摘要
目的探讨极低出生体质量儿不同时间添加母乳强化剂对生长发育及并发症发生率的影响。方法2015年1月至9月在天津市中心妇产科医院新生儿重症监护病房住院的极低出生体质量儿，排除出生时重度窒息、中途放弃治疗和死亡患儿，以及母乳喂养总量低于80%及单纯配方奶喂养的患儿，共纳入93例。采用完全随机分组方法将93例患儿分为2组：经口入量达50 mL/（kg·d）添加母乳强化剂的患儿为早强化组，共48例；经口入量达100 mL/（kg·d）添加母乳强化剂的患儿为晚强化组，共45例。比较2组患儿住院期间生长发育及并发症的发生率是否存在差别。采用独立样本t检验和χ2检验进行统计学分析。结果早强化组和晚强化组患儿在住院期间的体质量增长速度分别为（15.4±2.4） g/（kg·d）和（13.6±2.3） g/（kg·d），2组比较差异有统计学意义（t＝3.043，P＝0.004）。身长、头围的增长速度，矫正胎龄达34周时的体质量，恢复出生体质量时间，肠外营养时间，住院时间，出院时体质量、身长、头围差异以及出院时宫外生长迟缓发生率差异均无统计学意义（均P〉0.05）。2组患儿喂养不耐受、坏死性小肠结肠炎、院内感染、早产儿视网膜病变、支气管肺发育不良发生率差异均无统计学意义（均P〉0.05）。结论在极低出生体质量儿经口入量达50 mL/（kg·d）时添加母乳强化剂，可提高住院期间的体质量增长率，且不增加极低出生体质量儿并发症的发生率。
Objective To investigate the effects of human milk fortifier （HMF） addition at different time points on the growth, development and the incidence of complications in very low birth weight （VLBW） infants. Methods A total of 93 VLBW infants admitted into Neonatal Intensive Care Unit of Tianjin Central Hospital of Obstetrics and Gynecology from January to September 2015 with more than 80% of total milk intake during hospitalization, excluding those who had severe asphyxia or abandoned treatment and died, were collected. The included cases were divided into 2 groups by using completely randomized grouping method, early fortification group （ n = 48 ） and delayed fortification group（ n = 45 ） adding HMF with the enteral intake of 50 mL/（ kg · d） and 100 mL/（ kg · d ）, respectively. The outcomes included growth development and the incidence of complications during hospitalization. Then, t test and chi - square test of independent samples were used for statistical analysis. Results There was significant difference in the weight growth rate between the 2 groups, and the growth rate of early fortification group and delayed fortification group were （ 15.4 ± 2.4） g/（ kg · d） and （ 13.6 ± 2.3 ） g/（ kg · d）, respectively （ t = 3. 043, P = 0. 004 ）. There was no significant difference in height growth rate, head circumference growth rate, weight at 34 weeks postmenstrual age, time of recovering birth weight and parenteral nutrition, hospitalization duration, body weight,body length, head circumference at discharge and the incidence of extrauterine growth retardation between the 2 groups （ all P 〉 0. 05 ）. There was no statistical difference in incidence of feeding intolerance, necrotizing enterocolitis, nosocomial infection,retinopathy of prematurity, bronchopulmnnary dysplasia between the 2 groups（ all P 〉 0.05 ）. Conclusions HMF with enteral intake of 50 mL/（ kg· d） contributes to weight gain rate in VLBW infants during hospitalization, but not to the increase in the incidence of complications.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2017年第7期528-531,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
极低出生体质量儿
母乳
母乳强化剂
Very low birth weight infant
Huamn milk
Human milk fortifier
