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目的探讨影响极低出生体重儿(VLBW)体重增长的相关因素。方法对1998年7月—2004年3月重庆医科大学儿童医院新生儿病房收治的51例VLBW进行回顾性分析。结果单因素分析发现,早开奶、热卡摄入量和蛋白质摄入量对体重增长有显著性影响(P<0·05)。多元逐步回归分析结果示,热卡摄入量和蛋白质摄入量是影响体重增长的显著因素,回归方程为Y(体重增长)=-6·426+0·120X1(热卡摄入量)+3·737X2(蛋白质摄入量)(P<0·01)。达到体重增长目标对象中单纯胃肠内营养组和部分胃肠外营养组热卡摄入量分别为(520·62±21·59)kJ/(kg·d)[(124·43±5·16)kcal/(kg·d)]、(451·49±68·41)kJ/(kg·d)[(107·98±16·35)kcal/(kg·d)],差异有统计学意义(P<0·05)。早开奶组出生体重恢复时间、住院时间和胃肠外营养液体量占总液量比例>75%时间平均秩分别为18·58、20·24、20·11,晚开奶组分别为33·00、32·48、31·83,差异有统计学意义(P<0·05)。结论VLBW在生后应保证足量热卡和蛋白质的供给,对于小于胎龄儿和有严重并发症的患儿更应该加强营养的补充,对VLBW应尽早喂养,同时需要胃肠外营养作为肠内营养的补充。
Objective To investigate the related factors that affect the weight growth of very low birth weight infants (VLBW). Methods A retrospective analysis of 51 cases of VLBW treated in neonatal ward of Children’s Hospital of Chongqing Medical University from July 1998 to March 2004 was conducted. Results Univariate analysis showed that early lactation, caloric intake and protein intake had significant effects on body weight gain (P <0.05). The results of multivariate stepwise regression analysis showed that caloric intake and protein intake were the significant factors affecting body weight gain. The regression equation was Y (weight gain) = -6.426 + 0.12X1 (caloric intake) + 3 · 737X2 (protein intake) (P <0.01). The intake of caloric intake in the group of pure gastrointestinal nutrition and partial group of parenteral nutrition to achieve the target of body weight gain were (520.62 ± 21.59) kJ / (kg · d) [(124.43 ± 5 · (Kcal / (kg · d)], (451 · 49 ± 68 · 41) kJ / (kg · d) [(107.98 ± 16.35) kcal / (kg · d)], the difference was statistically significant Significance (P <0 · 05). The rate of birth weight recovery, hospital stay and total amount of parenteral nutrition liquid in Zao Kai milk group was more than 75%, the average time rank was 18.58, 20.24 and 20.11, respectively, and those in late milk group were 33 · 00,32 · 48,31 · 83, the difference was statistically significant (P <0 · 05). CONCLUSIONS: VLBW should provide sufficient calories and protein supply after birth, and should be supplemented with nutrition for children younger than gestational age and with severe complications. VLBW should be fed as soon as possible and parenteral nutrition as intestinal Internal nutrition supplement.