현고우A조[(-1.24±0.79)비(-1.54±0.84),P＜0.05].출생시혈청백단백、전백단백、뇨소수평량조차이무통계학의의,이생후2주화출원전B조명현고우A조.결론 조산인생후조기영양조시적개선유효촉진료조산인주원기간적생장화영양상황.
Objective To explore the effect of aggressive nutritional support in early life on growth of preterm infants during hospitalization.Method Two retrospective cohorts of preterm infants were compared; 81 infants of group A (born between January 1,2005 and June 30,2006) and 79 infants of group B (June 1,2009 and November 30,2010) with gestational age above 28 weeks and birth weight between 1000 g and 2000 g,transfered to NICU of PUMCH within 12 hours after birth,hospitalized for ＞ or =2 weeks,who were free of major congenital anomalies and survived to discharge were recruited.The comparison of enteral and parenteral nutrition,growth rate,biochemical indices during hospitalization between these both groups were made.Result Compared to group A,group B was given greater volume of amino acid infusion on the 3~ and 7th day of life [2.00 (2.00,2.50) g/kg vs 1.50 (1.50,2.00) g/kg,3.00 (2.00,3.00) g/kg vs 2.00 (1.80,2.60) g/kg,all P ＜0.001 ],and Consumed more milk and total energy intake on the 3rd day of life [9.41 (2.66,18.74) ml/kg vs 14.47(4.23,30.77) ml/kg,P＜0.05,(64.87 ± 16.04) kcal/kg vs (55.62 ± 17.68) kcal/kg,P =0.001 ].Total energy intakes after a week of life were similar between the two groups.More infants received human milk fortifier in group B (62.8％ vs 14.3％,P =0.001 ).After stratification according to weight,both very low birth weight infants and infants with birth weight between 1500 g and 2000 g in group B grew more rapidly ( P ＜0.001 ).The percentage of growth retardation was increased after hospitalization in group A (65.4％ vs 40.7％,P ＜ 0.05 ),there were no statistically significant differences in group B.The mean Z scores at birth were comparable.The mean Z scores by discharge were higher in group B ( - 1.24 vs - 1.54,P ＜ 0.05 ).Serum albumin,prealbumin and urea values were similar in both groups at birth,but higher in group B after two weeks of life( P ＜ 0.001 ).Before discharge,Serum albumin,prealbumin,and urea values in group B was higher ( P ＜ 0.001 ).Conclusion Improvements in nutritional practices in early life of preterm infants effectively enhanced the growth and improved the nutritional status of preterm infants during hospitalization.