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目的分析早产儿宫外发育迟缓(EUGR)的相关因素,并针对其发生的可能性进行合理有效的预防。方法对2009年1月-2016年1月江西省景德镇市第二人民医院的40例早产儿进行住院体重监测,采用Logistic回归分析法对早产儿EUGR的影响因素进行总结并据此制定相应的预防措施。结果当出生体重≤1 500 g时,早产儿EUGR发生率为52.5%;当出生体重>1 500 g时,早产儿EUGR发生率为47.5%,不同出生体重比较,差异具有统计学意义(χ~2=7.46,P<0.05);出生胎龄<34周的早产儿24例,出院时发生EUGR 18例,占45.0%;出生胎龄≥34周的早产患儿16例,出院时发生EUGR 11例,占27.5%,两者比较,差异有统计学意义(P<0.05)。出生体重≤1 500 g的早产儿每日体重增长平均值为(23.5±10.1)g,达到标准体重平均时间为(11.1±3.9)d;而出生体重>1 500 g的早产儿每日体重增长平均值为(26.9±12.4)g,达到标准体重平均时间为(6.9±6.2)d,两组体重增长情况比较,差异无统计学意义(χ~2=3.90,P>0.05),而相比达到标准体重平均时间比较,差异有统计学意义(t=1.26,P<0.05)。Logistic回归分析结果显示,宫内发育迟缓、胎龄过小、体重过低、出生时全身感染、出生后体重持续下降为早产儿宫外发育迟缓的独立影响因素(P<0.05)。结论出生体重低、胎龄小,发生EUGR的概率大。宫内发育迟缓、胎龄过小、体重过低、出生时全身感染、出生后体重持续下降均会诱发EUGR,在住院治疗阶段应积极进行感染治疗和并发症预防,同时高度重视早产儿的营养干预,避免体重持续下降为预防EUGR发生的关键。
Objective To analyze the related factors of extrauterine growth retardation (EUGR) in preterm infants and to make rational and effective prevention against the possibility of its occurrence. Methods From January 2009 to January 2016, 40 preterm infants in the Second People’s Hospital of Jingdezhen, Jiangxi Province were monitored for in-hospital weight. The influencing factors of EUGR in preterm infants were analyzed by Logistic regression analysis and corresponding prevention Measures. Results The incidence of EUGR in preterm infants was 52.5% when the birth weight was less than 1 500 g. The incidence of EUGR in preterm infants was 47.5% when the birth weight was more than 1 500 g. The difference was statistically significant (χ ~ 2 = 7.46, P <0.05); 24 preterm infants born at gestational age <34 weeks, 18 cases of EUGR discharged at hospital, accounting for 45.0%; 16 preterm infants born at gestational age ≥34 weeks, EUGR 11 Cases, accounting for 27.5%, the difference between the two was statistically significant (P <0.05). The average daily body weight gain of preterm infants with birth weight ≤1 500 g was (23.5 ± 10.1) g, the average time to standard body weight was (11.1 ± 3.9) days, whereas that of preterm infants with birth weight> 1 500 g The average body weight was (26.9 ± 12.4) g and the mean time to standard body weight was (6.9 ± 6.2) days. There was no significant difference in weight gain between the two groups (χ ~ 2 = 3.90, P> 0.05) The average time to standard weight comparison, the difference was statistically significant (t = 1.26, P <0.05). Logistic regression analysis showed that intrauterine growth retardation, low gestational age, low birth weight, systemic infection at birth, and persistent weight loss after birth were independent influencing factors for preterm extrauterine growth retardation (P <0.05). Conclusions Low birth weight, small gestational age and high probability of occurrence of EUGR. Intrauterine growth retardation, gestational age is too small, low body weight, systemic infection at birth, weight loss after birth will induce EUGR, in the hospitalization phase should be actively involved in the treatment of infection and prevention of complications, and attaches great importance to nutrition of premature children Intervention to avoid the continued weight loss to prevent the occurrence of EUGR key.