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目的探讨生后早期“积极”的营养支持对住院期间极低出生体重儿的影响。方法选择2008年1月至2011年12月期间入住苏州大学附属儿童医院新生儿重症监护室(NICU)极低出生体重儿80例。其中观察组44例,实施“积极”的营养管理;对照组36例,实施传统的营养管理。比较两组营养摄入、体重增长情况、黄疸指数、血生化、血电解质指标以及并发症等差异。结果观察组较对照组相比,平均体重增长速率明显增高,生后2周和出院前的白蛋白(ALB)和前白蛋白(PA)的水平明显增高,宫外生长发育迟缓的发病率明显下降(P均<0.05)。但两组发生高胆红素血症的日龄、血清胆红素最高值、黄疸持续时间,两组静脉营养结束后血小板、肝功能和血脂水平,两组生后第1天、第7天的血糖、血pH、血肌酐(CR)、尿素氮(BUN)以及电解质等,两组坏死性小肠结肠炎(NEC)、肠道外营养相关性胆汁淤积(PNAC)的发生率差异均无统计学意义(P均>0.05)。结论对极低出生体重儿实施“积极”的营养管理是安全和有效的。
Objective To investigate the effect of early postnatal nutritional support on very low birth weight infants during hospitalization. Methods Eighty patients with very low birth weight (NICU) admitted to Children’s Hospital of Soochow University from January 2008 to December 2011 were enrolled. The observation group of 44 cases, the implementation of “positive” nutrition management; control group of 36 cases, the implementation of the traditional nutrition management. The differences of nutritional intake, weight gain, jaundice index, blood biochemistry, blood electrolytes and complications were compared between the two groups. Results Compared with the control group, the average growth rate of body weight in observation group was significantly higher. The levels of albumin (ALB) and prealbumin (PA) were significantly increased 2 weeks after birth and before discharge, and the incidence of ectopic growth retardation was significantly higher Decreased (P <0.05). However, the two groups of patients with hyperbilirubinemia day, serum bilirubin, jaundice duration, platelet, liver function and blood lipid levels after the end of two groups of intravenous nutrition, the first two days after birth, the first seven days The blood glucose, blood pH, serum creatinine (CR), blood urea nitrogen (BUN), electrolytes, etc. There was no statistical difference in the incidence of necrotizing enterocolitis (NEC) and parenteral nutrition-related cholestasis Significance (P> 0.05). Conclusion It is safe and effective to implement “positive” nutrition management for very low birth weight infants.