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目的通过研究早产儿住院期间年龄别体重z评分,评估早产儿住院期间生长情况并探讨可能的影响因素。方法采用回顾性调查的方法,收集住院2周以上、出生胎龄在28～33周之间早产儿的临床资料,计算其住院期间年龄别体重z评分的动态变化,z评分=(实测体重-该性别该胎龄体重平均值)/该性别该胎龄体重的标准差。结果共有438例早产儿入选,男293例,女145例;出生胎龄(31.3±1.4)周,出生体重(1638±345)g,出生时z评分(-0.60±0.68),住院时间(30.3±13.9)d,出院时矫正胎龄(35.6±1.8)周,体重(2058±300)g,出院时z评分(-1.44±0.95)。不同胎龄组、适于胎龄儿及小于胎龄儿组住院期间z评分随日龄增长均呈下降趋势,出生时体重(r=0.56,P<0.01)、出生时z评分(r=0.55,P<0.01)和出院时z评分呈正相关,而开始肠内营养日龄(r=-0.33,P<0.01)、肠内营养热卡达100kcal.kg-1.d-1的时间(r=-0.32,P<0.01)、总热卡达120kcal.kg-1.d-1的时间(r=-0.30,P<0.01)与出院时z评分呈负相关,败血症与出院时z评分显著相关(χ2=7.42,P<0.01)。结论年龄别体重z评分法是早产儿生长状态评估的一个较好指标。早产儿住院期间z评分总体呈下降趋势,适宜的宫内发育及生后积极的胃肠内外营养支持均可提高早产儿z评分,并改善其生长状况。
OBJECTIVE: To evaluate the length of hospitalization of preterm infants and to explore the possible influencing factors by studying the age-specific z-score of preterm infants during hospitalization. Methods A retrospective investigation was conducted to collect the clinical data of preterm infants who were hospitalized for more than two weeks and born between the gestational ages of 28 and 33 weeks. The z-score of age-specific z-scores during hospitalization was calculated. Z score = (measured body weight - The gender of the gestational age average body weight) / the gender of the standard deviation of gestational weight. Results A total of 438 preterm infants were enrolled, including 293 males and 145 females. The gestational age (31.3 ± 1.4) weeks, birth weight (1638 ± 345) g, z score at birth (-0.60 ± 0.68), hospital stay ± 13.9) d, corrected gestational age (35.6 ± 1.8) weeks after discharge, body weight (2058 ± 300) g, and z score at discharge (-1.44 ± 0.95). The z scores of different gestational age groups, suitable for gestational age and small gestational age groups all showed a decreasing trend with the increase of age. The birth weight (r = 0.56, P <0.01), birth z score (r = 0.55 (R = -0.33, P <0.01), and the time of starting enteral nutrition caloric 100kcal.kg-1.d-1 (r = -0.32, P <0.01). The total caloric intake of 120kcal.kg-1.d-1 (r = -0.30, P <0.01) was negatively correlated with z score at discharge, (Χ2 = 7.42, P <0.01). Conclusion The age-specific weight z-score method is a better indicator of the growth status of preterm infants. During the hospitalization of premature infants z score overall decline, appropriate intrauterine growth and postnatal active gastrointestinal and external nutritional support can improve the z score of preterm children and improve their growth status.