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目的探讨极低出生体重儿(VLBWI)住院期间营养支持、合并症及体重增长情况。方法将2005—2007年收住我院新生儿重症监护病房的VLBWI分为胎龄<30周组和≥30周组,回顾性分析两组患儿体重增长、营养支持及合并症情况,Logistic回归分析宫外发育迟缓(EUGR)的相关危险因素。结果胎龄<30周组(31例)患儿体重下降幅度、恢复出生体重日龄均高于胎龄≥30周组(39例)[9.6%±5.0%比6.9%±3.8%,(11.3±3.4)d比(8.6±3.6)d],前3周体重增长均低于胎龄≥30周组[(-11.3±13.3)g/d比(-4.3±14.7)g/d,(7.9±12.1)g/d比(15.6±12.8)g/d,(16.9±12.6)g/d比(22.7±8.2)g/d],P均<0.05;胎龄<30周组应用胃肠外营养时间及经口达推荐热卡日龄均长于胎龄≥30周组[(27.9±13.2)d比(21.5±12.1)d,(35.1±16.1)d比(27.6±9.4)d],P均<0.05;胎龄<30周组合并呼吸暂停、医院感染及应用呼吸机支持比例高于>30周组,差异有统计学意义(P<0.05);出院时EUGR45例(64.3%),胎龄和胃肠外营养时间是EUGR的相关危险因素(P<0.05)。结论大部分VLBWI在住院期间存在一定的营养及生长发育问题,胎龄和胃肠外营养时间是影响体重增长的高危因素;胎龄越小发生各种合并症几率越高。
Objective To investigate the nutritional support, complications and weight gain of very low birth weight infants (VLBWI) during hospitalization. Methods The VLBWI patients admitted to neonatal intensive care unit in our hospital from 2005 to 2007 were divided into three groups: the gestational age <30 weeks and the age ≥ 30 weeks. The weight gain, nutritional support and complications of the two groups were retrospectively analyzed. Logistic regression Analysis of related risk factors for extrauterine growth retardation (EUGR). Results The weight loss rate of the children with gestational age <30 weeks (31 cases) was significantly higher than that of the gestational age ≥30 weeks (39 cases) [9.6% ± 5.0% vs 6.9% ± 3.8%, (11.3 ± 3.4) d (8.6 ± 3.6) d], and the weight gain in the first 3 weeks was lower than that of gestational age≥30 weeks [(-11.3 ± 13.3) g / d vs (-4.3 ± 14.7) g / (P <0.05). The gestational age <30 weeks was higher than that in the control group (P <0.01) The nutritional time and the recommended daily oral calorie age were longer than those of gestational age ≥30 weeks [(27.9 ± 13.2) d vs (21.5 ± 12.1) d, (35.1 ± 16.1) d vs (27.6 ± 9.4) d], P (P <0.05). There were 45 cases of EUGR (64.3%) discharged at the time of discharge, and the proportion of discharged children with respiratory distress was less than 30 weeks Age and parenteral nutrition time were EUGR-related risk factors (P <0.05). Conclusion Most VLBWI patients have some problems of nutrition and growth during hospitalization. The gestational age and parenteral nutrition time are the risk factors of weight gain. The smaller the gestational age, the higher the incidence of various complications.