CAJ | 학술논문

目的：分析早产儿1岁以内体重、身长、头围追赶生长的影响因素，为早产儿体格评价、保健指导提供依据。方法以长沙市妇幼保健院管理的，生后12个月内定期随访的85例早产儿为研究对象，并按照出生时胎龄将其分为早期早产儿组（40例）和晚期早产儿组（45例）。采用标准差的离差法－Z评分（Z－score）对体重、身长和头围进行评估。分析85例早产儿婴儿期追赶生长特点，比较两组各月龄段发育落后率及各月龄段Z值增长（△Z）情况。进一步对12月龄时体重仍落后的相关因素进行分析探讨。结果85例早产儿出生时体重、身长及头围Z值＜－2者分别占88．2％（75／85），88．2％（75／85）和91．7％（78／85），到满周岁时对应各临床指标Z值＜均值－2的分别为9．4％（8／85）、4．7％（4／85）和2．3％（2／85）。两组早产儿体重、身长及头围△Z值在出生6月内均大于0．5，6月龄后则均小于0．3。在出生第1月龄时，两组早产儿体重、身长及头围△Z比较发现，晚期早产儿组明显大于早期早产儿组（t值分别为7．70、6．12和5．52，均P＜0．05），之后各月龄段各△Z未发现统计学差异。在12月龄时体重发育落后的早产儿宫内发育迟缓率高于适龄组（χ2＝4．50，P＜0．05），而出生后营养强化率（％）和早期家庭抚触率低于适龄组儿童（χ2值分别为7．07和4．66，均P＜0．05）。结论早产儿1岁以内为追赶生长最佳时期，体重、身长和头围的追赶生长呈先快后慢的特征。而出生后营养强化和早期家庭抚触可促进早产儿追赶生长。
목적：분석조산인1세이내체중、신장、두위추간생장적영향인소，위조산인체격평개、보건지도제공의거。방법이장사시부유보건원관리적，생후12개월내정기수방적85례조산인위연구대상，병안조출생시태령장기분위조기조산인조（40례）화만기조산인조（45례）。채용표준차적리차법－Z평분（Z－score）대체중、신장화두위진행평고。분석85례조산인영인기추간생장특점，비교량조각월령단발육락후솔급각월령단Z치증장（△Z）정황。진일보대12월령시체중잉락후적상관인소진행분석탐토。결과85례조산인출생시체중、신장급두위Z치＜－2자분별점88．2％（75／85），88．2％（75／85）화91．7％（78／85），도만주세시대응각림상지표Z치＜균치－2적분별위9．4％（8／85）、4．7％（4／85）화2．3％（2／85）。량조조산인체중、신장급두위△Z치재출생6월내균대우0．5，6월령후칙균소우0．3。재출생제1월령시，량조조산인체중、신장급두위△Z비교발현，만기조산인조명현대우조기조산인조（t치분별위7．70、6．12화5．52，균P＜0．05），지후각월령단각△Z미발현통계학차이。재12월령시체중발육락후적조산인궁내발육지완솔고우괄령조（χ2＝4．50，P＜0．05），이출생후영양강화솔（％）화조기가정무촉솔저우괄령조인동（χ2치분별위7．07화4．66，균P＜0．05）。결론조산인1세이내위추간생장최가시기，체중、신장화두위적추간생장정선쾌후만적특정。이출생후영양강화화조기가정무촉가촉진조산인추간생장。
Objective To analyze the influencing factors of physical catch-up growth of preterm infants during infancy including weight, length and head circumference, so as to provide reference for physical evaluation and clinical intervention.Methods Eighty-five preterm infants in the management of Changsha Hospital for Maternal and Child Health Care and followed up regularly in the first 12 months after birth were selected in the study, and they who were divided into early preterm group ( 40 cases ) and late preterm group ( 45 cases ) according to gestational weeks at birth.The standard deviation of the difference method ( Z-score) was used to evaluate weight, length and head circumference.The characteristics of catch-up growth during infancy of these 85 premature infants were analyzed.The ratio of growth retardation ( GR) and the increase in Z values (△Z) were compared between two groups in different age periods.Furthermore, the related factors of GR for weight at 12 month were analyzed.Results The percentages of neonates with △Z<-2 in weight, length and head circumference were 88.2%(75/85), 88.2%(75/85) and 91.7%(78/85), respectively at birth, and they were 9.4%(8/85),4.7%(4/85) and 2.3%(2/85), respectively at the age of 12 months.In two groups the△Z values of weight, length and head circumference were more than 0.5 under the age of six months, while they were less than 0.3 after six months of age.The△Z values of weight, length and head circumference in late preterm group were significantly more than those of early preterm group at the first month ( t value was 7. 70, 6.12 and 5.52, respectively, all P<0.05), but there was no statistical significance in the difference of△Z values at other months of age.The incidence of intrauterine growth retardation ( IUGR) was higher in the GR infants at 12 month of age than that in normal growth infants (χ2 =4.50,P <0.05), but nutrition fortifying rate and early family touch rate were lower (χ2 value was 7.07 and 4.66, respectively, both P<0.05).Conclusion The best time of catch-up growth for preterm infants is the first year after birth, and the catch-up growth in weight, length and head circumference is featured by growing fast at first and slowing down later.Nutrition fortifying at birth and receiving early touch in family can promote catch-up growth in preterm infants.